Hypoglycemia at night in non-diabetic

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susan-k-s

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I've been tracking my BG levels for two days now with a Libre 2 sensor. I'm not diabetic (my A1C was 35 recently) but I have had some recurring hypoglycemic incidents in the past, usually during exercising (walking) 2-3 hours after meals. These are now being managed during daytime by eating small meals/snacks more frequently and especially before exercising, but now I have evidence that they also happen during the night. See the graph generated with my Libre data collected last night.

I had two episodes - one between 03:38-03:53 when my BG dropped to 3.7 and between 06:53-07:08 when it dropped to 3.6 - it then recovered to 4.6 and 4.7 respectively. I woke up immediately following the first episode, but slept through the second. Is this something to be concerned about? When I mentioned my day-time hypo episodes to my GP, she wasn't concerned enough to initiate any investigations. She thinks it's because my BMI is at the lower end of normal (20.5) - could it be that I'm simply not eating enough? My diet is pretty healthy: wholefoods, no added sugar or processed food, moderate carbs in the form of fruit/veg/wholegrains/legumes - I also consume lots of dairy, some meat, fish, eggs, seeds, nuts - so it's pretty balanced and I try to keep my BG levels in check. Based on the last two days of data, I rarely went above 6 even after meals.

Has anyone had a similar experience and could offer some advice? What could be causing the night-time drops? Hormones? I'm 54 and still not in full menopause. Also, last year I experienced a state of high anxiety during which I didn't sleep for several months (by that I mean I only slept 2-3 hours a night at most) - I literally ran on adrenalin during day and night. I think this may have messed with my adrenals. I sleep okay now and I can manage my anxiety much better but I tend to wake up several times a night - sometimes every two hours - now I'm thinking it's because of low blood sugar?
 

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3.6 and 3.7 are completely normal blood sugars in non diabetics
 
susan-k-s said:
I've been tracking my BG levels for two days now with a Libre 2 sensor. I'm not diabetic (my A1C was 35 recently) but I have had some recurring hypoglycemic incidents in the past, usually during exercising (walking) 2-3 hours after meals. These are now being managed during daytime by eating small meals/snacks more frequently and especially before exercising, but now I have evidence that they also happen during the night. See the graph generated with my Libre data collected last night.

I had two episodes - one between 03:38-03:53 when my BG dropped to 3.7 and between 06:53-07:08 when it dropped to 3.6 - it then recovered to 4.6 and 4.7 respectively. I woke up immediately following the first episode, but slept through the second. Is this something to be concerned about? When I mentioned my day-time hypo episodes to my GP, she wasn't concerned enough to initiate any investigations. She thinks it's because my BMI is at the lower end of normal (20.5) - could it be that I'm simply not eating enough? My diet is pretty healthy: wholefoods, no added sugar or processed food, moderate carbs in the form of fruit/veg/wholegrains/legumes - I also consume lots of dairy, some meat, fish, eggs, seeds, nuts - so it's pretty balanced and I try to keep my BG levels in check. Based on the last two days of data, I rarely went above 6 even after meals.

Has anyone had a similar experience and could offer some advice? What could be causing the night-time drops? Hormones? I'm 54 and still not in full menopause. Also, last year I experienced a state of high anxiety during which I didn't sleep for several months (by that I mean I only slept 2-3 hours a night at most) - I literally ran on adrenalin during day and night. I think this may have messed with my adrenals. I sleep okay now and I can manage my anxiety much better but I tend to wake up several times a night - sometimes every two hours - now I'm thinking it's because of low blood sugar?
Click to expand...
The readings look within range for someone without diabetes. Min is 3.9 but that would be measured with a finger prick blood test not the libre which can read lower when low.

Are you getting low blood sugar symptoms?
 
Amity Island said:
The readings look within range for someone without diabetes. Min is 3.9 but that would be measured with a finger prick blood test not the libre which can read lower when low.

Are you getting low blood sugar symptoms?
Click to expand...

Only when I exercise while my levels are coming down from a spike. I get weak and sweaty, panicky even - it always gets better as soon as I eat something so I carry around some healthy snacks - and can completely avoid the situation if I eat something right before setting off on my walks and try to avoid big spikes.

I know there's a thing called reactive hypoglycemia but my GP wasn't familiar with the condition. I expect that's what it is. If the Libre is known to show lower numbers than the reality, perhaps I shouldn't worry. Thanks!
 
Given the nature of these dips - down and back up again - they could be compression lows. CGMs report false lows when pressure is applied such as if you lay on your arm when asleep.
For those of us with diabetes, we are told not to treat a hypo as a hypo until rechecked with a finger prick (unless we are hypo symptoms) as CGMs like Libre are not as accurate.
 
susan-k-s said:
Only when I exercise while my levels are coming down from a spike. I get weak and sweaty, panicky even - it always gets better as soon as I eat something so I carry around some healthy snacks - and can completely avoid the situation if I eat something right before setting off on my walks and try to avoid big spikes.

I know there's a thing called reactive hypoglycemia but my GP wasn't familiar with the condition. I expect that's what it is. If the Libre is known to show lower numbers than the reality, perhaps I shouldn't worry. Thanks!
Click to expand...
From what you describe it could well be reactive hypoglycemia. I've only ever met one person with this, they too describe it as that. Having to eat small amounts to keep blood sugar up but to avoid highs.
 
Amity Island said:
From what you describe it could well be reactive hypoglycemia. I've only ever met one person with this, they too describe it as that. Having to eat small amounts to keep blood sugar up but to avoid highs.
Click to expand...

I know it's supposed to be rare, but I don't think it's as rare as they say. I'm just hoping it will sort itself out if indeed it is hormone related.
 
helli said:
Given the nature of these dips - down and back up again - they could be compression lows. CGMs report false lows when pressure is applied such as if you lay on your arm when asleep.
For those of us with diabetes, we are told not to treat a hypo as a hypo until rechecked with a finger prick (unless we are hypo symptoms) as CGMs like Libre are not as accurate.
Click to expand...

I thought CGMs were more accurate than finger pricks - just running 15 mins later. In any case, just seeing the spikes gives me lots of information to go by. I don't think I lay on the Libre - as I tend to lie on my other side and now I consciously try to avoid turning over but of course it's possible while I'm asleep.
 
Those two dips shown on your screen are almost certainly to be compression on the sensor. I use the Dexcom G7, and that actually reports an alarm when that happens - with a message saying that the sensor is reporting abnormally and to ignore the results until pressure is removed.

I should add that of you apply the sensor to the back of your arm rather than the side makes compression less likely to happen.
 
susan-k-s said:
I thought CGMs were more accurate than finger pricks - just running 15 mins later.
Click to expand...
I don’t know where you got that impression.
The advise for people using insulin is that finger pricks take precedence if they differ from CGMs.
Plus, the algorithm Libre uses to convert interstitial fluid to blood glucose takes into consideration the delay. So although interstitial fluid is 15 minutes behind, Libre is not (apart from a few edge cases).
As is often written, CGMs are fantastic pieces of kit but only if you understand the limitations. Picking one off the shelve (or website) and expecting accuracy leads to huge disappointment and frustration.
 
Getting weak and sweaty after exercise is not a hypo, it's more than likely caused by not having enough food to fuel your exercise.
Reactive Hypoglycaemia usually happens shortly after eating, and is often called postprandial Hypoglycaemia. It's caused by the pancreas over reacting to a rise in glucose levels by producing too much insulin.
The extra insulin causes the sugar levels to plummet and a full blown hypo is the result.
Normal hypo treatments quickly raise blood sugar levels, which again cause the pancreas to over react. It can become a nightmare roller-coaster of highs and lows often causing several hypos a day. Ask any insulin user on here how that would feel.
What you have described sound like a normal response to exercise.
 
mikeyB said:
Those two dips shown on your screen are almost certainly to be compression on the sensor. I use the Dexcom G7, and that actually reports an alarm when that happens - with a message saying that the sensor is reporting abnormally and to ignore the results until pressure is removed.

I should add that of you apply the sensor to the back of your arm rather than the side makes compression less likely to happen.
Click to expand...

That function would be very handy, so I wouldn't freak out unnecessarily! Will keep that in mind, thanks!
 
helli said:
I don’t know where you got that impression.
The advise for people using insulin is that finger pricks take precedence if they differ from CGMs.
Plus, the algorithm Libre uses to convert interstitial fluid to blood glucose takes into consideration the delay. So although interstitial fluid is 15 minutes behind, Libre is not (apart from a few edge cases).
As is often written, CGMs are fantastic pieces of kit but only if you understand the limitations. Picking one off the shelve (or website) and expecting accuracy leads to huge disappointment and frustration.
Click to expand...

This is where I got that impression from:
 
susan-k-s said:
I've been tracking my BG levels for two days now with a Libre 2 sensor. I'm not diabetic (my A1C was 35 recently) but I have had some recurring hypoglycemic incidents in the past, usually during exercising (walking) 2-3 hours after meals. These are now being managed during daytime by eating small meals/snacks more frequently and especially before exercising, but now I have evidence that they also happen during the night. See the graph generated with my Libre data collected last night.

I had two episodes - one between 03:38-03:53 when my BG dropped to 3.7 and between 06:53-07:08 when it dropped to 3.6 - it then recovered to 4.6 and 4.7 respectively. I woke up immediately following the first episode, but slept through the second. Is this something to be concerned about? When I mentioned my day-time hypo episodes to my GP, she wasn't concerned enough to initiate any investigations. She thinks it's because my BMI is at the lower end of normal (20.5) - could it be that I'm simply not eating enough? My diet is pretty healthy: wholefoods, no added sugar or processed food, moderate carbs in the form of fruit/veg/wholegrains/legumes - I also consume lots of dairy, some meat, fish, eggs, seeds, nuts - so it's pretty balanced and I try to keep my BG levels in check. Based on the last two days of data, I rarely went above 6 even after meals.

Has anyone had a similar experience and could offer some advice? What could be causing the night-time drops? Hormones? I'm 54 and still not in full menopause. Also, last year I experienced a state of high anxiety during which I didn't sleep for several months (by that I mean I only slept 2-3 hours a night at most) - I literally ran on adrenalin during day and night. I think this may have messed with my adrenals. I sleep okay now and I can manage my anxiety much better but I tend to wake up several times a night - sometimes every two hours - now I'm thinking it's because of low blood sugar?
Click to expand...

Hello,

To my view. Your graph looks more “compression low” if whilst asleep? From my experience with a Libre 2 & armed with a meter. Plus being hypo aware. A low line on a Libre can last a lot longer (nearly an hour.) after I’ve treated it & come back up. That’s with exogenous insulin to blame for my lows.
 
Leadinglights said:
A bit like getting your medical advise from the Daily Mail or adverts for miracle cures that are designed to part your from your money.
Click to expand...
That is actually an official Abbott video. And it is accurately explaining how the difference between a blood reading and interstitial fluid works. The problem is, that it doesn’t take into account the algorithm built in to the Libre that attempts (not always successfully) to overcome the time lag.
 
Robin said:
That is actually an official Abbott video. And it is accurately explaining how the difference between a blood reading and interstitial fluid works. The problem is, that it doesn’t take into account the algorithm built in to the Libre that attempts (not always successfully) to overcome the time lag.
Click to expand...
That is different then, apologies. But it is not telling the whole story.
 
C.A.T said:
Getting weak and sweaty after exercise is not a hypo, it's more than likely caused by not having enough food to fuel your exercise.
Reactive Hypoglycaemia usually happens shortly after eating, and is often called postprandial Hypoglycaemia. It's caused by the pancreas over reacting to a rise in glucose levels by producing too much insulin.
The extra insulin causes the sugar levels to plummet and a full blown hypo is the result.
Normal hypo treatments quickly raise blood sugar levels, which again cause the pancreas to over react. It can become a nightmare roller-coaster of highs and lows often causing several hypos a day. Ask any insulin user on here how that would feel.
What you have described sound like a normal response to exercise.
Click to expand...

It's not quite like that though. Although I used
Satan’s little helper said:
Hello,

To my view. Your graph looks more “compression low” if whilst asleep? From my experience with a Libre 2 & armed with a meter. Plus being hypo aware. A low line on a Libre can last a lot longer (nearly an hour.) after I’ve treated it & come back up. That’s with exogenous insulin to blame for my lows.
Click to expand...

Yes, other people said that too. I hope that's what it is - it didn't happen last night, so that's a good sign.
 
Another vote here for those both being compression lows where you turned over and lay on your sensor arm compressing the tissue under the sensor and causing an erroneous low. You can see from the dip and then spring back that both profiles are almost identical with the rise afterwards going higher and then settling back down to where it actually should be and the rise after the dip is a straight uniform line. Absolutely classic Libre compression low graph. Genuine BG does not give repeatable patterns like that.
 
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