Hot flashes at night- false hypos or perimenopausal symptoms?

the above was the issue that first brought me to this website last year. at that time i had some responses saying that low blood sugar at night did give some people hot flashes. i then tested my blood sugar and found it to be 80 in the middle of the night, where it would usually be 98-115 in the day. i got the response here that i had nothing to worry about, that i couldn't be having a false hypo- that my hot flashes were from perimenopause.

then recently i read in 'think like a pancreas' that 30 point differences in daytime (not counting spikes) and nightime bg could bring on false hypos in some people. so then i was back to my original question- how can a woman of perimenopausal age tell if hot flashes are false hypos or just from perimenopause? one response i got from another site was:
"The rapid heart beat from a false hypo (or a real one) isn't usually accompanied by the dramatic change in perceived body temperature that comes with a hot flash. If you aren't throwing off the covers to cool yourself down--even on a January night with the heat turned down low--it isn't a menopausal hot flash."

i just wanted to ask the tudiabetes community if this answer jives with your experience: a night time hypo/night time false hypo is NOT accompanied by a hot flash so bad you have to throw off the covers.

do you agree with the above statement?

question 2: is it possible for one's night time endogenous basal insulin production to be out of sync with one's daytime one? is it possible for daytime basal insulin production to deteriorate faster than night time production? or are night time endogenous basal levels always lower than daytime endogenous basal levels?

I remember having lows and soaking my bed sheets.( I have a CGM now and I do not get that low at night anymore.) I never sweat like that with hot flashes. But, with both I have had to throw off the covers. I do not agree with the statement. A hot flash is a hot flash. They both are awful.

so if my hot flashes are from false hypos, there is nothing i can do about them until by bg deteriorates to the point that i qualify for medication. or i could try to sleep through them by taking benadryl off and on so i don't habituate to it. i'm surprised at how i still function with the lack of a good sleep night after night.

I have had night sweats/hot flashes for a long time, I'm not sure what the cause was in each time period, but I would guess endocrine and hormonal issues. I have read that Type 1 women go into menopause earlier. I started having hypos about 10 years before D symptoms or what I now know were D symptoms. I tested for that but I didn't link them to my night sweats, they seemed to mostly happen when I hadn't eaten for a long period with a lot of activity and I don't remember sweating at all with them, I never tested at night. I'm on insulin now for nearly three years and my hypos and bg changes often cause sweating. Have you had hormonal testing done?

no, but maybe that should be my next logical step. i don't sweat, but i get very hot, especially on the days that i do intense exercise in the morning fasted.

how old were you when the hot flashes happened? the only reason i know my bg is not normal is because my husband started testing himself and i did it just for fun. i didn't think i would have a problem even though both my father and mother (passed away) had diabetes because i am not overweight. when i tested after a bowl of unsweetened oatmeal, i was over 200 one hour later. but my fasting always used to be 90 and my a1c at its highest was 5.9

so do you think your early hot flashes could have been diabetes related? doctors have never caught my problem. i did by accident.


meee, how did you come to know you were diabetic? if my husband hadn't bought a meter, i would still going high and not even know. now i have the chance to delay it (prevent?) diabetes. at the minimum i am buying myself time to learn all i can and be prepared to take care of myself without the shock of it all plus being a lot older with worse memory/health.

I would do the hormonal testing with your gyn. Mine started in my late 20's and have kept going, but being on insulin helped a bit, oddly enough. I was on hrt for two years also and that was the best. I think they were now definitely, I've had symptoms for years, but I guess I will never know for sure. I went to a gazillion doctors too, and I still ended up in an icu unit in dka etc.

My night sweats started late 20's hot flashes in my 30's. I started thinking something was wrong around the time of the hypos and had planned to ask to do a gtt but I didn't because I thought it was hypoglycemia from not eating enough at times. I have always gone through periods of higher/lower appetite and higher/lower activity. Then years later other multiple symptoms started and I did go to around 12 doctors none of whom tested bg while I had symptoms of high bg, my gp diagnosed me while I was already in dka at 279 bg then I was in the hospital 3 days later. I wish I had just tested myself when all the other and then dka symptoms started- most people aren't thinking too clearly then due to high bg and no one in my family has any type of D that I know of at least. I'm sure a lot of people have diagnosed themselves.

meee, you said your night sweats started in your 20s and hot flashes in your 30s. does that mean that you got hot and sweated a lot for years, and then it changed to just being hot with not sweats?

also, sometimes i am hot with a rapid heartbeat and sometimes i just get hot multiple different times at night. meee, did you also get hot without the rapid heartbeat everytime? also, early on, did you have what supposedly are the earliest symptoms of diabetes in women that i have heard of- yeast infections, urinary tract infections, and/or peeing a lot?

meee, do you still sometimes get hot at night? are you past menopause? and how did/do you deal with not getting a good night's sleep? i have to keep the car radio off so i am not distracted and cause an accident i am so tired.

False hypos usually occur when you get used to an elevated blood sugar like 150-250 mg/dl and then having a normal blood sugar will bring on hypo symptoms. It can also occur when your blood sugar drops suddenly. I find it unlikely that a drop of 30 mg/dl would bring it on.

There are many, many things that can cause this. For instance sleep apnea can cause this. You get woken up when you stop breathing and your body has released all these stress hormones. I still sometimes have this happen even with my treated sleep apnea. I take a melatonin at night to help me sleep through the night.

And as to overnight insulin production, most people produce more basal insulin overnight to offset the increased insulin clearance that happens in the early morning hours. It is this increased clearance that contributes to Darn Phenomenon in those of us bless with too little insulin.

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I do still get night sweats from bg changes now on insulin. I think the hf are different for everyone- the first time I remember having one where I said: "this was a hot flash" was when I was outside gardening in the heat- I started to feel ill, dizzy, I had palpitations and then a flash of heat over my face. I'm going to add you as a friend and I will pm you more info :-)

I had all the urinary symptoms too and two very severe yeast infections- one two years before dka and one 4 weeks before- I should have been diagnosed at each of those events.

I used to worry about this exact question. Then I started having the pre- and menopausal hot flashes. The difference for me was with the menopausal ones, I felt like I was generating massive heat form the inside out. WIth hypo night sweats I got clammy and then cold and had a hard time warming up. Hope this helps.

thanks, everyone!

Perfect Description!

I had the same issues about 10 years ago which lead me to go to an endo thinking I had Hypoglycemia. I found out I was in early menopause and that my blood sugar was spiking post meals, but then going low before the two hour mark. I eventually wound up using hormonal cremes after I had a hysterectomy. I think you should have your hormones checked to be sure. I don't get hot flashes at night anymore since using the cremes, but still have blood sugar swings.

Hi Bjm and everyone on this forum,
I am new to this site and really inspired by all your stories and looking for advice.

Myself 50 year old lady who has been investigated by doctors for multiple diagnoses due to non-specific symptoms for last 5 years.All results returned negative except for hormone levels last year which indicated menopause.
Last week I nearly passed out-symptoms were very much like hypoglycemia although I do not have diabetes.Symptoms resolved after sugar intake.However I am confused whether it was actually a hypo or a hot flush and how to deal with the situation.

Any advice will be welcome and thanks