"I always wake up in the middle of the night feeling thirsty, and after drinking water, I have to get up to urinate. It's a total hassle all night long." In the endocrinology clinic, many patients have experienced such troubles. Hou Zeling, a doctor in the endocrinology treatment team at Hainan Chengmei Hospital, said that if abnormal symptoms occur frequently at night, it is likely to be a "signal" that blood sugar levels are too high, especially for middle-aged and elderly people and high-risk diabetes groups. Don't take it lightly.
Typical manifestations of thirst, increased drinking, frequent nocturia, and metabolic disorders
"Always feeling thirsty at night and waking up frequently to urinate... These are the most common nocturnal signs of elevated blood sugar levels," said Dr. Hou Zeling. When the glucose concentration in the blood is too high, the kidneys cannot fully reabsorb the glucose, and excess glucose is excreted in the urine. During this process, glucose takes away a large amount of water, leading to increased urine output and forming "osmotic diuresis". An increase in the frequency of urination at night and rapid water loss from the body stimulate the thirst center, waking people up in the middle of sleep, and then falling into a cycle of "drinking water - urinating - drinking more water", seriously affecting sleep quality.
Generally, healthy adults urinate no more than twice at night. Hou Zeling reminds that if the frequency of urination at night exceeds two times and is accompanied by obvious thirst, one should be alert to blood sugar issues. This symptom is easily misunderstood as "drinking too much water before bed" or "decreased kidney function due to aging", but for people with high-risk factors such as a family history of diabetes, obesity, and sedentary lifestyle, blood sugar monitoring should be prioritized.
Numbness in hands and feet, itchy skin, are the "distress signals" from nerves and skin
In addition to thirst and increased urination, numbness in the hands and feet, and itchy skin at night may also be related to elevated blood sugar levels. Dr. Hou Zeling stated that long-term hyperglycemia can damage peripheral nerves, leading to abnormal nerve conduction function. Patients often feel numbness and tingling in the extremities, like ants crawling, especially during quiet nights, which may even affect their ability to fall asleep.
Meanwhile, hyperglycemia can also affect skin metabolism, leading to dry skin, decreased elasticity, and an increased risk of bacterial and fungal growth, which can trigger itching.
This itching is mostly concentrated in the limbs, waist, and abdomen, and it may worsen during temperature changes at night and when attention is focused. Scratching may also lead to skin damage, increasing the risk of infection.
"There have been patients who, due to skin itching at night, mistakenly thought it was an allergy and self-medicated, only to have their symptoms worsen. Upon examination, it was found that the culprit was elevated blood sugar levels," said Hou Zeling.
Lethargy, fatigue, abnormal weight, and a "chain reaction" of systemic metabolism
"Many patients with elevated blood sugar levels may feel sleepy at night and lack energy during the day, and may also experience unexplained weight loss." Dr. Hou Zeling explained that glucose is the main source of energy for the body. When blood sugar levels are too high, body cells cannot effectively absorb and utilize glucose, and the cells are in a state of "energy starvation," which can lead to fatigue, lethargy, and a tendency to feel tired during the day even if there is sufficient sleep at night.
To meet energy needs, the body will start to break down fat and protein, leading to weight loss. This combination of "lethargy + weight loss" is easily overlooked or mistaken for "sub-health", but for middle-aged and elderly people, it may be an important indication of elevated blood sugar levels.
Expert reminder
Prolonged high blood sugar levels pose far more serious risks than just causing discomfort at night.
Hyperglycemia, like an "invisible killer", continuously damages blood vessels and organs throughout the body:
For the cardiovascular system, it may lead to severe diseases such as atherosclerosis, coronary heart disease, and stroke;
For the kidneys, it will gradually damage the glomerular filtration function, ultimately leading to diabetic nephropathy and even kidney failure;
When the blood vessels in the eye are affected, retinal lesions are prone to occur, which can lead to blindness in severe cases;
In addition, it can aggravate nerve damage, leading to diabetic foot problems such as foot ulcers and infections. In severe cases, patients may face the risk of amputation.
Therefore, timely detection and intervention of abnormal blood glucose signals are crucial to avoid these severe complications.
Dr. Hou Zeling reminds that the occurrence of the aforementioned symptoms at night does not necessarily indicate excessive blood sugar levels. However, it is necessary to promptly visit the hospital for examinations such as fasting blood glucose and 2-hour postprandial blood glucose to obtain a definitive diagnosis. In daily life, it is important to control diet, reduce intake of high-sugar and high-fat foods, exercise regularly, and maintain a good sleep-wake cycle. If diabetes has been diagnosed, it is necessary to strictly follow the doctor's advice on medication, regularly monitor blood sugar levels, and avoid complications. Paying attention to bodily signals at night can help safeguard blood sugar health earlier.
Expert Introduction
Hou Zeling, Attending Physician
Medical expertise: Specialized in the diagnosis and treatment of diabetes and related complications, as well as thyroid diseases such as hyperthyroidism, hypothyroidism, and thyroiditis. Additionally, proficient in the diagnosis and treatment of common endocrinology diseases including obesity, gouty arthritis, lipid metabolism disorders, electrolyte metabolism disorders, and primary aldosteronism.
Article | Huang Fei