Worry about hypoglycemia at night

Speaking of hypoglycemia, patients with diabetes are certainly familiar with it. Almost all patients have experienced hypoglycemia. It is one of the most common acute complications of diabetes. Fortunately, most patients will have warning symptoms when hypoglycemia occurs. As long as they eat in time to raise blood sugar, it will not cause serious harm to the body.

However, some hypoglycemia events occur without warning signs, which are called asymptomatic hypoglycemia. In addition, although there are early warning signs when some hypoglycemic events occur, it is difficult for patients to detect them.

"Nocturnal hypoglycemia" is one of these common conditions. Because patients are in a deep sleep state at night, it is often difficult to detect the occurrence of hypoglycemia. Once timely and effective monitoring and treatment are not possible, nocturnal hypoglycemia may occur repeatedly, eventually leading to the disappearance of early warning signals and the development of asymptomatic hypoglycemia.

Not only that, because nocturnal hypoglycemia often cannot be corrected in time, it will cause irreversible damage to the patient's cerebral cortex cells, leading to shock, inducing angina pectoris, myocardial infarction, aggravating cerebral infarction, and even life-threatening.

Studies have pointed out that patients with type 2 diabetes are more likely to have hypoglycemia at night than during the day, and more than 50% of severe hypoglycemia occurs at night.

Although it is difficult to detect early warning signs of hypoglycemia in deep sleep, patients can detect it from some clues after waking up. When the following situations occur, it often prompts the patient to have a nighttime episode of hypoglycemia:

1. Often awakened by nightmares, accompanied by symptoms such as palpitation and sweating.

2. Dizziness, headache, and physical weakness after getting up.

3. Underwear and bedding are damp when you wake up in the morning.

4. Drowsiness.

The Trap of Nocturnal Hypoglycemia - Sumujie Phenomenon

There is another situation that also indicates that the patient has experienced nocturnal hypoglycemia, which is the Sumuji phenomenon. Sumuji's phenomenon refers to the phenomenon in which patients develop rebound hyperglycemia in the morning after hypoglycemia at midnight.

Sometimes, diabetic patients will find that their fasting blood sugar is elevated when they get up early in the morning to measure their blood sugar. In order to lower their blood sugar, they increase the amount of medication without consulting their doctor. As a result, their fasting blood sugar rises instead of falling. At this time, everyone should be wary of Sumujie phenomenon, especially patients who use insulin or insulin secretagogues at night.

Between two and three in the morning is the lowest point of human blood sugar. When blood sugar is too low, the human body will secrete glucagon hormone to promote the decomposition of glycogen into glucose, increase blood sugar, and alleviate hypoglycemia. When normal people's blood sugar rises, insulin will be secreted accordingly, so that the blood sugar will no longer rise after returning to normal levels. However, diabetic patients cannot maintain blood sugar at normal levels due to insufficient insulin secretion, resulting in fasting hyperglycemia in the morning.

Therefore, when patients find fasting high blood sugar in the morning, they need to go to the hospital for treatment in time and do not increase the amount of medication without authorization. If fasting hyperglycemia is caused by Sumudji's phenomenon, what needs to be done is to reduce the dosage.

How to avoid nighttime hypoglycemia

In fact, nocturnal hypoglycemia in diabetic patients is often due to the failure to adjust the relationship between diet, exercise and medication.

In terms of medication: When injecting premixed insulin before dinner or injecting medium-acting or long-acting insulin before going to bed, the injection site is best to choose the buttocks or thighs to delay the absorption of insulin and reduce the occurrence of nighttime hypoglycemia. If the amount of activity at night is higher than usual, the amount of insulin at night can be appropriately reduced.

In terms of diet: Irregular diet, poor appetite, and insufficient food types and amounts can easily cause hypoglycemic reactions. In this regard, patients should improve their living habits and eat regularly and quantitatively. Patients who use insulin are best to monitor their blood sugar before going to bed and add meals appropriately according to the situation. Also, don't drink alcohol at night.

In terms of exercise: When the amount of exercise is temporarily increased, it is necessary to add meals in time. Now that the temperature is low at night, you should try to avoid going out for exercise at night. After dinner, you can choose indoor walking, Tai Chi, or exercise on a stationary bicycle or treadmill. The amount of exercise should not be too large, and do not exercise within two hours before going to bed.