Fortunately, there are simple ways to prevent nighttime low blood sugar, or hypoglycemia.
Avoiding Nighttime Hypoglycemia: 8 Tips
1. Know the symptoms of hypoglycemia. Feeling anxious and/or having a rapid pulse before bedtime can indicate approaching hypoglycemia. When blood sugar drops below 70 mg/dl during the night, you may experience sweating, shakiness, headache, confusion and even nightmares. You can also wake up to a high glucose reading owed to your body compensating for the nighttime low.
2. Before turning in at night, check your blood sugar. A typical bedtime target is 140 mg/dl. If your glucose is low, a healthy snack in proportion to the drop in blood sugar will help – if your blood sugar is slightly low, eat a small-sized snack. Pump users, consider a reduction in insulin dosing. (Check with your doctor if unsure.)
3. Avoid strenuous late-night exercise. Complete your exercise routine at least two hours before bedtime. Strenuous exercise before turning in can contribute to low overnight glucose levels. If you exercise late and your glucose is less than desirable at lights out, you may need to increase your bedtime snack.
4. Eat your dinner. A common cause of overnight hypoglycemia is eating a too-light evening meal or skipping it all together. If you enjoy eating dinner later in the evening, talk to your doctor about using rapid-acting insulin at dinnertime, instead of regular insulin. Rapid-acting insulin stops lowering glucose within two to four hours. Regular insulin lowers blood sugar for up to six hours.
5. Limit alcohol intake. If you drink alcohol during the evening, have it with food and do not indulge in alcohol close to bedtime. No more than one drink per day for women and two for men are recommended.
6. Keep a remedy at hand. Keep juice or glucose tablets near your bed to quickly treat nighttime lows, especially if this is a recurring problem for you.
7. Monitor nighttime levels. Every so often, check your blood sugar at 3 a.m. It will give you and your doctor a helpful snapshot of your nighttime glucose levels.
8. Be proactive about frequent lows. If you experience frequent overnight hypoglycemia or have hypoglycemia unawareness (do not feel the signs of low glucose), consult your doctor about managing nighttime dips. He or she may recommend using a continuous glucose monitor (CGM) that will alert you when your blood sugar is too high or low.