Diabetes experts warn vs nighttime low blood sugar

MANILA, Philippines - Diabetes experts have warned against the menace of “nocturnal hypoglycemia” or nighttime low blood sugar, saying this could cause serious health consequences and even death.

According to Diabetes Philippines president Dr. Richard Elwyn Fernando, people with diabetes should always be on guard against nocturnal hypoglycemia, which is the “side effect of any medication that brings down the blood glucose lower than normal.”

“It occurs when the blood glucose level falls below the target physiological level — 4mmol/l or 72mg/dl — at nighttime… that becomes very dangerous,” he said in a press briefing organized by pharmaceutical giant Novo Nordisk on Tuesday.

Fernando said this is the reason why it is important to “tailor” the medication of diabetics according to their needs.

Novo Nordisk Pharmaceuticals (Phils.) Inc. general manager Jeppe Theisen cautioned that in severe cases, nocturnal hypoglycemia could cause “coma seizures, brain damage and deaths.”

“Almost 50 percent of all hypoglycemia events occur during the night. It affects up to 50 percent of adults with Type 1 diabetes and over 33 percent of people with Type 2 diabetes,” Theisen added.

Fernando said that despite the huge impact of nocturnal hypoglycemia on health, many diabetics are not aware of it.

“This occurs at night and that makes it more dangerous. It should not be an issue anymore because we have very good treatment for diabetes,” he added.

Data on nocturnal hypoglycemia in the Philippines are not available but Fernando said some eight million Filipinos are diabetic and half of them are not even aware of their condition.

This condition develops when the dose of diabetes medication that a person is taking and the level of activities that he carries out and the food he takes are not co-related.

“The factors that can contribute to the development of nocturnal hypoglycemia include not having a nighttime snack when a person usually has one, imbalance between the diabetes medications a person takes, and the timing and frequency of meals, (and) early or delayed meals,” he said.

Fernando said “increased physical activity in the past 24 hours, alteration of insulin and other blood glucose-lowering medications, content of meals and alcohol consumption” could also trigger this condition.

Symptoms include difficulty in waking up, night sweats, waking up with a headache, waking up tired despite a full night’s sleep, nightmares, and talking during sleep.

Its medical complications include decreased heart rate and cardial output and myocardial contractiliy (heart); stroke, myocardial infraction, acute cardiac failure and ventricular arrhythmia (blood vessels); and seizures, convulsions and coma (brain).

As first aid, a companion of a person experiencing nocturnal hypoglycemia are advised to put some sugar at the back of his cheek inside his mouth and then bring him to a hospital.

Although most diabetics experience nocturnal hypoglycemia episodes several times a month, Fernando said, “They remain underreported and many go unrecognized.”

“This is because people with diabetes may not be aware they are having nocturnal hypoglycemia events and therefore are unable to treat themselves or seek assistance,” Fernandez added.