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October 24, 2001

Hypoglycemia

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Question from Israel:

My 13 year old son developed diabetes 10 months ago, and he occasionally wakes up in the middle of the night (probably once or twice a week) feeling he’s having a hypo, though in reality his levels aren’t that low. (They’re often around 100-120 mg/dl [5.6-6.7 mmol/L].) However he’s worried that he won’t make it through until morning without eating or drinking juice, so will have a biscuit or orange juice at 2-4 am (obviously depending on when he wakes up). Is this really necessary or would he be likely to last until he gets up at 6.30 am without doing this (and rotting his teeth!)?

Answer:

A lot depends on what the blood glucose is in the morning. I would have thought that glucose levels of 100-120 mg/dl [5.6-6.7 mmol/L] should mean that he will last until the morning, but if he is high before bed and has dropped significantly through the night, he may be at risk for nocturnal hypoglycemia. If this is the case, then reducing the amount of long acting insulin (NPH) he gets in the evening should help to prevent hypos if this is the pattern he is having.

JS