5 Tips to Prevent Blood Sugar from Dropping at Night

If you frequently wake up in the morning with headaches and a feeling of exhaustion, you may suffer from nighttime hypoglycemia. Hypoglycemia, also known as low blood sugar, occurs when your blood glucose levels drop below normal, typically below 70 milligrams per deciliter (mg/dL). Although this condition can affect anyone, it’s most common in those with diabetes.

Sulay Shah, M.D., an endocrinologist at Old Bridge Medical Center, offers tips to prevent your blood sugar from dipping at night and explains more about the condition.

What are some tips to prevent nighttime blood sugar level dips?

1. Check your level before bed. According to Dr. Shay, since there are no warning signs for nighttime hypoglycemia, the only way to know if you are at risk is to monitor your blood glucose levels. “If you check and you notice that your levels are close to 70 mg/dL at bedtime, then you know you might be at risk,” Dr. Shah says. In this case, he recommends eating some complex carbohydrates, such as a peanut butter sandwich, an apple with peanut butter, or one slice of multigrain toast with avocado.
2. Don’t skip dinner. If you aren’t eating dinner, Dr. Shah advises skipping your rapid-acting insulin or medicines like glipizide or glimepiride, which can lower your blood sugar levels. “The goal here is to match your meal and medication,” he says.
3. Potentially adjust your exercise routine. Though you can exercise at any time, Dr. Shah warns that aerobic exercises, such as swimming or treadmill running, can cause your blood sugar to dip, whereas anaerobic exercises, such as weight lifting, can raise it. Therefore, Dr. Shah encourages anaerobic exercises first, followed by aerobic exercises.“Before you work out, check your blood glucose. If your blood sugar is below 80 mg/dL, eat at least 10 to 15 grams of carbohydrates—such as ¾ of an apple—before the workout and another 10 to 15 grams after. As always, you must modify your insulin accordingly,” he says. As explained by Dr. Shah, roughly 5 to 6 hours after you exercise, the body becomes more insulin sensitive, and muscles will utilize blood sugar to counteract the stress of the exercise.
4. Monitor your alcohol intake. If you notice that your blood sugar is dropping after having a few drinks, then Dr. Shah warns you may need to eat complex carbohydrates with the alcohol. Dr. Shah notes that blood sugar tends to drop 3 to 4 hours after drinking alcohol. “When you regularly drink alcohol, you are decreasing the amount of stored glucose in the liver, which helps to maintain a blood sugar level in the normal range,” he explains.
5. Understand your risk factors. Certain people, such as older adults and those with kidney or liver disease, need to make sure their blood sugar is not too tightly controlled. “Talk with your physician so they can modify your glycemic target to keep you in a safe range,” Dr. Shah says.

What are the signs of hypoglycemia?

Nighttime hypoglycemia may cause you to frequently wake up in the middle of the night. Some other signs you may be experiencing hypoglycemia during your sleep include:

• Waking up with a headache
• Waking up in a sweat
• Getting unusual feelings of tiredness throughout the day
• Experiencing anxiety or heart palpitations
• Feeling confused, dizzy or weak

How do you treat hypoglycemia?

Treating hypoglycemia involves immediate steps to raise your blood sugar level, as well as later treatment or medication dose adjustments to prevent it from happening again.

To immediately raise your blood sugar, Dr. Shah recommends the rule of 15: eat 15 grams of carbohydrates, then check your blood sugar 15 minutes later. Fast-acting carbohydrates include:

• 4 glucose tablets
• 4 ounces of fruit juices

“Keep repeating these steps every 15 minutes until your blood sugar reaches above 70 mg/dL,” he explains. Once your level has stabilized, it’s important to then eat a snack or even a full meal to maintain that balance, Dr. Shah adds.

“If your symptoms are more severe and/or a person is unable to swallow, you may need an injection of glucagon,” he says.

To prevent episodes of hypoglycemia in the future, Dr. Shah says that you may need to change your prescribed medications and dosages or adjust your meal plans.

Why is it important to treat hypoglycemia?

If hypoglycemic episodes are frequent and left unaddressed, Dr. Shah explains that you can put yourself at risk for several medical problems, including:

• Cognitive impairment
• Dizziness or weakness
• Cardiovascular disease
• Poor glucose control

Who else can be affected by hypoglycemia besides the diabetic population?

According to Dr. Shah, diabetics are more at risk of being diagnosed with hypoglycemia. However, he says there are certain people at risk for developing hypoglycemia, including those with carbohydrate sensitivities or those who have undergone gastric bypass surgery.

Are there any newer technologies to prevent hypoglycemia?

Dr. Shah says that new technology exists that can reduce the risk of hypoglycemia. “We are lucky that in this day and age, we can predict hypoglycemia and prevent it through technology like continuous glucose monitors,” explains Dr. Shah. Additionally, he notes that newer insulins are available to help reduce episodes of hypoglycemia.

“One of our roles as your doctor is to educate you about the self-management of diabetes and to create a personalized care plan,” explains Dr. Shah. “By self-managing your condition, you will reallAy feel empowered enough to take control of your health.”

Next Steps & Resources

• Meet our expert: Sulay Shah, M.D.
• Make an appointment online with a doctor near you, or call 800-822-8905. 
• Learn more about our diabetes services.