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November 22, 2001

Hypoglycemia

Question from Catania, Sicily, Italy:

After a hypo (particularly night hypos when I don't always wake up), I always go hyper. Is there a way I can avoid or reduce this upswing? I usually respond to a hypo with a small glass of fruit juice. I am particularly keen to resolve this question as my doctor has told me that during a (hoped for) pregnancy I should expect more frequent hypos due to keeping sugars low, but obviously I don't want to undo the good work by then going sky high!

Answer:

I know nothing about your insulin regimen, but the best way to reduce your nocturnal hypoglycemia and subsequent fasting upswing would be to adapt your Regular/analog short-acting insulin at dinner (and NPH at bedtime if, as I hope, you split insulin for the nighttime) insulin dosage. To me that’s the only valuable way to ameliorate your blood sugar swings, and it must be based on frequent blood sugar determinations. Ask your diabetes team for further help.

MS