Overnight Hypoglycemia and Hyperglycemia Mitigation for Individuals with Type 1 Diabetes: How Risks Can Be Reduced

Abstract

People with type 1 diabetes (T1D) must monitor their blood glucose concentration and administer insulin to keep blood glucose values within a desirable range of 70-180 mg/dL. The over administration of insulin can lead to low blood glucose (hypoglycemia), while failure to administer enough insulin can lead to high blood glucose (hyperglycemia). Hypoglycemia is a short-term risk that can result in drowsiness, shakiness, confusion, and even loss of consciousness or a seizure. Hyperglycemia is primarily a long-term risk that can result in diabetic retinopathy (blindness), diabetic neuropathy (numbness), and diabetic nephropathy (kidney failure). Thus, a person with T1D is walking a tightrope between the short-term risks of hypoglycemia and long-term risks of hyperglycemia, making insulin administration decisions difficult. Challenges include meals, which increase glucose levels, and exercise, which tend to decrease insulin levels and increase insulin sensitivity.