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Night hypo on a pump

caretaker

caretaker

Well-Known Member
Messages
276
Location
essex
Type of diabetes
Type 1
Treatment type
Pump
some thinks is bothering me what happens when you have a hypo in the night and you don't have CGM to warn you of suspend the pump. .
I know at the moment being on injections .. i wake up with a soaking wet bed due to swearing and a BG through the roof. go to bed with BG 7 and wake with a BG 16+
 
You treat the hypo with 10 or 15 quick acting carbs then test 15 mins later to make sure all is fine. This is exactly the same way you should be treating a hypo when using injections.
 
Assuming the same with MDI's, you should also get some low GI carbs to make sure you don't hypo again.
 
Jemzor said:
Assuming the same with MDI's, you should also get some low GI carbs to make sure you don't hypo again.
Click to expand...
No you don't give low GI foods after a hypo, when using a pump. :)
 
You can suspend the pump when your having a severe hypo, but the advice for pump users is to use the 15/15 rule for treating hypo's, meaning you treat the hypo with 15g of fast-acting carbs and wait 15 mins and test your bg again.
 
noblehead said:
You can suspend the pump when your having a severe hypo, but the advice for pump users is to use the 15/15 rule for treating hypo's, meaning you treat the hypo with 15g of fast-acting carbs and wait 15 mins and test your bg again.
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There is no point what so ever to suspend the pump.
Your hypo is happening right now and the insulin suspend will not take effect for at least 1 hour. Only result is high sugars a few hours later.
 
CarbsRok said:
There is no point what so ever to suspend the pump.
Your hypo is happening right now and the insulin suspend will not take effect for at least 1 hour. Only result is high sugars a few hours later.
Click to expand...

Ah right, this is what I was told in my pump training, if you were experiencing a severe hypo you were to temporarily suspend the insulin delivery, so would you not do this if you were on a extended bolus for example and you had a bad hypo.
 
noblehead said:
Ah right, this is what I was told in my pump training, if you were experiencing a severe hypo you were to temporarily suspend the insulin delivery, so would you not do this if you were on a extended bolus for example and you had a bad hypo.
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If it's an extended bolus by all means stop it but do not stop your basal. I think it's odd how HP's seem to forget the time lapse for insulin working.
 
sorry
Thanks everyone for that
but what i'm trying to say is.
not how to treat the hypo
but how do you know your having one when a sleep.
I know because of waking up. normally about 2 am in a cold sweat.the hypo has already happened leaving me with a high sugar from liver dump.
Do you get the same thing with a pump or is the basal so small over a longer time ...this wont happen ..
 
Hypo symptoms are exactly the same :) If you wake up drenched in sweat and your numbers are high, how do you know you have had a hypo and the high number isn't just caused by high blood sugars? 16+ is not a number I would associate with a hypo rebound that hasn't been treated.
 
CarbsRok said:
No you don't give low GI foods after a hypo, when using a pump. :)
Click to expand...

OK. So treating a hypo when on a pump is different to treating a hypo when on MDI's. Any reason for this?

Is it because the effect of basal insulin absorption on a pump is slower than from a basal insulin injection? (hence sugar levels will stay higher on a pump and the likelihood of hypoing again is low)
 
Jemzor said:
OK. So treating a hypo when on a pump is different to treating a hypo when on MDI's. Any reason for this?

Is it because the effect of basal insulin absorption on a pump is slower than from a basal insulin injection? (hence sugar levels will stay higher on a pump and the likelihood of hypoing again is low)
Click to expand...
The idea that was brought in a few years back to follow up a hypo with slow acting carbs has been debunked. Back in the 60's I was always told 2 sugar lumps for a hypo and that was it. Today is more refined glucose tabs do the trick :)
The idea that someone came up with for treating with low GI is done on a theory that it soaks up excess long acting insulin floating around.
With a pump you use quick acting for both basal and bolus and can adjust your basal by the hour so in theory if basal right there is no excess insulin.
 
CarbsRok said:
The idea that was brought in a few years back to follow up a hypo with slow acting carbs has been debunked. Back in the 60's I was always told 2 sugar lumps for a hypo and that was it. Today is more refined glucose tabs do the trick :)
The idea that someone came up with for treating with low GI is done on a theory that it soaks up excess long acting insulin floating around.
With a pump you use quick acting for both basal and bolus and can adjust your basal by the hour so in theory if basal right there is no excess insulin.
Click to expand...
It seems to be what im talking about
my bolus would be used with evening meal about 5 pm and i don't snack.
at 10 pm BG about 8. now i have the basal........... lots. 45 units And at 2 am BG 7 and no lower if im lucky ... In the morning end up at 14..for me that's OK

if i try to have a lower bed BG i will Hypo

from 10 pm, to 6 am my BG always seems to climb.. i cant keep just uping basal ... And bolas should not come into as ive not eaten or injected for over 7 hours
at 10 pm -8 and at 6 am -14

if i try to go to bed with anything under 7 i will hypo
lets hope the pump sorts out my basal
 
caretaker said:
It seems to be what im talking about
my bolus would be used with evening meal about 5 pm and i don't snack.
at 10 pm BG about 8. now i have the basal........... lots. 45 units And at 2 am BG 7 and no lower if im lucky ... In the morning end up at 14..for me that's OK

if i try to have a lower bed BG i will Hypo

from 10 pm, to 6 am my BG always seems to climb.. i cant keep just uping basal ... And bolas should not come into as ive not eaten or injected for over 7 hours
at 10 pm -8 and at 6 am -14

if i try to go to bed with anything under 7 i will hypo
lets hope the pump sorts out my basal
Click to expand...

A pump would providing that you make the necessary changes as and when needed. You can so fine tune the pump.. Depending upon choice. Its unbelievable really.
 
@caretaker ........its not that uncommon for diabetics to need less insulin in the early hours of the morning but from about 4am the need for insulin increases. What can you do???........I had similar to yourself and what I did was to get my eve meal carb ratio set to more or less give me the same bg level 4hs later. I then sorted out the evening shot of basal to deal with the rise in bg levels from 4am onwards but because the increased basal would also cause me to hypo between midnight and 3am, I just made sure that I eat a short acting carb snack before going to bed. That was much better than going hypo whilst asleep.

Of course with a pump all the basal rates can be adjusted to allow for the drops in bg and the increases but it takes a while to get the basal rates adjusted correctly and even then, there will be times when they will need to be adjusted again but in general there are less night hypos with a pump than there are using MDI.
 
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