It’s the worst. THE WORST! If you are treating your diabetes with insulin, you know what I’m talking about. That feeling when you wake up in the middle of the night soaked in sweat and shaking due to low blood sugar.
Your whole body goes into stress mode, and all you can think about is EATING! I absolutely hate it, so I wanted to share my approach on how to treat low blood sugar at night with you guys. I hope this can help some of you and I would love to hear your best advice and tricks as well. If you have a smart way of dealing with nightly lows, please write it in the comments below this post so everyone can learn it.
So how do I treat low blood sugar at night?
What I do is treat it for what it is, a medical emergency. So I test my blood sugar and immediately eat or drink 8-15 grams of carbs in the form of 2 glucose tablets or 125 ml juice. I then assess whether I need a low glycemic carb as well (you can read more about low-glycemic carbs here). The assessment is pretty quick, and for me only involves checking that I didn’t bolus within the last 4 hours. If I did, I might have to cover that with a few rice cakes.
The reason why I say 4 hours is because I bolus with Novolog and that stays active in the body for about 4 hours. If it has been more than 4 hours since I took my bolus, I know that just the sugar or juice will get me through the night.
My recommendation is to be honest with yourself, and if you can’t go into the kitchen and just have those 15 grams of carbs without emptying the fridge every time, then keep your emergency carbs in the bedroom next to where you sleep (that’s always a good idea anyway).
I also recommend that you don’t treat your lows with candy or cake. As I said, it’s a medical emergency and you need a carb that will hit your blood stream quickly. Pure sugar or juice is the best for that since the fat in candy or cake will slow down carb absorption. Also, you don’t need a treat in the middle of a low blood sugar. You’re not enjoying it anyway, just stuffing your face.
How to prevent low blood sugars in the future?
There is probably no way to completely eliminate low blood sugars at night (unless you are on a pump with suspend function) but I have learned to limit them quite a bit. What I do is pretty simple, I try to learn from my mistakes. If I have a low during the night, I’ll go back and see how my bolus and basal patterns were the day before, what I ate, and what I did.
For example, my last low blood sugar was at 4 am a few nights ago, and when I went back and analyzed the data, this is what I found: Since it was 4 am and my last snack was at 11 pm, the low couldn’t be due to my last bolus. I also hadn’t changed my basal amount. However, I had moved my workout to later in the evening. So my conclusion was that to avoid future nightly lows, I should take less basal insulin before I go to bed if I work out later in the evening. That’s a pretty easy fix. I reduced my nightly basal and now I’m sleeping through the night again and waking up with perfect sugars.
Do my tactics work every time?
HA! No, I still have nights where I go low and nights where I overeat to treat it, but they are really far apart. I’m not perfect, but always analyzing why I had a low and making adjustments going forward has helped a lot in reducing my nighttime lows. And having the right food and drink easily available has helped me treat my lows in the right way.
What is your best trick for treating or avoiding nightly lows?
Suggested next post: What a Low Blood Sugar Feels Like
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