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Nighttime Low Blood Sugar

Hypoglycaemia – How to Treat and Prevent Low Blood Sugar

While low blood sugar can happen at any time during the day, some people may experience low blood sugar while they sleep. Reasons this may happen include:

  • Having an active day.
  • Being physically active close to bedtime.
  • Taking too much insulin.
  • Drinking alcohol at night.

Eating regular meals and not skipping them can help you avoid nighttime low blood sugar. Eating when you drink alcohol can also help. If you think youre at risk for low blood sugar overnight, have a snack before bed.

You may wake up when you have low blood sugar, but you shouldnt rely on that. A continuous glucose monitor can alert you with an alarm if your blood sugar gets low while youre sleeping.

How Is Hypoglycemia Diagnosed

If you suspect you have low blood sugar, its important to check your blood sugar right away. If you dont have a blood glucose meter and youre on diabetes medications that increase insulin, talk with your doctor about getting a meter.

If you experience low blood sugar often say, a few times a week see your doctor right away to find out why. Your doctor will begin your visit by requesting your medical history, asking questions about your eating habits, and learning more about the symptoms youre experiencing.

If you dont have diabetes but suspect you have hypoglycemia, talk with your doctor about your symptoms. Your doctor will use three criteria, sometimes referred to as Whipples triad, to diagnose low blood sugar:

  • Signs and symptoms of low blood sugar. Your doctor may require you to fast, or abstain from drinking and eating for an extended period of time, so they can observe your low blood sugar signs and symptoms.
  • Documentation of low blood sugar when your signs and symptoms occur. Your doctor will order a blood test to analyze your blood sugar levels in a laboratory.
  • Disappearance of the signs and symptoms of low blood sugar. Your doctor will want to know whether the signs and symptoms go away when your blood sugar levels are raised.

When Your Blood Sugar Gets Low

Check your blood sugar whenever you have symptoms of low blood sugar. If your blood sugar is below 70 mg/dL, treat yourself right away.

1. Eat something that has about 15 grams of carbohydrates. Examples are:

  • 3 glucose tablets
  • One half cup of fruit juice or regular, non-diet soda
  • 5 or 6 hard candies
  • 1 tablespoon or 15 mL of sugar, plain or dissolved in water
  • 1 tbsp of honey or syrup

2. Wait about 15 minutes before eating any more. Be careful not to eat too much. This can cause high blood sugar and weight gain.

3. Check your blood sugar again.

4. If you do not feel better in 15 minutes and your blood sugar is still lower than 70 mg/dL , eat another snack with 15 g of carbohydrates.

You may need to eat a snack with carbohydrates and protein if your blood sugar is in a safer range — over 70 mg/dL — and your next meal is more than an hour away.

Ask your provider how to manage this situation. If these steps for raising your blood sugar do not work, call your doctor right away.

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Who Should Do The Test

According to the American Diabetes Association, screening for diabetes is recommended in people over 45 , or at any age if you have certain risk factors, including :

  • Being overweight, obese, or physically inactive
  • Having a close relative with diabetes
  • Belonging to a certain race/ethnic group
  • Having signs of insulin resistance or conditions associated with insulin resistance, such as high blood pressure , low good cholesterol and/or high triglycerides , and polycystic ovary syndrome
  • Having had diabetes in pregnancy

Normal Blood Glucose Levels In A Healthy Person

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Blood sugar levels can be measured as either high, low, or normal, depending on how much glucose is in a persons bloodstream. Glucose is a simple sugar thats always present in the bloodstream and can be measured at any time when someone is fasting, or has just eaten . Blood glucose levels fluctuate throughout the day as a result of various factors including, medical conditions, age, physical activity, medications, stress, dehydration, menstrual periods, alcohol and the type of food consumed. An ideal blood sugar level for a healthy person, regardless of age, in the morning should be less than 100 mg/dL. A normal blood glucose level range for adults without diabetes who havent eaten for at least eight hours could be anywhere between 80-100 mg/dL. For adults without diabetes, a normal blood glucose level after eating is 90 to 110mg/dL.

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What Are Abnormal Glucose Levels And Why Do They Matter

Why is it unhealthy for glucose levels to be too high or too low ?

Hyperglycemia refers to elevated blood glucose levels. This usually occurs because the body does not appropriately remove glucose from the blood this can happen due to many complex reasons. Elevated glucose levels can damage blood vessels and nerves over time this can then lead to problems in the eyes, kidneys, and heart, as well as numbness in the hands and feet. Very high levels can lead to coma and even death in some cases. People with fasting glucose levels higher than 100 mg/dl have impaired glucose tolerance and should speak with their healthcare provider.

Some people may think that to avoid all these issues, they should just keep their blood glucose levels as low as possible. If too high is bad, then low must be good, right? Not exactly. When glucose gets too low, its called hypoglycemia. The threshold for hypoglycemia is typically thought to be when glucose falls below 70 mg/dl. When this happens, the body may release epinephrine , the fight or flight hormone, which can lead to a fast heart rate, sweating, anxiety, blurry vision, and confusion, but also helps the body mobilize glucose into the blood. If blood glucose levels stay too low for too long, it can cause seizures, coma, and in very rare instances, death.

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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Summary Of Normal Glucose Ranges

In summary, based on ADA criteria, the IDF guidelines, a persons glucose values are normal if they have fasting glucose < 100 mg/dl and a post-meal glucose level < 140 mg/dl. Taking into account additional research performed specifically using continuous glucose monitors, we can gain some more clarity on normal trends and can suggest that a nondiabetic, healthy individual can expect:

  • Fasting glucose levels between 80-86 mg/dl
  • Glucose levels between 70-120 mg/dl for approximately 90% of the day
  • 24-hour mean glucose levels of around 89-104 mg/dl
  • Mean daytime glucose of 83-106 mg/dl
  • Mean nighttime glucose of 81-102 mg/dl
  • Mean post-meal glucose peaks ranging from 99.2 ± 10.5 to 137.2 ± 21.1 mg/dl
  • Time to post-meal glucose peak is around 46 minutes 1 hour

These are not standardized criteria or ranges but can serve as a simple guide for what has been observed as normal in nondiabetic individuals.

Research And Statistics: How Common Is Hypoglycemia

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Because hypoglycemia is largely a symptom of an underlying condition, its unclear exactly how common it is in the United States. However, heres what we do know:

  • According to the Centers for Disease Control and Prevention , 34.2 million people in the United States have diabetes. This is roughly 10.5 percent of the population, and the majority of these cases are type 2 diabetes.
  • In the type 2 diabetes sphere, elderly adults are at highest risk for hypoglycemia unawareness. Previous research reported in Diabetes Care found that only 1 in 13 older adults with type 2 diabetes were able to correctly identify their symptoms.
  • According to CDC data, 235,000 people with diabetes were admitted to the emergency room in 2016 due to hypoglycemia.
  • Overall, the CDC estimates that 57,000 people with diabetes were hospitalized for hypoglycemia.
  • Insulin excess is responsible for between 4 and 10 percent of deaths in patients with type 1 diabetes, according to past research published in Diabetes Care.
  • A previous study identified a higher rate of hypoglycemia-related hospital visits in African American men with type 2 diabetes.

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Are High Levels Of Blood Sugar Dangerous

Yes, high blood sugar levels can be dangerous. Although high blood sugar levels commonly produce symptoms of excessive urination, excessive thirst and hunger, and weight loss, over time these high blood sugar levels can cause

  • lower-extremity paresthesias and/or loss of feeling,

Low blood sugar levels begin at 70 mg/dL or less.

  • People with diabetes who take too much medication or take their usual amount but then eat less or exercise more than usual can develop hypoglycemia. Although much rarer, hypoglycemia may develop in some people without diabetes when they take someone elses medication, have excessive alcohol consumption, or have hepatitis or a rare tumor of the pancreas .
  • The treatment for hypoglycemia is oral glucose intake (15.0 grams of sugar, for example, 1 tablespoon of sugar, honey, corn syrup, or IV fluids containing glucose. Rechecking your blood sugar levels in about 15 minutes after the treatment is advised.

Why Low Blood Sugar Makes You Anxious

When your blood sugar drops, your body tries to bring it up. It pumps out epinephrine , a âfight or flightâ hormone that, among other things, tells your liver to make more glucose .

Adrenaline also makes your heart race and your palms sweat. And it can make you feel cranky and anxious. These are warning signs that your blood sugar is too low. If it stays there, your body puts out more hormones, including one called cortisol, also known as “the stress hormone,” partially because it helps control things like your mood and fear.

Put adrenaline and cortisol together, and you’ve got a recipe for anxiety.

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Whats Considered A Normal Glucose Level

Your doctor will likely test your blood glucose levels as a screening test for diabetes during a standard yearly check-up. Additionally, many people track their glucose at home with an over-the-counter finger-prick test. When you check blood glucose , either at a doctors office or with a home finger stick glucose monitor, the results are in milligrams of glucose per deciliter of blood.

One of the most common glucose measurements is fasting plasma glucose or fasting blood glucose , and its found by checking blood glucose levels after not having any calories at least eight hours before the test. According to the American Diabetes Association , people can be classified into three categories depending on their fasting plasma glucose levels: normal, prediabetes, and diabetes. To be considered normal, fasting glucose must be under 100 mg/dl.

Of note, CGM devices measure interstitial glucose levels compared to blood/plasma glucose levels measured in the FPG tests. While interstitial glucose and blood/plasma glucose levels correlate highly, they are not precisely the same, and diagnoses are not made from interstitial measurements.

Below is a summary overview of data about 24-hour glucose trends in nondiabetic individuals wearing CGM to gain a better understanding of whats normal.

Random Glucose Testing And Disease Management

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In adults without diabetes, glucose levels are managed through the actions of our internal insulin and the bodys use of sugar for energy. If they received random glucose tests throughout the day, their glucose levels would remain relatively stable. This would be true even if they:

  • varied their diet
  • experienced stress
  • ate at different times of the day

In people with diabetes and prediabetes, glucose levels can vary widely over the course of the day. This is particularly true if the disease isnt managed well. In these people, random test results will vary widely. Tests may also be consistently high.

A random test is one performed outside your normal testing schedule. Random testing is an important part of diabetes management. If random glucose levels are acceptable, your strategy is probably working. Wide swings in your levels suggest you may need to change your management plan.

Remember, high sugar levels are what cause the complications seen with diabetes over time. Symptoms of acute high blood sugar levels include:

  • increased thirst

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How Can Continuous Glucose Monitoring Help You Maintain Optimal Glucose Levels

It is not uncommon for your glucose levels to increase after a meal: you just ate food that may contain glucose, and now your body is working on getting it out of the bloodstream and into the cells. We know that we want to prevent excessive spiking of glucose levels because studies show that high post-meal glucose spikes over 160 mg/dl are associated with higher cancer rates. Spikes are also associated with heart disease. Repeated high glucose spikes after meals contribute to inflammation, blood vessel damage, increased risk of diabetes, and weight gain. Additionally, the data shows that the big spikes and dips in glucose are more damaging to tissues than elevated but stable glucose levels. Therefore, you should strive to keep your glucose levels as steady as possible, at a low and healthy baseline level, with minimal variability after meals.

Keeping your glucose levels constant is more complicated than just following a list of eat this, avoid that foods. Each person has an individual response to food when it comes to their glucose levels studies have shown that two people can have different changes in their glucose levels after eating identical foods. The difference can be quite dramatic. One study found that some people had equal and opposite post-meal glucose spikes in response to the same food.

What Are The Symptoms Of High Blood Sugar

The symptoms of high blood sugar can vary depending on severity.

Early signs and symptoms of high blood sugar

When your blood sugar is around 200 mg/dL, but not yet dangerously high, you may experience the following symptoms:

  • Increased thirst
  • Shortness of breath

If you are experiencing any of the later-stage symptoms of high blood sugar, seek immediate medical attention.

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After You Have Low Blood Sugar

If your low blood sugar was mild , you can return to your normal activities once your blood sugar is back in its target range.

After you have low blood sugar, your early symptoms for low blood sugar are less noticeable for 48 to 72 hours. Be sure to check your blood sugar more often to keep it from getting too low again, especially before eating, physical activity, or driving a car.

If you used glucagon because of a severe low , immediately call your doctor for emergency medical treatment. If you have had lows several times close together , you should also tell you doctor. They may want to change your diabetes plan.

Why Your Blood Sugar Drops

Preventing and Managing Hypoglycemia ( Low Blood Sugar)

The goal of diabetes treatment is to lower your blood sugar. But sometimes, it drops too low. Most people feel symptoms if it goes below 70 milligrams per deciliter . It can happen when you:

  • Take too much diabetes medicine
  • Exercise more than normal

People who donât have diabetes can get low blood sugar, too. Some medicines and diseases can cause it. It can also happen if you:

  • Drink too much alcohol
  • Eat lots of sugary, high-carb foods

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How To Test Your Blood Sugar At Home

To perform a blood sugar test, you will need to prick your finger with a lancet . Youll put a small sample of blood from this onto a strip inserted into the blood glucose meter.

Before you test your blood sugar at home, its important to find out from your doctor what a healthy blood sugar range is for you. Your doctor will determine this range based on factors such as:

  • the type of diabetes you have
  • how long youve had diabetes
  • whether you have any other chronic health conditions

If you dont have a blood sugar testing machine on hand and are experiencing signs or symptoms of low blood sugar with diabetes, your symptoms may be enough to diagnose low blood sugar.

Symptoms Of Low Blood Sugar

How you react to low blood sugar may not be the same as how someone else with low blood sugar reacts. Its important to know your signs. Common symptoms may include:

If youve had low blood sugar without feeling or noticing symptoms , you may need to check your blood sugar more often to see if its low and treat it. Driving with low blood sugar can be dangerous, so be sure to check your blood sugar before you get behind the wheel.

You may not have any symptoms when your blood sugar is low . If you dont have symptoms, it will be harder to treat your low blood sugar early. This increases your risk of having severe lows and can be dangerous. This is more likely to happen if you:

  • Have had diabetes for more than 5-10 years.
  • Frequently have low blood sugar.
  • Take certain medicines, such as beta blockers for high blood pressure.

If you meet one or more of the above and you have hypoglycemia unawareness, you may need to check your blood sugar more often to see if its low. This is very important to do before driving or being physically active.

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