What Are The Signs Of Hypoglycemia
An individual may frequently wake up in the middle of the night as a result of nighttime hypoglycemia. In other instances, though, people may know if they experienced hypoglycemia during their sleep if they notice the following symptoms:
- Waking up with a headache
- Waking up in a sweat
- Getting unusual feelings of tiredness throughout the day
- Experiencing anxiety or heart palpitations
- Feeling confused, dizzy or weak
What Is The Dawn Phenomenon
Another reason for high nighttime blood sugar levels is the dawn phenomenon. The dawn phenomenon occurs early in the morning when the body naturally signals your liver to produce glucose, giving your body the energy it needs to wake up.
The hormonal changes associated with the dawn phenomenon happen to people with or without diabetes, though those without diabetes do not experience hyperglycemia. If you take insulin, you may need to try a new basal insulin or adjust the timing and amount of your basal dose or your nighttime basal rates to cover an early morning rise.
What Causes Low Blood Sugar At Night
Hypoglycemia, or low blood sugar, is defined as a glucose reading less than 70 mg/dL.
People with diabetes must manage their blood sugar and their medication regimen carefully to avoid hypoglycemia.
However, if you do not have diabetes, it is unlikely youâll experience sustained hypoglycemia resulting in troublesome symptoms.
Some people experience what is known as nocturnal hypoglycemia when glucose dips during sleep. This happens to people with diabetes if they eat too little in the evening or give themselves too much insulin. In addition, people with diabetes may experience low blood sugar if they exercise too much without supplementing their food intake.
Here are some more variables that can contribute to low blood sugar:
- Alcohol: Although alcohol can cause a spike in blood sugar, an excess can also cause glucose to plummet.
- Medications: For people with diabetes, insulin and other diabetes medications are a frequent cause of low blood sugar.
However, a review published in The Journal of Clinical Endocrinology & Metabolism showed that other medications may contribute to low blood sugar< sup> 10< /sup> as well, such as:
- Antibiotics, such as ciprofloxacin, levofloxacin, moxifloxacin
- Quinidine, a medication used for malaria treatment
- Pentamidine, used for severe infections
That said, researchers noted that very low-quality evidence backs up the association between low blood sugar and the use of non-diabetic drugs.
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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.
Managing Your Childs Diabetes
One of the most important differences between children and adults with diabetes is day-to-day management, Quinn says. âAs children grow, hormones human growth hormone in particular make them more resistant to insulin,â she says. âInsulin dosages need to be adjusted quite regularly .â She adds that itâs critical for children with diabetes to be seen regularly by a doctor, in order to keep their medication doses on track with their growth.
Type 1 diabetes is typically treated through insulin injections. Type 2 is treated through lifestyle changes and possibly medication , according to KidsHealth. No matter which type of diabetes your child has, itâs critical to check their blood sugar regularly to make sure that their blood sugar levels are in the target range.
Uncontrolled diabetes can eventually lead to eye problems, nerve damage, kidney disease, high blood pressure and/or stroke, according to the American Diabetes Association. This may sound frightening, but the good news is that these complications can be avoided through proper diabetes management. Therefore, though it may be challenging at times, itâs very important that you as a parent help your child learn how to manage his or her own diabetes. After all, at some point, it will be your childâs responsibility to manage his or her own health.
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Techniques To Manage Your Blood Sugar In The Morning
Based on your glucose levels and trends, there are a few things you can do to manage your glucose levels so they dont run high in the morning. Some of these strategies focus on adjusting medications to better suit your needs. Other strategies include adjusting your exercise routine, as well as what and when you are eating before bed.
If your glucose levels are in range before bed, they may rise throughout the night without enough insulin. This can be especially true for people who take long-acting insulin in the morning, since it may be wearing off before your next dose.
Consider changing the time of day when you take your long-acting insulin. You may also benefit from switching to either twice-daily basal insulin or ultra-long-acting insulin, or from starting on an insulin pump. Read our article, Are You on the Right Kind of Insulin, to learn more.
Check your blood glucose during the night between 3 am and 8 am. If you are running high during these hours, you may be experiencing the dawn phenomenon.
Talk with your healthcare team about finding the best nighttime insulin regimen for you. If you take basal insulin, you may need to delay the timing of your dose to as close to bedtime as possible. Another option is to try an insulin pump or automated insulin delivery system. AID systems will automatically adjust your basal insulin doses throughout the night to help keep your glucose levels stable.
Tests For Blood Sugar Levels And Normal Blood Sugar Levels For Non
If you are non-diabetic but are predisposed to diabetes due to the various causes mentioned above, it is very important to keep a regular check on your blood sugar levels and know the normal blood sugar levels for non-diabetics. There are specific ranges that doctors use to determine if a patient is healthy or at a risk of developing diabetes. Some of the common tests done to determine blood sugar levels are as follows:
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When To See A Healthcare Provider
Getting professional medical advice from a healthcare provider like an endocrinologist is the best way to learn more about whether your blood sugar levels are where they should be. Not getting proper treatment for low or high blood sugar levels can be serious and lead to health complications, especially for those with diabetes. Diabetes complications include nerve damage, kidney disease, heart disease, or heart attacks.
If you see a healthcare provider about your blood sugar levels, be prepared to answer questions about risk factors like what you eat, how much you exercise, and about your family history. Some healthcare providers may want to take a blood sample to test your blood sugar levels. They may also order an A1C test, which is a blood test that measures blood sugar levels over several months. You may have to fast eight hours beforehand to get accurate test results, so its always a good idea to check before your appointment.
If your blood sugar level goes above 250 mg/dL, you should go to the ER for immediate medical attention, says Dr. Tarugu. Emergency rooms are equipped to handle high blood sugar levels and can administer treatments like insulin therapy and fluid or electrolyte replacement.
The Big Picture: Checking Your Blood Glucose
Blood sugar monitoring is the primary tool you have to find out if your blood glucose levels are within your target range. This tells you your blood glucose level at any one time.
Its important for blood glucose levels to stay in a healthy range. If glucose levels get too low, we can lose the ability to think and function normally. If they get too high and stay high, it can cause damage or complications to the body over the course of many years.
The logging of your results is vital. When you bring your log to your health care provider, youll have a good picture of your body’s response to your diabetes care plan. To help keep track of your levels, we have a glucose log. We also have a blood glucose log available for purchase that is smaller so you can carry it with you.
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What Should Your Blood Sugar Be When You Wake Up
Whenever possible, aim to keep your glucose levels in range between 70 and 130 mg/dL in the morning before you eat breakfast, and between 70 and 180 mg/dL at other times. For some people, including older adults or pregnant women, a slightly looser or tighter glucose range might be best, and you should discuss with your healthcare provider what your goals may be.
Managing your glucose levels is key to preventing short and long-term complications. Though the occasional high blood glucose wont put you in immediate danger consistently high glucose levels over a long period of time are associated with complications of diabetes such as heart disease and stroke, chronic kidney disease, nerve damage, eye disease and more.
Additionally, high glucose levels especially in people with type 1 diabetes can put you in immediate danger. These high levels, if combined with high blood ketone levels, can cause diabetic ketoacidosis , a potentially life-threatening condition that occurs when a person has high blood ketones and not enough insulin. Symptoms of DKA include shortness of breath, fruity-smelling breath, nausea and vomiting, confusion, or loss of consciousness.
Normal Blood Sugar Ranges In Healthy Non
For a person without any type of diabetes, blood sugar levels are generally between 70 to 130 mg/dL depending on the time of day and the last time they ate a meal. Newer theories about non-diabetic blood sugar levels have included post-meal blood sugar levels as high as 140 mg/dL.
Here are the normal blood sugar ranges for a person without diabetes according to the American Diabetes Association:
- Fasting blood sugar : under 100 mg/dL
- 1 hour after a meal: 90 to 130 mg/dL
- 2 hours after a meal: 90 to 110 mg/dL
- 5 or more hours after eating: 70 to 90 mg/dL
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Ways To Prevent Low Blood Sugar At Night
Detecting nighttime dips in blood sugar can be tricky, but these simple strategies can help you prevent nighttime hypoglycemia and sleep without worry.
Nighttime dips in blood sugar levels are common among people with diabetes. Authors of a study published in June 2013 in Quality of Life Research noted that people with diabetes type 1 or type 2 experience low blood sugar during sleep more frequently than many doctors realize.
Nighttime hypoglycemia can be caused by a number of different factors, from exercising too close to bedtime to drinking alcohol in the evening. If untreated, low overnight blood sugar levels can lead to headaches and loss of sleep and in extreme cases, seizures or even death. The good news is that preventing low blood sugar while you sleep can be achieved with a few simple steps:
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In summary, diabetic medications prescribed by your doctor are necessary to treat your condition however, you should also be aware that the long term potential nutritional side effects may be just as big a risk factor for your health as the disease you set out to treat in the first place. Put the odds in your favor and maintain your health with NutraMD Diabetes Essential Nutrients® supplement
How do I know I am keeping my blood sugar under control?Frequent blood tests are used to monitor your blood sugar. Most patients with diabetes should have a home blood monitoring kit. Some doctors ask their patients to check their blood sugar as frequently at 6 times a day, though this is an extreme. The more information you have about your blood sugar levels, the easier it will be for you to control it. People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high. What Should Blood Sugar Be At Bedtime For Non Diabetic
When your blood sugar is too high, your doctor refers to it as hyperglycemia. When your blood sugar is too high, you may not experience any symptoms, but the high levels of glucose in your blood is causing damage to your blood vessels and organs. That is why it is important to have your body utilize the sugar properly and get it out of your bloodstream.
Damage to the retina from diabetes is a leading cause of blindness.
Damage to the kidneys from diabetes is a leading cause of kidney failure.
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Normal Blood Sugar Levels For People With Type 2 Diabetes
Together with your doctor, you can determine your ideal blood sugar goals for different times throughout the day.
Adults with type 2 diabetes should normally aim for the following typical ranges:
Before you eat: 70130 mg/dl
After you eat: less than 180 mg/dl
At bedtime: 100140 mg/dl
These numbers may differ from person to person, depending on underlying conditions, treatment, and age.
Try To Avoid Food At Least 3 Hours Before Bed
For most people we work with, 3 hours of fasting before bed helps to even out nighttime glucose values. If it has calories, then donât eat or drink it. Simple as that!
However, if your schedule makes it difficult to avoid food within 3 hours of sleep, there are still strategies available to minimize high glucose values before bed, such asâ¦
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Normal Ranges For Blood Sugar
People who dont have diabetes or pre-diabetes keep their blood sugars between 60 100 mg/dl overnight and before meals, and less than 140 mg/dl after meals. Although the ultimate goal of diabetes management is to return the blood sugar to the natural or non-diabetic level, this may be difficult without excessive low blood sugars or hypoglycemia.
Check Your Blood Sugar Before Bed
For everybody with type 1 or type 2 diabetes, its absolutely critical that they check their blood sugar before going to bed to make sure theyre not going to have an episode of low blood sugar during the night, says Helena W. Rodbard, MD, medical director of Endocrine and Metabolic Consultants, a private practice in Rockville, Maryland, and past president of the American College of Endocrinology.
If your blood sugar levels are low at bedtime, eat a healthy snack before going to sleep. The size of the snack should be in proportion to the dip in blood sugar. For instance, a small drop in blood sugar requires only a small snack. If you use an insulin pump, consider temporarily reducing the active dose of insulin.
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Blood Sugar Levels 2 Hours After Youve Eaten
Many foods have types of carbohydrates called starches and sugars. When you eat foods with these types of carbohydrates, your body breaks them down into glucose, which is a type of simple sugar, and releases the glucose into your bloodstream. Aside from glucose produced by your liver, food is the main source of plasma glucose.
Two hours after eating, your blood sugar levels rise. They rise more when you eat more carbohydrates, when you do not eat fiber, fat, or protein with your carbs, and when you eat certain types of carbohydrates, such as refined sugars and starches.
These are target values from The Joslin Diabetes Center, which include levels for people with diabetes:
What Are The Blood Sugar Targets For Diabetes
The ADA recommendations are general guidelines and may be modified according to individual situations. Discuss with your medical provider what treatment goals are best for you. For example, if you are not taking any medications or your diabetes treatment doesnt increase the risk of low blood sugars your provider may recommend that you keep your blood sugar in the normal range or closer to the normal range. Pregnant women or women thinking about getting pregnant also have lower blood glucose targets.
When you have diabetes and are treated with insulin replacement therapy or medications that increase insulin release from your pancreas, the insulin levels in your blood stream are imperfectly matched to how much insulin you actually need and there is always a risk of having too much insulin effect. Too much insulin effect can cause a low blood sugar or hypoglycemia. To minimize this risk, your provider may recommend that you target higher blood sugars such as a pre-meal blood sugar of 90-130 mg/dl and post meal blood sugar of less than 180 mg/dl.
American Diabetes Association Recommendations
|After Meal Glucose Level||< 180 mg/dl|
*Hemoglobin is a measure of your average blood glucose control over the previous 3 months. Think of the A1c as a long-term blood glucose measure that changes very gradually.