Hypoglycemia

Consequences

Nocturnal hypoglycemia

• Is frequent, often prolonged, usually asymptomatic and does not necessarily disturb sleep patterns
• Counter-regulatory responses may be impaired during sleep
• Should be suspected if
  • pre-breakfast BG is low
  • confusional states, nightmares or seizures occur during the night, or impaired thinking, lethargy, altered mood or headaches are experienced on waking
• Can only be confirmed by BG tests at regular intervals during the night
• The association with subsequent hypoglycemic unawareness may be reversed by maintaining BG above 3 mmol/l during the night
• Is not regularly predictable on the basis of a bedtime BG level (predictability is improved by BG measurement towards midnight)