Dubai, United Arab Emirates, November 5, 2014: Hypoglycaemia, a state in which the concentration of glucose levels in the blood falls to an abnormally low level, can be a frequent incidence for people with diabetes at night. Nocturnal hypoglycaemic episodes can be a real cause of concern for people living with diabetes and their families, impacting a patient’s sleep patterns, their relationships and their ability to work.9 The World Awake Research conducted by Novo Nordisk globally, has revealed that almost 50% of all hypoglycaemic events occur at night, with most commonly experienced symptoms being poor quality of sleep, chronic fatigue, morning headache, night-time convulsions, night sweats and nightmares that can impact productivity at work.
Dr. Mohamed Hassanein Consultant in Diabetes & Endocrinology, Dubai Hospitalhas raised his concern with regards to the issue:
“Controlling nocturnal hypoglycaemic episodes in people with diabetes has been a key concern for doctors with a focus on the management of diabetes with insulin therapy. As these episodes tend to increase mortality rates and severely affect the quality of life in patients, we often work closely with them to minimize these episodes. It is very important for them to understand their own symptoms and one of our constant efforts is to empower them with the knowledge and th skill to detect these episodes,” says Dr. Mohamed Hassanein.
Dr. Tarek Fiad- Consultant Diabetologist at Sheikh Khalifa Medical City Hospital in Abu Dhabi and a member of the AACE association drew the attention to the importance of hypoglycemia as a major hindrance to the attainment of the desired diabetes control.
“Nocturnal hypoglycaemia is a silent condition which passes unnoticed by many patients and healthcare professionals alike. Individuals who may suffer from hypoglycaemia can have good diabetes control but subjects with high glucose levels are equally prone. Abnormally low glucose can affects subjects with diabetes in different ways. Sufferers can experience disturbed and unrefreshing sleep but with severe form of hypoglycaemia, the body is exposed to major stress which can be life-threatening at times. We encounter a significant number of patients who experience night-time hypoglycaemia, some of whom do not correctly attribute their symptoms to the abnormally low glucose level. It is up to us as healthcare professionals to empower our patients with the necessary knowledge which allows them to prevent hypoglycaemia and identify their symptoms correctly. In addition, using medications with lower risk of hypoglycaemia can go a long way in ensuring that the risk of hypoglyceamia is kept to the minimum,” says Dr. Tarek Fiad.
The World Awake Global Research(supported by International Diabetes Federation-IDF), which was conducted amongst diabetics living with treatment, revealed that 77 % of them are worried about nocturnal hypoglycaemic episodes and it disrupts their sleep.4 Nearly 49% of those surveyed did not discuss them with their primary care physician, general practitioner (GP) or family doctor.4 Nocturnal hypoglycaemia can be serious and even self-treated events have been shown to have a significant impact on functioning of people with diabetes, including the quality and amount of sleep.5 Sleep deprivation can not only impair glucose tolerance,6 but can also lead to increased body mass index and obesity, higher blood pressure and development of hypertension,7 and cardiovascular disease.8
Nocturnal hypoglycaemia is usually caused by factors like absence of a nighttime snack when one is usually taken, early or delayed meals, increased physical activity in the past 24 hours, and imbalance in the anti-diabetic regimen, alcohol consumption and content of meals.
The experts have suggested undertaking the below measures to deal with the complications:
- Nocturnal hypoglycaemia which can be self-managed can be treated by eating between ten and fifteen grams of fast-acting carbohydrates after an episode occurs, which should raise blood glucose levels back to normal
- Preventing the episodes by eating a snack containing slow acting carbohydrates or food containing a good source of protein before going to bed
- Working closely with physicians to adjust the insulin regimen
- Monitor the blood glucose level regularly specially before going to bed and in the morning
About the World Awake global patient survey
The global quantitative research was funded by Novo Nordisk and conducted by Aequus Research Ltd amongst 1,107 adults (over 18 years old) with both Type 1 and Type 2 diabetes between July and September 2013. All participants were treated with insulin and had experienced a night time low blood sugar event in the last 30 days. Participants were from seven countries including Argentina (n=173), Canada (n=170), France (n=171), India (n=173), Japan (n=150), Sweden (n=100) and the UK (n=170). Qualitative research working with respondents from the quantitative survey was also undertaken with 30 respondents from each of the seven countries.