Night time hypoglycemia

[GoldenKatie]

I had a very bad episode of hypoglycemia a couple of days ago.  Blood sugar had been about 285 in the a.m.  I had a large Mexican lunch around 2 p.m.  Around 4 p.m. I guess I went into low blood sugar.  It came on VERY suddenly and fairly severe.   I believe I almost passed out.  I was sweating profusely and my legs wouldn't go straight and were buckling under me.  (I'm not sure what brought it on so quickly and severely after eating a large meal)???? I was able to get to some candy and bring myself out of it.

My question is, what happens when this happens this severely at night?  Do you wake up?  If not, what brings the blood sugar back up.

I don't have much education on how to manage the diabetes.  I'm on Januvia and Glipizide - which I had taken early in the morning.

Thanks

[Anita Ramsetty, MD]

Hi,
It is very scary when you have those feelings but  it is better that it happened in the day when you were up and about. Did you check your glucose to see how low you were? The only reason I ask is that some people feel terribly low because of the rate of the drop( e.g from 250 to 120 in 30 minutes) and not because of the number itself. If it was the rate of drop, I would be less worried about serious consequences like passing out. But if you told me you dropped to 45, then that is more concerning and your medication should be changed. It was more likely due to the Glipizide than the januvia.

At night, if your nervous system is nice and healthy, as are your liver and adrenals, you will do one or several of the fllowing:
1)wake up sweating or shaking--your body's alarm system. If this ever happens and you are still thinking clearly, check your blood sugar immediately. If not(or your sugar is low), get something to drink like orange juice, or some glucose gel which you should have near your bed.
2)your blood sugar comes up on its own, thanks to your own regulation process which saves you from dangerously low sugars.
3)you sleep through it

Right now the best thing you can do is to check your blood sugars before you go to bed at night. If they are under 100, have a small snack like half a peanut butter sandwich, or some fruit with cheese etc(something with protein, fat and carbs).This is extra insurance against going low at night when it could be dangerous. If you are low at night alot, talk with your doctor soon about decreasing your medication.
Hope this helps.
take care.

[PikaPika88]

What can the diabetics do if they have impaired liver and/or kidneys?  I went on bed when my blood glucose fell to 3.5.  But next morning when I woke up, the blood glucose went up to 7.6????  

[GoldenKatie]

Sorry, I should have included that information.  I tested and it was 63.

I hesitate to test each night (or often).  Even though my insurance will pay for test strips, my doctor is very reluctant to prescribe them.  She feels that there is little point in testing unless I am on insulin.  I usually save the test strips for when I'm feeling lousy and not sure if blood sugar is causing the problem.  I had just happened to test that morning.

I feel very uneducated in this area as to what I should be doing/not doing to help myself.

Thanks for your information and help.

[PikaPika88]

Me too!

[Anita Ramsetty, MD]

Hi,
Given that you are having problems with lows, it is very important that you are able to test regularly--this is now a medical necessity and your doctor can put that as an indication so your insurance will help pay for the strips. Using insulin is not the only indication for testing blood sugars regularly.

Glucose of 63 is not scary in terms of dangerous problems(like passing out, seizures etc) but it can feel terrible especially if your body is used to being much higher.

When people with diabetes have liver or kidney problems, or get used to having low blood sugars al the time, their body fails to "alarm" and bring the sugars up on it's own, so you can run into alot of trouble there. Right now you should work hard on avoiding those lows.
Take care.

[GoldenKatie]

Thank you very much for your information.  I truly appreciate it.

[PikaPika88]

Thanks, Dr.  I learn somethings today.  My Dr never tells me that and never discuss or talk about that!  I thought my bed can make magic..... Everytime, I'm not feeling well then I craw up to my bed and sleep.