Hypoglycemia at Night: A Cause for Alarm?

Hypoglycemia at Night: A Cause for Alarm?

Abstract

Editorial Hypoglycemia at Night: A Cause for Alarm? Stephanie A. Amiel, B.Sc., M.D., FRCP S leep is important to us. We don’t fully understand why, but we spend about a third of our lives doing it. All animals sleep, variably from 2 h (giraffes) to 18 h (pythons) in a 24-h day. Humans sleep very variably, but with a mean of around 8 h. If we are sleep deprived, we have problems of executive function, memory, and appetite control. The importance of sleep may be underlined by the tendency to sleep more when opportunity affords, making up the so-called ‘‘sleep debt.’’ It has long been known that hypoglycemia is common during sleep in insulin-treated diabetes—and that much of it occurs without the patient’s knowledge. Gale and Tattersall,1 conducting in-hospital hourly venous blood glucose measurements in a small and diverse group of people with poorly controlled insulin-treated diabetes in 1979, found that over half were hypoglycemic in the night and that on half of those occasions the hypoglycemia occurred without the patient’s knowledge. A similarly sized study, conducted 30 years later, using continuous glucose monitoring (CGM) on 2 nights in people specifically with type 1 diabetes and on very