Overnight hypoglycemia in adults with type 2 diabetes leads to a decreased awakening response in the hours after the event, affecting the ability to respond with an adequate intake of carbohydrates, according to recent study findings. Forty-two adults with type 2 diabetes were screened for the study. Twenty completed two overnight sleep sessions in a lab setting. During one overnight visit, researchers induced hypoglycemia with a hyperinsulinemic clamp; after participants reached sleep stage N2, researchers turned off glucose infusion until the plasma glucose target of 48mg/dL.(2.7 mmol/L) to 50mg/dL.( 2.8 mmol/L )was reached and maintained for 15 minutes. The participants were then brought back into normal glycemic range for the remainder of the night. During a separate visit, plasma glucose was maintained in the normoglycemic range for the duration of the session; participants were assigned to the two sessions in random order. When compared with the normoglycemic night, the rate of awakenings fell 27% between hours 4 and 8 on the hypoglycemic night; awakenings were 20% fewer during hours 0 to 8. Researchers measured significantly higher hormonal responses to hypoglycemia (adrenaline, growth hormone and cortisol) on the hypoglycemic night. The study adds further understanding of the problems with sleep-related hypoglycemia and its relation to daytime impairment and comorbidity. P. Jennum MD, DMSc.Diabetes Care 10-2015