The document provides information on how to prevent low blood sugar at night for those with diabetes. It discusses maintaining a consistent bedtime routine, avoiding exercise and alcohol in the evenings, eating dinner earlier, and choosing protein-rich snacks before bed. It also recommends monitoring blood sugar levels throughout the day and at night, as well as communicating with one's doctor about any fluctuations in nighttime blood sugar.

1. How to Prevent Low Blood Sugar at Night
Co-authored by Lyssandra Guerra
Last Updated: October 6, 2020 References
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Low blood sugar levels (hypoglycemia) can wake you up in the middle of the night with feelings of
anxiousness, nausea, dizziness and hunger. Nighttime hypoglycemia is a common concern for
Type 1 diabetics, since the pancreas no longer secretes insulin to compensate for the lows.
Keeping track of your diet to ensure adequate protein, complex carbohydrates, and healthy fats is
equally important for anyone who is experiencing low blood sugar at night. If you are diabetic,
it is important to monitor your blood sugar levels throughout the day and especially at night to
prevent hypoglycemia. In addition, you should find a bedtime routine that is both comfortable and
predictable while avoiding exercise, alcohol and other disruptions of your regular nighttime
routine.
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Method
1 Avoiding Triggers of Low Blood Sugar Levels at Night
Keep a consistent bedtime routine. Changes in your bedtime routine such as
eating late, exercising in the evening, or other shifts in activity can cause low blood
sugar at night. It is best to stick to a regular routine before going to bed, including in
relation to when you eat, take insulin shots, and exercise.
Avoid exercising at night. If you exercise in the evening, you might reduce your
blood sugar levels and possibly experience low blood sugar levels during sleep.
If you must exercise in the evening, remember to eat a modest snack to help
maintain your glucose levels.
Keep in mind if you exercised vigorously or for a prolonged period of time earlier in
the day, this can affect your insulin sensitivity for up to 24 hours. You may need to
adjust your insulin regimen accordingly.
Avoid alcoholic drinks at night. If you drink in the evening, your body will be at a
higher risk of low blood sugar levels. Your liver may be too busy getting the alcohol
out of your system to produce enough glucose during the night.
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2. 4 Eat dinner earlier in the evening. If you eat dinner late in the evening or only a
couple hours before going to sleep, you may experience low blood sugar at night.
To avoid this problem, try eating dinner earlier in the evening.
If you must eat a late dinner, you may need to use a fast acting insulin such as
aspart or lispro instead of your regular insulin. Be sure to consult with your
doctor. These fast acting insulins stop lowering glucose levels after two to four
hours as opposed to three to six hours for regular insulin medications, so you will
be less likely to experience nighttime hypoglycemia. However, you should be aware
that each unit of fast acting insulin can potentially lower your blood glucose more at
nighttime than if you were to take the equivalent unit during the day.
You should also take note of any insulin that remains in your system from previous
doses of insulin medication. If you take too much fast acting insulin at night to cover
eating late, you can inadvertently cause more nighttime hypoglycemia.
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Method
2 Stabilizing Your Blood Sugar Levels with Diet
Meet with a diabetes educator or nutritionist. It is important to work with a
diabetes educator or a nutritionist who specializes in diabetes to develop an
appropriate eating plan. Follow the eating plan that your diabetes educator or
nutritionist designs for you. Also, make sure to let them know if you are struggling with
any part of the plan.
Try a protein rich snack before going to bed. By trying different types of snacks
such as raisins or nuts, you will get a feel for which snacks work best for avoiding
low blood sugar at night.
Try eating peanut butter on apple slices.
Try a food product designed specifically for nighttime hypoglycemia. There are a
variety of snacks designed specifically to prevent low blood sugar levels at night
without inducing any excessive rises in blood sugar levels. You might try Choice
DM, Ensure or Extend.
Try eating some Greek yogurt. Greek yogurt is a great source for protein,
although you should keep an eye on the sugar content especially in flavored
varieties.
Enjoy a stick of beef jerky at night. This snack has loads of protein, but you should
keep an eye on the sodium content in these snacks.
Eat a protein rich breakfast. You can try eating eggs and bacon or eggs and
beans in the morning. A protein rich breakfast will help you stabilize your blood
sugar levels through the day. By having consistent blood sugar levels during the day,
you will be less likely to experience problems in the evening.
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Avoid simple carbohydrates. You should try to avoid simple carbohydrates such
as white rice or white bread. A diet high in such carbohydrates can cause rapid
rises in your blood sugar levels, which are followed by crashes. Instead, try to eat a
limited amount of complex carbohydrates such as brown rice or seven grain bread.
Eat whole grain, high fiber carbohydrates. Consume whole grain, complex
carbohydrates to control blood sugar levels. Whole grain, complex
carbohydrates with lots of fiber include lentils, brown rice, brown bread, and whole grain
cereals.
Try integrating peas, lentils, and beans into your diet, since these foods include
carbohydrates, fiber, plenty of flavor and keep you full for a long time.
Enjoy whole grain cereal in the morning.
Eat a slice of whole grain bread as a snack.
Serve a cup of brown rice with lentils for dinner.
Enjoy herbal tea in the evening. Instead of pop or juice, which contain lots of
sugar, try drinking herbal tea, like hibiscus, cinnamon, rooibos, or mint tea, in the
evening. A cup of herbal tea will calm your nerves and get you ready for bed.
Chamomile is another good choice.
If you do not like hot tea, try drinking a cup of iced herbal tea in the evening.
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Method
3 Coping with Low Blood Sugar Levels at Night
Check your blood glucose an hour before going to bed. By checking your blood
glucose levels, you will be able to determine whether your blood sugar is low or
high. If it is low, you can treat the low blood sugar by having a snack.
Tell your doctor about any fluctuations in your blood glucose levels at night. You
may need to change your insulin injections if your blood sugar is either too low or
too high before going to bed.
Test and have a snack if you wake up at night with low blood sugar. If
symptoms of low blood sugar cause you to wake up in the middle of the night, then
the first thing you will need to do is test your blood sugar. Then, you can have a snack
to help raise your glucose level if it is low.
If your glucose level is low (typically less than 70), then you can eat 15 grams of
carbohydrates, such as 4 oz of fruit juice or 7 to 8 pieces of gummy or regular
lifesavers.
Then, wait 15 minutes and retest. If your blood glucose level is still low, repeat the
same snack.
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4. 3
If your blood glucose level is above 70 and your next meal is more than an hour
away, then eat another 15 gram carb snack.
Ask your doctor about your blood glucose levels. If you are currently on a tight
blood glucose control schedule and experience nighttime hypoglycemia, you should
ask your doctor if you are taking the right kind and amount of insulin during the day.
You might ask your doctor whether you should replace your regular with a fast
acting insulin at night.
You might ask your doctor: “Should I try a fast acting insulin to prevent nighttime
hypoglycemia?”
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Expert Q&A
Question
How can I change my diet to prevent low blood sugar in my day to day life?
Lyssandra Guerra
Certified Nutrition & Wellness Consultant
Expert Answer
Make sure you're eating balanced meals. Each meal should have a healthy fat such as
avocado, a protein such as an animal protein or a vegetable protein, and some
vegetables.
Tips
Keep high-carb snacks near your bed at night, such as dextrose tablets or glucose gel.
Also, have some injectable glucagon nearby. This is necessary if your glucose levels
become dangerously low. Someone else in your household will need to be educated on
how to inject it, because if you have severe hypoglycemia, then you will not be
physically capable of doing so.
Always follow your physician’s instructions for taking your medications and insulin.
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5. References
1. Lyssandra Guerra. Certified Nutrition & Wellness Consultant. Expert Interview. 25 March
2020.
2. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-
control/hypoglycemia-low-blood.html
3. http://www.diabeticlivingonline.com/complications/blood-sugar/sleep-safe-sound-
avoiding-overnight-low-blood-sugars?page=0%2C2
4. http://www.joslin.org/info/avoiding_nighttime_lows.html
5. http://www.joslin.org/info/avoiding_nighttime_lows.html
6. http://www.joslin.org/info/avoiding_nighttime_lows.html
7. https://www.drugs.com/mtm/insulin-aspart.html
8. https://www.drugs.com/mtm/insulin-lispro.html
9. http://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-
management/exorcising-the-specter-of-nighttime-hypoglycemia/
10. http://www.diabeticlivingonline.com/complications/blood-sugar/sleep-safe-sound-
avoiding-overnight-low-blood-sugars?page=0%2C1
11. http://www.diabeticlivingonline.com/complications/blood-sugar/sleep-safe-sound-
avoiding-overnight-low-blood-sugars?page=0%2C1
12. http://www.diabetesselfmanagement.com/diabetes-resources/definitions/nighttime-
hypoglycemia/
13. http://www.webmd.com/diabetes/features/diabetic-diet-6-foods-control-blood-sugar#2
14. http://www.webmd.com/diabetes/features/diabetic-diet-6-foods-control-blood-sugar#2
15. http://universityhealthnews.com/daily/sleep/do-you-bolt-awake-at-3-a-m-low-blood-sugar-
symptoms-may-be-to-blame/
16. http://www.webmd.com/diabetes/features/diabetic-diet-6-foods-control-blood-sugar#1
17. http://www.pcrm.org/health/diets/recipes/complex-carbohydrates-vs-simple-
carbohydrates
18. http://www.pcrm.org/health/health-topics/hypoglycemia-and-diet
19. http://www.webmd.com/diabetes/features/diabetic-diet-6-foods-control-blood-sugar#2
20. http://www.pcrm.org/health/health-topics/hypoglycemia-and-diet
21. http://www.pcrm.org/health/health-topics/hypoglycemia-and-diet
22. http://www.pcrm.org/health/health-topics/hypoglycemia-and-diet
23. http://www.webmd.com/diabetes/features/diabetic-diet-6-foods-control-blood-sugar#1
24. http://www.webmd.com/diabetes/features/diabetic-diet-6-foods-control-blood-sugar#1
25. http://www.diabeticlivingonline.com/complications/blood-sugar/sleep-safe-sound-
avoiding-overnight-low-blood-sugars
26. http://www.diabeticlivingonline.com/complications/blood-sugar/sleep-safe-sound-
avoiding-overnight-low-blood-sugars
27. https://www.niddk.nih.gov/health-information/diabetes/preventing-diabetes-problems/low-
blood-glucose-hypoglycemia
28. http://www.diabetesselfmanagement.com/diabetes-resources/definitions/nighttime-
hypoglycemia/

6. 29. http://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-
management/exorcising-the-specter-of-nighttime-hypoglycemia/