Target blood glucose ranges may vary not only throughout life, but also through typical days!
For example, you can choose to have a higher blood sugar level before exercise or lower blood sugar level before eating dessert. This all depends on the individual.
However, one of the frequently asked questions is what to do with your blood sugar level when you go to bed.
In this article, we will discuss the importance of having safe blood sugar levels before bedtime, what to do to achieve that, and other tips for improving blood sugar control in the evening.
What is normal blood sugar?
This range varies for everyone, but diabetics usually aim to have blood sugar levels between 70 and 130 mg/dl throughout the day before meals.
The American Diabetes Association recommends blood glucose levels above 180 mg/dL two hours after meals. Work with your doctor to find out what ideal range works for you and your health goals.
For example, in pregnant people, blood glucose control should be tighter, fasting glucose levels are between 70 and 100 mg/dL, and blood glucose levels that do not exceed 140 mg/dL after meals.
For those suffering from not realizing that they cannot detect or feel hypoglycemia levels, their target blood glucose level may be slightly higher to avoid hypoglycemia levels.
However, blood glucose levels targeted before bed tend to differ slightly in daytime blood glucose levels.
Why are your blood sugar targets different at bedtime?
Many people struggle with blood sugar levels overnight. This is because you are not waking up for 8-10 hours of stretches, in the form of taking extra insulin or eating carbohydrates to avoid both hyperglycemia and hypoglycemia!
It can be difficult to expect full blood sugar levels all night after dinner. And while overnight hyperglycemia can be annoying and can make us feel uncomfortable (and even contribute to diabetes complications in the long run), overnight hypoglycemia levels are suddenly dangerous and should be avoided whenever possible.
This is especially true if you are struggling with a decline in consciousness or do not have a continuous glucose monitor (CGM) that will help you detect your hypoglycemic levels.
What is the recommended blood sugar level when you go to bed?
The target blood glucose range can be lower during the day, but it is generally recommended not to sleep with blood glucose levels below 100 mg/dl, especially if you have active insulin (still active in the bloodstream and therefore likely to lower you).
Most blood sugar below 100 mg/dl should be treated with snacks to ensure that blood sugar levels are stable for sleep.
This can help prevent dangerous hypoglycemic levels overnight, especially if you are using multiple daily injections (MDIs) and/or if you do not have a continuous glucose monitor (CGM).
On the other hand, your blood sugar levels are too high and you don’t want to sleep, which can lead to dangerous high blood sugar while you’re sleeping, and the next morning can be set for long-lasting hyperglycemia.
We will work with your doctor to see what’s best for you, but blood glucose levels above 180 mg/dL before bedtime should be corrected with an insulin bolus.
Tips for stabilizing blood sugar levels when you sleep
This video and the following tips will help you stabilize your blood sugar levels at bedtime, so you won’t be too high or too low overnight.
Prevents hypoglycemia overnight
- I have a snack full of both fat and protein before going to bed, which slows down carbohydrate digestion and stabilizes glucose levels.
- If you exercise regularly, do so early in the day
- Because carbohydrate dinners are low, there is less insulin before going to bed.
- Generally, it limits alcohol, and especially just before going to bed, as this can cause blood sugar levels to crash.
- If using an insulin pump, lower the insulin basal rate overnight
- If you are using multiple daily injections (MDIs), take a long-acting dose in the morning. Work with your doctor before adjusting the insulin dose or timing.
- You can get a continuous glucose monitor (CGM) and set an alarm higher than that which treats hypoglycemia levels, so you can wake up and adjust before experiencing dangerous hypoglycemia.
Prevents hyperglycemia overnight
- Because you eat low-carb dinners, you’ll find that there are fewer carbohydrates in your system before you go to bed.
- Eat dinner early in the evening and don’t lighten up for 1-2 hours before going to bed
- Increase protein and fat content in dinner
- Walk for 10-20 minutes after dinner to help prevent post-meal glucose excursions
- Take a hot shower before going to bed. Fever stimulates blood vessel insulin and helps lower blood sugar levels
- Increase your overnight basal fee or, if you have an MDI, split the long-acting dose and take half of it in the morning and half before bed.
- Get CGM and set a high alarm so you can get alerted when your blood sugar levels are rising sharply while you sleep, and you can do bolus and course adjustments if necessary.
Conclusion
Managing your blood sugar levels overnight can be the most difficult part of diabetes. However, good blood glucose control all starts overnight with good blood glucose levels at bedtime.
The target blood glucose range varies from person to person, but it is usually best to not have a blood glucose below 100 mg/dl before bedtime and not exceed 180 mg/dl.
Some strategies can help prevent hypoglycemia overnight, such as slowing down your basal speed, changing the timing of your insulin, eating high-protein, high-fat snacks before bedtime, and not exercising in the evening.
Some strategies that help prevent hyperglycemia levels overnight include eating carbs at dinner, eating dinner early in the evening, going for short walks after dinner, taking a hot shower, increasing basal fees, and/or changing around the timing of your insulin dose.
In both cases, it is important for a more peaceful (and safer!) night sleep to have CGM to warn you of high and hypoglycemic levels before it becomes dangerous.
Work with your doctor to know what your ideal blood sugar level is before bedtime, and whether tactics are the best to help prevent both hyperglycemia and hypoglycemia during sleep.
For more tips on managing your nightly blood sugar, you can read our guide: How to avoid high blood sugar at night
