Nocturnal hypoglycemia in patients with insulin-treated diabetes.

While use of intensive insulin therapy has proven effective for reducing risk of long-term complications of hyperglycemia in people with diabetes, overnight hypoglycemia remains a significant barrier to intensive therapy. Findings from numerous studies indicate that nocturnal hypoglycemia is a frequent event among patients with type 1 diabetes, while severe hypoglycemic episodes are approximately three times more likely in patients on intensive insulin therapy than in those on conventional therapy. Nocturnal hypoglycemia remains frequent, even when specific approaches-use of short-acting insulin analogues to manage postprandial glucose surges, peakless long-acting insulin analogues as basal therapy, and strategically selected bedtime snacks-aim to avert this problem. Thus, nocturnal hypoglycemia continues to threaten the well-being of patients with diabetes and cause concerns for their family members and caregivers. Continuing research is required to improve methods for detection and prompt correction of hypoglycemia in order to achieve a safe level of euglycemia in people with diabetes.