Should older adult with T1D worry about overnight low sugar?
Patient's Query
Hello doctor,
My dad is 75 years old and has had type 1 diabetes for almost 40 years. His last HbA1c was 7.1%, which his doctor said was actually very good for his age.
However, we have noticed that he wakes up shaky and confused on some mornings. One night, around 3:00 a.m., his blood sugar dropped to 54 mg/dL, and we had to give him juice right away.
Should older adults with type 1 diabetes be worried about overnight low blood sugar at the age of 75, even when their daytime blood sugar levels and HbA1c look good?
Is this something we simply have to accept as part of living with diabetes at his age?
Kindly help.
Thank you.
Hello,
Welcome to icliniq.com.
I have read your query and understood your concern.
I am sorry your father is experiencing this because overnight low blood sugar can be frightening, especially at his age.
A hemoglobin A1c (HbA1c) of 7.1% is generally an excellent result for many older adults with long-standing type 1 diabetes (T1D), but it does not show when blood sugar is dropping overnight.
A blood glucose of 54 mg/dL at 3:00 a.m. is significant hypoglycemia (low blood sugar) and should not be considered something that simply has to be accepted.
Older adults have heightened risk of severe hypoglycemia, which can lead to falls, confusion, seizures, heart rhythm problems, and injuries. Preventing these episodes is just as important as maintaining good overall blood sugar control.
He should let his diabetes care team know about these nighttime low blood sugar episodes as soon as possible because his insulin regimen may need to be adjusted, particularly his evening basal insulin (long-acting insulin) or his dinner insulin dose.
If he is not already using a continuous glucose monitor (CGM) with low-glucose alarms, this can be very helpful in detecting overnight drops before they become dangerous.
Until he is reviewed, checking his blood sugar before bedtime, avoiding going to sleep if it is already low, and following his diabetes team's advice about having a bedtime snack, if appropriate, may help reduce the risk of overnight hypoglycemia.
I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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