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Causes & risk factors

Risk factors based on diabetes type1–4

Factors that may increase risk of nocturnal hypoglycaemia5,6

  • Stress
  • Diabetic neuropathy
  • Physical exercise, especially during the evening
  • Excess insulin during the day
  • Previous episodes of nocturnal hypoglycaemia
  • High dose of basal insulin
  • Failure to check blood glucose at bedtime
  • Excess rapid-acting insulin to correct high glucose, particularly at bedtime, or to cover bedtime snacks
  • Premix or short-acting insulin before dinner
  • NPH insulin (isophane) in the evening

Key needs to mitigate risks

Key needs to mitigate risks alttext


  1. Yale JF et al. Hypoglycaemia. In: Diabetes Canada Full Guidelines. 2018. Available at:
  2.  International Hypoglycaemia Study Group. Minimizing hypoglycemia in diabetes. Diabetes Care 2015;38:1583.
  3.  Inzucchi SE et al. Management of hyperglycemia in Type 2 diabetes, 2015: A patient-centered approach. Diabetes Care 2015;38:
  4.  Weinstock RS et al. Risk factors associated with severe hypoglycemia in older adults with Type 1 diabetes. Diabetes Care 2016 Apr;39:603.
  5.  Vu L et al. Predicting Nocturnal Hypoglycemia from Continuous Glucose Monitoring Data with Extended Prediction Horizon. AMIA Annu Symp Proc. 2019;874-882
  6.  Brunton SA. Nocturnal hypoglycemia: Answering the challenge with long-acting insulin analogs. MedGenMed 2007;9:38.