Nocturnal Hypoglycaemia

Nocturnal hypoglycaemia occurs predominantly in type 1 diabetics and is frequently unrecognised.

It classically occurs around 2am. It may be caused by:

  • Early or no evening snack
  • Alcohol
  • Inappropriate insulin dose or timing

Nocturnal hypoglycaemia is thought to play a part in the development of hypoglycaemic unawareness due to changes in the glycaemic threshold.

The glycaemic threshold is the plasma glucose level at which counter-regulatory hormones, such as glucagon, are activated and can move higher or lower depending on the usual glycaemic control of the individual

Learning Bite

If blood sugars are usually high the patient may feel hypoglycaemic (hypo) even when the plasma glucose level is in the normal range.