One of the toughest elements of effective diabetes management involves maintaining healthy blood glucose levels during nighttime. Nocturnal blood glucose levels depend on multiple factors ranging from insulin dosage, dinner timings and even your sleep patterns. People with diabetes could experience both hypoglycemic and hyperglycemic bouts during nighttime. Though both of these conditions adversely affect your body, extremely low blood sugar levels could even manifest into a midnight medical emergency and hence should be carefully monitored and managed.
Somogyi effect and dawn phenomenon
When your body goes to sleep, there will be a slight dip in the blood glucose levels, but if you have not timed your insulin shot dosage and medication and have taken them late then there are chances of a drastic dip in the glucose levels. Sensing this sugar plunge, your body will try to raise your sugar levels by secreting glucagon and adrenaline to prevent serious hypoglycemic consequences like diabetic coma. This is often referred to as the Somogyi effect. Blood glucose levels tend to go up during early morning as your body prepares to wake up and there is an increase in the secretion of growth hormones and cortisol. This early morning rise in blood glucose is called the dawn phenomenon. Interestingly, people who experience the Somogyi Effect are likely to have higher blood glucose in the morning because of the combined effects of both the Somogyi and dawn phenomenon which is often referred to as rebound hyperglycemia.
“People with diabetes must make it a habit to check their blood glucose levels between 3 am and 4 am to monitor whether their blood glucose levels are drastically dipping,” says Dr Anand S, assistant professor, Department of Endocrinology at Amrita Hospital, Kochi.
Five tips to manage blood glucose dip at night
1. Always check your blood glucose level before going to bed
Dr Rajeshwari Janakiraman, Chief Consultant- Diabetology Endocrinology, Manipal Hospital, Bengaluru adds that it is important for people with diabetes to check their blood sugar levels before they go to sleep especially if they are on multiple doses of insulin.
2. Have a light snack before bed
Experts recommend that if a person has recurrent hypoglycemia, they should opt for a light snack before they go to sleep. “One can have nuts like almonds, pistachios, ground nuts, or peanuts so that their sugar levels don’t drop during the night,” says Dr Gurulakshmi, consultant, endocrinology, Gleneagles Global Health City, Chennai.
3. Have your dinner and diabetes medication on time
One must cultivate a habit of having dinner on time as skipping dinner and eating less food are often the primary causes of low blood glucose levels during the night in people who are already on insulin and other diabetes medications. Time your food intake along with your dose of diabetes medication to avoid the risk of nocturnal hypoglycemia. “If you change your diet and dinner time every day, then your blood sugar levels will fluctuate throughout the night,” says Dr Anand.
4. Avoid strenuous activity and exercise at night
People with recurring bouts of hypoglycemia at night are generally advised not to indulge in any form of physical activity and exercise just before going to bed as it could lead to low blood glucose levels later in the night. “If you spend your energy working out before bed, you will utilize the glucose in your body which will cause low blood sugars in the night,” says Dr Anand.
5. Avoid alcohol consumption at night
People with diabetes have been advised to avoid alcohol consumption at night. The liver will give priority to breaking down the alcohol consumed and will delay the release of glucose when the body requires it during the night. This could have serious complications during sleep in people with chronic diabetes who are already on insulin medication. Interestingly, calorie-rich alcohol variants like beer and rum could also cause a sudden spike in blood glucose levels immediately after consumption.
Five tips to avoid high blood glucose at night
1. Avoid snacking on junk food before going to bed
People with diabetes, especially the type 2 variant should always avoid late-night snacking. It not only increases blood glucose levels while going to bed, but it could also lead to higher sugar levels in the morning. Late-night unhealthy snacking is also one of the major factors responsible for obesity hypertension and early onset of type 2 diabetes, says Dr Gurulakshmi.
2. Having a sedentary lifestyle during the day
Lack of adequate physical activity combined with an unhealthy and calorie-rich diet are two factors to be tackled to control high blood sugar levels and ensure effective type 2 diabetes management. Workouts and physical activity help to take up excess glucose from the blood and break it down but in those with a sedentary lifestyle, blood glucose levels are likely to remain constantly high.
3. Have an early dinner and limit alcohol consumption
It is advisable for people with type 2 diabetes to have a healthy and balanced dinner by 7pm so that insulin in your body gets ample time to break down the glucose ingested through food. Having a fiber and protein-rich early dinner is one of the main instructions included in all diabetes management diets and reversal plans. Though it is often suggested that people with diabetes can drink in moderation, some of the alcoholic beverages like beer and rum that are rich in calories could lead to high blood glucose levels, if consumed in excess on a regular basis.
4. Skipping diabetes medication
People on diabetes medication are likely to experience high blood glucose levels at night if they forget to take their diabetes medication. Some people skip their medication and often end up having a heavy dinner too which spikes their blood glucose level later at night.
People with diabetes should avoid stress as it triggers the release of stress hormones, potentially affecting their blood glucose levels. Yoga, deep breathing exercises, reading books before going to bed or any activity that promotes general well-being and reduces stress could be helpful.
- People with diabetes could experience both hypoglycemic and hyperglycemic bouts during nighttime
- It is important to take the necessary precautions as extremely low blood sugar levels could even manifest into a midnight medical emergency.
- One should have the habit of checking their blood glucose levels between 3 am and 4 am.
- It is important to have a healthy lifestyle and a good diet to manage blood glucose dip at night.