Nocturnal hypoglycemia usually occurs from 1:00 to 3:00 a.m., often in sleep, mild sweating, tremor, severe pain hypersensitivity, with paroxysmal spasms and choreographic movements, followed by pupil dilatation, and even tonic spasm and paroxysmal convulsions, and then gradually coma, weakening of respiration, drop in blood pressure, and so on.
It should be pointed out that not every diabetic patient will have the above symptoms when nighttime hypoglycemia occurs, and some of them even enter the coma stage directly without any aura. In addition, nightmares, morning headache and weakness may also be the manifestation of nighttime hypoglycemia, but is often easy to be ignored by sugar lovers.
What are the causes of nighttime hypoglycemia in diabetics?
Eating too little, not eating meals on time, and excessive exercise can all lead to hypoglycemia. In addition, medication (insulin, hypoglycemic drugs) dosage adjustment, improper method of medication or inaccurate timing of medication can also lead to the appearance of hypoglycemia.
As a reminder, diabetic patients must be treated promptly during hypoglycemic episodes. If the patient is conscious, carbohydrates that can be absorbed quickly, such as sugar and water, should be given immediately and monitored closely. Severe and accompanied by loss of consciousness must not be fed, water, so as not to cause choking, but should be immediately sent to the hospital rescue. In addition, preventive measures should be taken before it is too late.
First, strengthen the monitoring of pre-bedtime blood glucose, if the pre-bedtime blood glucose is lower than 5.6mmol / L, it is recommended to add appropriate meals, you can drink some milk and eat some cookies, or eat some fruits, to replenish the body's blood glucose.
Second, remember the dose of insulin you should inject, and follow the doctor's instructions for subcutaneous injection, according to the doctor's instructions for the correct use of insulin pens. Some patients inject premixed insulin, premixed insulin should be shaken well when injecting, if shaking unevenly, it may lead to fast-acting and long-acting insulin not being able to mix together, thus resulting in a hypoglycemic reaction at night.
There is another condition that also indicates that a patient has experienced nocturnal hypoglycemia, and this is the Sumuje phenomenon. The Sumuje phenomenon is a phenomenon in which a patient experiences a morning rebound hyperglycemia after a midnight hypoglycemia. Sometimes, diabetic patients will find their fasting blood glucose is elevated when they get up early in the morning and increase the dosage of medication without consulting their doctor in order to lower their blood glucose, which results in the fasting blood glucose rising instead of decreasing. This is the time to be alert to the phenomenon of Sumuje, especially for patients who use insulin or insulinotropic agents at night.
2:00 ~ 3:00 a.m. is the lowest point of the body's blood glucose, when blood glucose is too low, the human body will secrete glucagon to promote the breakdown of glycogen into glucose, so that blood glucose rises and relieve hypoglycemia. When blood sugar rises in normal people, insulin is also secreted to keep blood sugar from rising after it returns to normal levels. However, diabetic patients are unable to maintain their blood glucose at normal level due to insufficient insulin secretion, which leads to the emergence of early morning fasting hyperglycemia. Therefore, when patients find early morning fasting hyperglycemia, they need to go to the hospital in time to seek treatment and do not increase the dosage of medication without authorization. If the fasting hyperglycemia is caused by the phenomenon of Sumuje, then what needs to be done is to reduce the dosage of medication.
