Night time Hypos

keep an apple or natural fructose around you....

your liver will help out at those levels, but it would be nice to wake up..........I know I do.........

I feel I am a light sleeper, so that may be why, but I also have good hypo warnings between 3.5 to 4.........

how are your hypos warnings......?

Hi Topher,
Doesn't your CGM have an alarm on it? I have mine set at 4.5 which means I shouldn't get down to a "proper" hypo.
If it's a case of not hearing the alarm you can usually change the volume or I've read of people putting the CGM on a tin plate or similar to boost the sound.

Theoretically a non-diabetic person can go as low as 3.5 and its considered "normal".
The problem is, if you keep going to 3.3 your hypo awareness will be much worse (your body gets "used to" it) which means next time you may go down even lower and not wake up.

Do you have an alert set ob your cgm for lows? It should wake you up when going low, especially during sleep, because the risk of not waking up is too big.

A bg of 3.3mmol is a low so ideally the settings on the cgm should be changed.

Will the liver come to peoples rescue?..... well sadly this partly depends on the length of time someone has been diabetic. Over time.....the alpha cells responsible for glucagon to prompt the liver to release glucose, die off just like the beta cells. This started happening for me after about 15yrs so beware..... be armed with hypostop, lucozade and last resort..glucagon jab

iHs said:

Over time.....the alpha cells responsible for glucagon to prompt the liver to release glucose, die off just like the beta cells.

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wow, I wasn't aware of this.............

why do they "die off"...........?

it wont be same as the beta cell "destruction" from the immune system will it.........?

a future of no dawn phenomenon to look forward to.........

novorapidboi26 said:

wow, I wasn't aware of this.............

why do they "die off"...........?

it wont be same as the beta cell "destruction" from the immune system will it.........?

a future of no dawn phenomenon to look forward to.........

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I dont know tbh but chat to your D consultant.

I doubt my consultant would know anything about this to be honest...........but that's just mine I suppose.........might try and ask just to see if he does........

a quick Google suggests that absence of communication between the alpha and beta cells is what knocks the alphas responsiveness to low blood sugars out of whack....

I suppose if you go through your diabetic life with only a small number of hypos then your alpha cell response might still stay in tact........or do you think if you have many hypos, you will be keeping the alpha cells on their toes..............

i am fortunate enough to have a good alpha cell response after 15 years, although I have only really had regular hypos, 1-2 week, over the last 5 years......

Do you know why you had a hypo ?

I had one last night as i'd over dosed on insulin and woke at 3am at 2.9, I always seem to be about here when I hypo during the night, i've had suspicions of having a hypo before during the night but not woken until morning, so I think there is a 'trigger point' at which you brain screams glucose.

Knowing why you had the hypo in the first place is important to ensure you don't hypo again during the night.

novorapidboi26 said:

your liver will help out at those levels, but it would be nice to wake up..........I know I do.........

I feel I am a light sleeper, so that may be why, but I also have good hypo warnings between 3.5 to 4.........

how are your hypos warnings......?

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Good...I start sweating and shaking (parkinsons..like)

I've woken up at 2.4 a few times fist time didn't know I was low till I tested (I always test glucose levels if I wake before my alarm goes off). It's annoying that I don't know I'm going or am low. Was out today before going out I tested at 9 got back home n was at 2.6 n I had 0 clue. I'd not taken any insulin but my body is under high stress (my mom passed less then 48 hours ago).

Hi Topher. It is a worry that you are sleeping through hypos of 3.3. It shows you have a reduced awareness of feeling hypo as ideally you should be waking up when as low as that. What is your awareness like when awake?
It's sometimes a good idea to let your sugars run a bit higher than usual for a while in order to help get your awareness back. Also, it's very important to treat a hypo as quickly as poss ( to limit the time you're hypo so as not to get used to being lower). I find drinking lucozade the quickest treatment by far (and easier in the night than munching glucose tablets)
I agree that if you're lucky enough to have access to a CGM you should really be looking at setting alarms to prevent you getting too low and using it to its full potential.
I hope that helps.
Take care.




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It is possible to have good hypo awareness during the day and the ability to sleep through hypos - or more come round with someone else feeding you - I think it depends how deeply you sleep and when the hypo hits...so if you are in a deep part of sleep some people may not wake up. I would have the cgm set around 4.5 so you can sort anything out rather than rely on your body doing it for you. I read the same report as iHS about the longer you've had diabetes the slower the cells get that sort you out with your glucagon.Also I'm not convinced from my experience that dawn phenomenon is all down to hypos either. I have a get up and out of bed rise, that will come and go - literally the minute I get out of bed and moving I can have a rapid rise and not have been near any food......but then as diabetes does - it doesn't happen all the time and my days really don't vary that much - so go figure I just deal with the numbers I have and assume it must be hormonal or something unseen and unfood/unexercise/insulin dose/un-stress related....maybe somedays I just need adrenalin to get up - but maybe that isn't dawn phenomenon as it doesn't start at 4/5am?