Can I Prevent Nocturnal Hypoglycemia?

Ask our CDE

Can I Prevent Nocturnal Hypoglycemia?

Question: My blood sugars have been going very low at night (around 35 mg/dL) before I am awakened. What can I proactively do to condition my body to wake up sooner from a low blood sugar at night?



Answer: Thank you for your question. Your low blood sugar that occurs while sleeping (nocturnal hypoglycemia) is quite serious. First and foremost, you need to notify your physician and see if there needs to be a change in your medication.


Approximately 50% of hypoglycemic episodes actually occur during the evening. Symptoms of nocturnal hypoglycemia include:

  • Waking up with a headache
  • Night sweats
  • Vivid dreams
  • Waking up hungry
  • High OR low morning blood sugars

Strategies to prevent nocturnal hypoglycemia include:

  • Ensure you are taking your insulin as prescribed
  • Do not skip bedtime snacks
  • Check blood sugar before going to bed. If <110mg/dL increase calories and carbs in bedtime snack
  • Consider setting an alarm at 3:00 a.m. to check blood sugars
  • Ask your doctor if Continuous Glucose Monitoring may be a good option for you.


I know that having low blood sugars can be very scary, so plan in advance to have a glucose source next to your bed in case this happens while you are sleeping. Plan to have 10-15 grams of quickly absorbed carbohydrates. I recommend working with your personal Dietitian, CDE, and Physician to come up with a plan that will work best for you.