Helpful Hints For Treating Hypoglycemia
Here are a few helpful hints for low blood sugars:
What Causes High Morning Blood Sugars
Two main culprits prompt morning highs: the dawn phenomenon and waning insulin. A third, much rarer cause, known as the Somogyi effect, may also be to blame.
The occasional morning high will have little impact on your A1C, a measure of your average blood sugar levels over time that indicates how well managed your diabetes is. But if those highs become consistent, they could push your A1C up into dangerous territory.
Why Do Blood Sugars Spike Overnight
As with everything diabetes, the answer is nuanced and can depend on the person and their situation, but mostly blood sugars tend to spike overnight because were not keeping as close of a watch on them.
Think about it: two hours after breakfast or lunch, youre probably testing your blood sugar or monitoring it on your continuous glucose monitor , tracking changes, and dosing appropriately. That same eye for detail is required after exercise, where you normally treat with appropriate low snacks before it becomes dangerous.
That isnt the case when youre sleeping 7-9 hours per night, which can cause people with diabetes a lot of problems.
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How Do You Treat Hypoglycemia
Treatment for hypoglycemia involves both the immediate steps needed to raise your blood sugar level in addition with the later treatment or medication dose adjustment to prevent recurrence.
To immediately raise your blood sugar level, Dr. Shah advocates the rule of 15eating 15 grams of carbohydrates and then checking your blood sugar level 15 minutes later. Fast-acting carbohydrates include:
- 4 glucose tablets
- 4 ounces of fruit juices
Keep repeating these steps every 15 minutes until your blood sugar reaches above 70 mg/dL, he explains. Once your level has stabilized, its important to then eat a snack or even a full meal to maintain that balance, Dr. Shah adds.
If your symptoms are more severe and/or a person is unable to swallow, you may need an injection of glucagon, he says.
To prevent episodes of hypoglycemia in the future, Dr. Shah says that treatment may involve the changing of prescribed regimens and dosages or adjusting your meal plans.
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What Are The Causes Of Nighttime Hypoglycemia
Having an active day or exercising close to bedtime with diabetes can lower glucose and cause hypoglycemic during sleep or overnight. Other factors that can put you at risk for nighttime hypoglycemia are too much basal insulin or consuming alcohol in the evening. While your liver is busy clearing the alcohol from your blood it stops producing glucose putting one at risk for having a lower glucose level.
Some people forget that their premeal insulin can last for up to five to six hours. If you eat a late dinner and go to sleep a few hours later, your glucose may be okay before going to bed. However, since the insulin you took for dinner is still working in your body, your glucose could drop during the night.
Monitoring Sugars Is Vital
When youre ill or just dont feel like eating much, its important to monitor your blood sugar levels more closely than ever. How often depends on whether you have Type 1 or Type 2 diabetes and what medications you take.
For Type 1 diabetes: Be sure to monitor your blood sugar before meals and before bedtime, typically four times per day, says Garvey.
Beyond that, check your blood sugars if you notice symptoms of low blood sugar. Those symptoms include:
For Type 2 diabetes: If youre taking a sulfonylurea medication, check your blood sugars at least twice a day in the morning and at bedtime.
Its important to keep in mind that sulfonylureas may cause your blood sugar to drop during the day if you dont eat anything after taking your medication, Garvey says.
If your only treatment is metformin, you may not need to check your blood sugar more than once a day. This medication doesnt typically cause hypoglycemia.
Its important to be aware of the symptoms associated with low blood sugars, says Garvey. Be ready to check your blood sugar and eat or drink 15 grams of simple sugar such as glucose tablets or 4 ounces of juice to correct a low blood sugar if needed. This treatment is also recommended for Type 1 diabetes, she says.
It was, however, predicted that consistent high sugar consumption in healthy people will overwhelm their insulin production and leave them open to a range of conditions common with diabetes, like cardiovascular diseases.
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Understanding High Blood Sugar At Night
Blood sugar, also called glucose, is the body’s main source of energy. The body gets most of its glucose by metabolizing the carbohydrates in food, per Kaiser Permanente. For people with diabetes, their systems struggle to manage glucose correctly, leading to high blood sugar. But the treatment of diabetes can also cause low blood sugar .
“Some diabetes medications lower blood glucose levels during the night,” Jo-Anne Rizzotto, a registered dietitian nutritionist and director of educational services at Harvard’s Joslin Diabetes Center, tells LIVESTRONG.com. “But if blood sugar levels drop too low, the liver responds by releasing stored glucose.” This nocturnal release of glucose can cause high blood sugar during the night and into the next morning, known as the Somogyi effect. The good news? “People with type 2 diabetes don’t have this issue unless they’re on glucose-lowering medications,” says Rizzotto.
The Somogyi effect should not be confused with the so-called “dawn phenomenon,” another cause of high morning blood sugar, Rizzotto says. The dawn phenomenon is a product of human evolution it occurs in all people and involves the body pumping out extra glucose in the early morning hours to get the body ready to wake up.
Check Your Blood Glucose Levels
For many people with diabetes, checking their blood glucose level each day is an important way to manage their diabetes. Monitoring your blood glucose level is most important if you take insulin. The results of blood glucose monitoring can help you make decisions about food, physical activity, and medicines.
The most common way to check your blood glucose level at home is with a blood glucose meter. You get a drop of blood by pricking the side of your fingertip with a lancet. Then you apply the blood to a test strip. The meter will show you how much glucose is in your blood at the moment.
Ask your health care team how often you should check your blood glucose levels. Make sure to keep a record of your blood glucose self-checks. You can print copies of this glucose self-check chart. Take these records with you when you visit your health care team.
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Nighttime Low Blood Sugars
You may experience a low blood sugar night. The low blood sugar might wake you up and your symptoms might be similar to those you have during the day. However, the symptoms may be different. You might have nightmares, sleep poorly, perspire, or feel hot and cold. In the morning you may have a headache, feel nauseated, or feel confused. Notify your doctor if this happens. Check your blood sugar at the time you have the symptoms.
Treatment for a low blood sugar that occurs at night is the same as described earlier.
Your doctor may request that you check a 3:00 a.m. blood sugar 1 to 2 times per week in order to detect any low blood sugars during the night.
Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health care professional.
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When To Go To The Er
High blood sugar can be very concerning because your body can start burning fat for energy instead of blood glucose.
This can cause conditions such as DKA and hyperglycemic hyperosmolar syndrome . These conditions are medical emergencies and can be fatal if left untreated.
DKA is a serious complication of type 1 diabetes. Its rare in people with type 2 diabetes, but can occur.
Symptoms that can indicate you should go to the emergency room include:
- ketones in your urine, as diagnosed using a urine dipstick test
High blood sugar levels can cause a fluid imbalance in the body and can cause the blood to become acidic in a manner that doesnt support life.
Medical treatments for these conditions include administering intravenous insulin on a continuous basis and IV fluids to correct dehydration.
High blood sugar can become a medical emergency. Go to the ER if you suspect DKA or HHS.
Low Blood Sugar Levels Before Bed
Low blood sugar levels before bed are just as problematic as hyperglycemia for people with type 2 diabetes.
Some people with diabetes have a condition called nocturnal hypoglycemia. This occurs when blood sugar levels fall below 70 mg/dl.
You are at risk of suffering from this condition if you:
Dont eat dinner
Do strenuous exercise before going to bed
Drink alcohol in the evening
Develop an infection
The symptoms of nocturnal hypoglycemia include a racing heartbeat, changes in your breathing, poor sleep, nightmares, and sweating.
If they are low, you can increase your blood sugar levels by eating a healthy snack before bed.
The following steps can help prevent the problem from happening in the future:
Check your blood sugar levels before going to bed
Speak to your doctor about changing your insulin dosage and timing
Dont skip meals
Avoid drinking alcohol before bedtime
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Insufficient Sleep Can Throw Blood Sugar Out Of Whack
Restless nights hurt more than your mood and energy they may also spell trouble for your blood sugar. A review published in December 2015 in Diabetes Therapy concluded that a lack of sleep may hinder glucose control and insulin sensitivity in people with type 2 diabetes.
Sleep is restorative, Bonsignore says. Not getting enough sleep is a form of chronic stress on the body, and anytime you have added stress, youre going to have higher blood sugar levels.
Unfortunately, people with type 2 diabetes commonly report troubles sleeping, McDermott says. Those with high body-mass indexes are at particular risk for sleep apnea, in which breathing frequently starts and stops during sleep.
To improve your sleep quality and duration, work to get into a consistent sleep routine where you go to bed and wake at the same time every day. Your goal: Nab seven to nine hours of sleep per night, per recommendations from the National Sleep Foundation. If you continue to have sleep troubles or suspect you have sleep apnea , reach out to a sleep medicine specialist for support, Bonsignore says.
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