Nocturnal hypoglycaemia and sleep disturbances in young teenagers with insulin dependent diabetes mellitus
Open accessAbstract
OBJECTIVE: To determine the effect of nocturnal hypoglycaemia on sleep architecture in adolescents with insulin dependent diabetes mellitus (IDDM). DESIGN: 20 adolescents with IDDM (mean age 12.8 years, mean glycated haemoglobin (HbA1c) 8.9%) were studied on one night. Plasma glucose was measured every 30 minutes and cortisol and growth hormone levels every 60 minutes. Sleep was recorded using standard polysomnographic montages, and sleep architecture was analysed for total sleep time, stages 1-4, rapid eye movement, fragmentation, and arousals. RESULTS: Six subjects (30%) became hypoglycaemic (five subjects < 2.5 mmol/l), with one being symptomatic. There were no differences in age, HbA1c, duration of diabetes, or insulin regimen between hypoglycaemic and non-hypoglycaemic subjects. Hypoglycaemia was not predicted by glucose measurements before bed. There was no detectable rise in plasma cortisol or growth hormone concentrations during hypoglycaemia. Sleep architecture was not disturbed by nocturnal hypoglycaemia with no differences found in sleep stages, fragmentation, or arousals. CONCLUSIONS: Nocturnal hypoglycaemia is a common and usually asymptomatic complication of treatment in adolescents with IDDM. Moderate hypoglycaemia has not been shown to affect sleep architecture adversely. These findings are consistent with, and may explain, the observation that severe hypoglycaemia, with consequent seizure activity, is more common at night than during the day. Counterregulatory hormone responses to nocturnal hypoglycaemia may be less marked than with similar degrees of diurnal hypoglycaemia.
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Asymptomatic nocturnal hypoglycemia is common and often lasts greater than 4 hours.
“Asymptomatic nocturnal hypoglycemia is common and often lasts greater than 4 hours (11,(28)(29)(30)(31).”
From Hypoglycemia (2018) · cites this paper as [28]
The Discussion describes nocturnal hypoglycaemia as common and usually asymptomatic in adolescents with insulin-dependent diabetes; the Abstract reports that five of six affected subjects had no symptoms. The duration passage reports 3.96 hours on average (range 1–7 hours), but does not establish that episodes often lasted more than four hours. (LLM, conf=0.86)
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Untitled work
Diabetes Canada Clinical Practice Guidelines Expert Committee (n.d.) · Diabetes Canada
- Authors
- Porter, P. A., Byrne, G., Stick, S., & Jones, T. W.
- Affiliations
- Princess Margaret Hospital for Children (AU)
- Royal Children's Hospital (AU)
- Venue
- Archives of Disease in Childhood
- Publisher
- BMJ
- Published
- 1996-08-01
- Volume
- 75
- Issue
- 2
- Pages
- 120-123
- ISSN
- 0003-9888 (ISSN-L)
- 1468-2044
- PMC
- PMC1511622
- OpenAlex
- W2025316647
- Cited by
- 44
- References
- 25
- Citations by year
- 2026: 2 · 2023: 1 · 2021: 2 · 2020: 2 · 2018: 2 · 2017: 1 · 2016: 2 · 2015: 2 · 2014: 1 · 2013: 3 · 2012: 1
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Disease in Childhood (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- nocturnal hypoglycemia, sleep architecture, type 1 diabetes, adolescents, sleep disorders, counterregulatory hormones, cortisol, growth hormone, HbA1c
- MeSH terms
- Adolescent, Blood Glucose, Child, Circadian Rhythm, Diabetes Mellitus, Type 1, Female, Humans, Hypoglycemia, Male, Sleep Wake Disorders, Sleep Stages
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