Hypo during night time

[Keefus147]

Hello,

This is my first post here.
I'm a type one diabetic for 36 years but recently I'm not waking up if I have a hypo while I'm asleep.

I have always gotten up in the past but the last few years it's causing me issues and my wife.
My wife is always on edge of I don't wake up. This has started to cause problems with out marriage as it's too much pressure for her.

I have the dexcom one which I use the scanner that comes with it but this doesn't always wake me up. The hospital are planning to give me the dexcom 6 but this date hasn't been guaranteed as it's all down to NHS funding.

I have Ms for the last 8 years and I have found it a lot difficult to maintain my sugars since my ms.

My HbA1c has always been great but the last few months I have had to try and get my blood a little higher so I don't have hypos.

Before the dexcom I had the freestyle libre 2 and this was on my phone, even on full this still didn't wake me

Has anyone had this problem before and if so how did they fix this?

Any help would be very much appreciated.

Thanks

Keith

 

[Pipp]

Hello and welcome @Keefus147 .
I am sorry you have not had any responses to your query, and I am not able to answer. So I am just bumping this up so that it will be noticed by some of our more knowledgeable members who have T1 and an understanding of hypo issues will notice and offer advice.

@EllieM, @Jaylee, @Antje77 , @Juicyj , @himtoo, @Hopeful34 , @In Response

Are you able to advise?

 

[In Response]

Just a tangential thought - are you sure these are real hypos and not compression lows?
Any CGM can report a false low if pressure is applied to the sensor as this may stop the flow of fluid to the filament.
This is most common at night when you lie on the sensor.
Unfortunately, the alarm will still go off and wake you (or your wife)) but you can usually see if it is a compression low because the graph will fall suddenly and rebound as quickly without any hypo treatment.

If these are real hypos, I do not understand your question.
Are you asking how to avoid hypos or how to ensure they wake you?

To avoid hypos, the first thing I would do is look to understand what is causing them.
The obvious answer is "too much insulin" but is that because your basal is too high? Have you done a basal test recently? Or is it because you took too much bolus for your evening meal? Maybe you need a carb counting refresher. Or is it something like exercise or alcohol lowering your glucose output from your liver?

To ensure you wake, there are two things - make your body more sensitive to lower BG which is what you are doing by raising your target BG; and make the alarm more obvious. I know some people have rigged up technical solutions to do this. It could be something like directing your alarm to a speaker or a smart watch which can vibrate.

 

[Jaylee]

Hello,

This is my first post here.
I'm a type one diabetic for 36 years but recently I'm not waking up if I have a hypo while I'm asleep.

I have always gotten up in the past but the last few years it's causing me issues and my wife.
My wife is always on edge of I don't wake up. This has started to cause problems with out marriage as it's too much pressure for her.

I have the dexcom one which I use the scanner that comes with it but this doesn't always wake me up. The hospital are planning to give me the dexcom 6 but this date hasn't been guaranteed as it's all down to NHS funding.

I have Ms for the last 8 years and I have found it a lot difficult to maintain my sugars since my ms.

My HbA1c has always been great but the last few months I have had to try and get my blood a little higher so I don't have hypos.

Before the dexcom I had the freestyle libre 2 and this was on my phone, even on full this still didn't wake me

Has anyone had this problem before and if so how did they fix this?

Any help would be very much appreciated.

Thanks

Keith

Hi,

Does a normal phone set alarm clock wake you?

I’m not sure what noise the Dexcom app makes as an alarm, but anything that just goes bing for me I tend to ignore.
My alarms need to be jarring as hell either for work or for a low?

There are some 3rd party apps that can work with Dexcom where you can change the alarm sound to suit you…

 

[Jasmin2000]

If I'm heading for lows I have a small bowl of porridge - my BG goes up to 7 for ages and it can take me through 4-5 hours.

 

[Hopeful34]

As @Jaylee said 3rd party apps are good, so you have a choice of alarms and volume. Our bodies can get so used to a sound (especially if the alarm has been going off a lot) that we ignore it.

Has the Consultant suggested a hybrid closed loop pump, as this would stop delivering insulin if you were going to go low.

 

[ElenaP]

.....I'm not waking up if I have a hypo while I'm asleep.
..... it's causing me issues and my wife.
...... started to cause problems...
...... hospital are planning..... dexcom 6 but .... NHS funding.

I agree with the recommendation above to try to get a closed loop pump. I have had a closed loop with Dexcom G6 and Tandem t:slip X2 (other pumps are available) and now I have hardly any night-time hypos. The pump is fiddly to use, but worth it because I get better sleep.

I am sorry to read that you have MS. I have some knowledge of Multiple Screlosis because my late husband had MS for over 30 years. If the agility in your fingers is affected, then filling the pump with insulin can be frustrating, but still manageable. What does your consultant say about MS , or MS medication, affecting blood glucose?

Your wife, but not you, being woken up by the blood glucose alarms is a big issue. Yours is not the first marriage where the non-diabetic partner is not getting enough sleep because of the alarms. Many couples manage this by sleeping in separate bedrooms. There are numerous happily married couples who sleep in separate bedrooms. Some to get away from partner's snoring, others because of different working hours or needing lights on for reading in bed. Thus both partners get a better sleep. The point is that these arrangements keep marriages happy, when both parties agree.

You have already been given suggestions on trying rig up stronger alarms, and those will be worth trying. In my case, I use the Dexcom G6 with an iPhone where I can adjust the volume of the alarms. The low-glucose alarm gets increasingly noisier if I ignore it.

It would be helpful to get the Dexcom G6 sensors as soon as possible. I suggest that you tell the hospital diabetes team about the strain on your marriage. Tell the GP also, as a letter from the GP may help. This is more urgent than the closed loop system.

In the meanwhile, if you try not to eat anything for some four hours before bed and go to sleep with readings eight or above, that would allow for some movement during sleep but still keep yours reading within the range. That is assuming that your basal dose is correct. If it is some time since you last did basal testing, it may be worth doing that with help from your DSN.

Good luck.

 

[EllieM]

Hi @Keefus147 not sure I can add much to the very helpful suggestions you've already received but I can sympathise with the stress this is putting on your marriage.

I have lost hypo awareness in the past after having had too many hypos, and regained it by keeping my bg a bit higher for a while (in my particular case my consultant advised to aim for a level of 6-12 for few weeks/months). But after 54 years of T1 my awareness is less good than it was even twenty years ago so I do find a dexcom (G6 and G7) invaluable.

And last night was full of hypos (due to an new move to pump therapy and settings which are still being tweaked) and it stressed my husband out as well as me, so I feel your pain.

I think if you can get a G6 out of the NHS it should be possible to rig an extra loud alarm, so I think this should help a lot.

Good luck.

 

[Jaylee]

As @Jaylee said 3rd party apps are good, so you have a choice of alarms and volume. Our bodies can get so used to a sound (especially if the alarm has been going off a lot) that we ignore it.

Anything that beeps or bings takes a while for me.

Choosing some obnoxious “rave” tune is more likely to have me up…

 

[In Response]

I notice @Keefus147 has not returned to this conversation to answer what they need help with
- reducing hypos
- hearing the alarm when they happen at night.

These are two different things, requiring different solutions.

Clarification could help with the advice.

 

[Jaylee]

I think if you can get a G6 out of the NHS it should be possible to rig an extra loud alarm, so I think this should help a lot.

I’ve trialed the G6 using a free 3rd party app called Diabox.

With Diabox or even xDrip It’s possible to customise a sound file on the device to play as an alarm tone instead of the default.
I still wake with hypos, but the earlier the warning lessens the severity & cognitive disruption for me..