7 Surprising Reasons People Have Low Blood Sugar at Night 

Have you ever experienced low blood sugar at night without having diabetes?  If you have then don’t worry, you are not alone. Certain medical conditions can cause low blood sugar which is likely to occur at night due to our body being in a fasting state.  .  

Some of the medical conditions that can cause low blood sugar are: whipple’s triad, medications, illnesses, malnutrition, hormone deficiencies, tumors, and bariatric surgery.  Dealing with low blood sugar from these conditions are more common than others.     

It is important to understand what low blood sugar is, how these conditions cause low blood sugar, how to identify low blood sugar and how to treat it.  There will also be vegan bedtime snack ideas.  Stick around to the end to soak up this valuable knowledge.   

What is Low Blood Sugar? 

Low blood sugar for a person who does not have diabetes is <55md/dL (3.0 mmol/L).  

Causes of Low Blood Sugar In Non Diabetics 

There are many different conditions that can cause low blood sugar.  Usually,  due to hyperinsulinemia, an excess of insulin in the body proportional to glucose. A diagnosis of hyperinsulinemia done by the doctor can only occur while the person has low blood sugar or during a prolonged fast that is supervised (1). 

1. Whipple’s Triad

Whipple’s Triad refers to when a person has low blood sugars.  Triad refers to 3 criteria that need to be seen (1).  

1. Symptoms of low blood sugar: sweaty, dizziness, ect. 
2. Low blood sugar <55mg/dL
3. Relief of symptoms after glucose has been administered. 

2. Medications 

There are many different types of medications that can cause the body to have low blood sugar.  This is the most common cause of low blood sugar at night without diabetes. The body either produces too much insulin or glucose production is blocked.  These medications are (2): 

Insulin

Glyburide

Glipizide

Glimepiride 

ACE inhibitors 

Quinolone 

Ciprofloxacin

Levofloxacin

Moxifloxacin

Garenoxacin.

3. Critical illnesses

Illnesses that affect the kidneys and liver can also affect the blood sugar levels. The kidneys process and excrete insulin as well as create more glucose.  

When the kidneys are not able to process insulin effectively then insulin can still do its job of transporting glucose into the cell. Additionally, if the kidneys can’t make more glucose then this is a sure disaster for low blood sugar (3). 

The liver regulates the glucose in our system by making more glucose when our body needs more.  Additionally, the liver stores excess glucose, called glycogen, to be utilized when the body needs it during periods of fasting, i.e at night.  

Low blood sugar can occur if the liver is impaired and unable to break down the glycogen into individual glucose to release into the bloodstream when glucose levels are low (3).  

4. Malnutrition 

Malnutrition is more common than most people think.  Many people come into the hospital malnourished.  This is due to many reasons. Elderly people may not eat enough due to a lack of appetite. A person may not be able to adequately access food due to physical injury, illness or disability and may only have limited help at their house. 

Other people may eat junk food which does not provide the body with the nutrients it needs. Alcohol and liver disease may cause a person to not want to eat or provide  feelings of being full when a person eats a small amount of food.  

Because of this, the body is not running as efficiently as it could.  This means that certain organs that produce glucose or release glucose from glycogen won’t function properly and can lead to low blood sugar (1). 

5. Hormone Deficiencies 

A hormone deficiency can cause low blood sugar especially in the adrenal glands which produce hormones including  cortisol and growth hormones. The adrenal glands sit right on top of the kidneys.   

Cortisol is a hormone that circulates throughout the body to the liver, muscle, and pancreas to stimulate the production of glucose (4).  When cortisol levels are insufficient in the body, they are unable to stimulate glucose production which causes low blood sugar (3).  

Growth hormone affects blood sugar levels by promoting glucose production in the liver and kidneys.  It also stimulates the breakdown of stored glucose in the liver.  Therefore when there is a deficiency of growth hormone in the body it is not able to increase low blood sugar by releasing stored glucose (5).  

6. Non-Islet Cell Tumors

Non-Islet cell tumors can be found in the liver or any soft tissue in the body.  Low blood sugar due to this type of tumor is very rare. It does occur when the tumor consumes the glucose in the body (2,3).  

7. Bariatric Surgery

Bariatric surgery is becoming more frequent in our society.  Depending on the type of surgery such as the Roux-en-Y gastric bypass, complications can occur.  The Roux-en-Y gastric bypass is when the pouch of the stomach is formed and that is then connected to the small intestine.

Due to this bypass, low blood sugar may occur due to dumping syndrome.  This is where too much high sugary foods goes from the stomach through the intestine so rapidly the body can’t handle it causing diarrhea.  

Dumping syndrome does not allow the nutrients to absorb much and therefore the sugar from the foods eaten is not absorbed. This can cause low blood sugar (4).  

Symptoms of Low Blood Sugar

• Shakiness
• Trouble Concentrating
• Sweating
• Blurry Vision
• Rapid Heart Rate 
• Fatigue
• Dizziness

Testing for Low Blood Sugar 

After experiencing low blood sugar at night.  A doctor should test to determine the cause of the low blood sugar.  Testing can only be done while you are having symptoms of low blood sugar or during a supervised fast.  

After the doctor determines the cause of your low blood sugar then the appropriate course of treatment to prevent it can occur.  Your doctor may recommend a nutritional intervention, medical intervention or surgical intervention depending on the cause of the low blood sugar (2). 

Tips To Prevent Low Blood Sugar 

• Be aware of the symptoms for low blood sugar 
• Always keep snacks around to raise blood sugar 
• Balance meals with protein, fat and carbs
• Buy a meter and check to see if blood sugar is low, if symptoms are present 
• Discuss with doctor reason for low blood sugars to appropriately correct the issue 

Inaccurate Reading for Blood Sugar Levels 

This occurs when there is an issue with the test tube or a delay in proceeding the test tube. The test tube to read your blood sugar level should have a substance to stop the activity of glucose.  If it doesn’t then glucose may continue to be active which can give a false reading. A delay in processing can also affect the blood sugar level reading (2).

Preventing Low Blood Sugar With Bedtime Snacks

• ½ PB and Jelly or Banana Sandwich 
• Trail Mix with nuts and fruit/ vegan chocolate
• Apple with peanut butter or sunflower seed butter
• Coconut yogurt with fruit 
• Avocado toast 

Conclusion 

People with different medical conditions can have low blood sugar at night. When the blood sugar is <55mg/dL that is considered low blood sugar.  Buying a meter or watching for symptoms can help you track or be aware when you have low blood sugar. 

It is important that when you have low blood sugar at night to have snacks next to you by your bed.  You can also have a bedtime snack to prevent low blood sugars at night.  

Low blood sugar at night without diabetes can be caused by Whipple’s Triad, medications, critical illness, malnutrition, hormone deficiencies, non-islet cell tumors, and bariatric surgery. Since a doctor can’t diagnose without testing your blood sugar when it is low then consider going in for a supervised fast to determine the cause of your low blood sugar.  

Be aware of the reason you have low blood sugar and see medication intervention.  In the meantime if you do feel any dizziness or shakiness then please have a snack to bring blood sugar up such as orange juice, banana or raisins. Have you ever experienced low blood sugar at night without diabetes and if so what was your experience like?