Hypos during the night

Sounds like her basal insulin is too high. Please have her contact her diabetes nurse to discuss her doses.

Sorry to read about the problems your wife is having @grahamrb
You mentioned that her low alarm goes off so I am going to assume she has a CGM.
Does she check the CGM reading with a finger prick?
The reason I ask is because "Compression Lows" are a problem with CGMs. This is when pressure applied to the CGM such as when you lie on it when asleep can cause it to report an incorrect low. Therefore, it is important to always check lows before treating (unless it is very obvious).

I would also agree the basal is likely to be too high. Going to bed on 10mmol is unnecessarily high – it is better to go to bed on 6–8. As long as the basal is the correct level, this will not cause lows.

Sorry your wife is having so many hypo's @grahamrb
Has she done an overnight basal rate test recently? If not, that's a good place to start.
If her basal rate is correct, then it may be that her insulin:carb ratio is off depending on what time she last ate before bed, or had she given any correction doses of insulin in the evening?
Is she checking with a finger prick test that her levels have risen sufficiently after a hypo before going back to sleep?

Repeated hypos during the night are exhausting and demoralizing. I speak from experience. How much time is there usually between her fast-acting with her evening meal and the basal taken, I assume, last thing at night ? What time do the hypos start ? My problem was partly caused by my evening meal being rather late, sometimes 8pm, because my husband was driving thirty odd miles to get home and I sometimes worked late to fit in with the bus timetable and eat with him.. My mealtime insulin was not 'played out' when I was going to bed, so hypos were the result. The DSNs suggested solution was to move house to be nearer work !!!

Just a heads up @grahamrb I had a discussion with dentist about night time hypos and teeth cleaning. He said don’t. Apparently unless we leave a fair amount of time before washing teeth you just brush the sugar in and create more problems. Just have a glass of water by bed and swill round mouth a couple of times.

Hi.

Just a quick response.

I got my Libre 2 after 40 years of dealing with this “pain in the ****” disease from 13 years old.

I ate at 6-7 in the evening to make sure my Humalog was not acting before bed which would work for you hopefully.

I tried to get my readings at 11-12pm between 5-10mmol before bed.

I then set my low alarm to 4.5mmol and monitored.

I was getting alarms regularly but woke up in a state where I could deal with it and monitored until I had the correct amount of Glucose tabs and rich tea bics to not go over 10mmol. This took some doing as the Libre has a timelag on the readings.

This was impossible as the amount of alarms per night was too much being in a full time job.

I eventually, after a week of reducing my 24 hour Lantis Glargine reduced my intake by 10 units. Then the dips started disappearing so the insulin was dealing with my bodies glucose production without driving me down. My daytime readings during this time I cared not a jot.

I don’t have breakfast but still had to inject 2 units of Humalog quick acting insulin to deal with the gap where my long acting was wearing out and the newly injected long acting was taken.

My best readings are now from 11pm to 11am.

I am trying to deal with the rest of the day now but the reaction times of Humalog v Food is so inconsistent that unless you live the most boring of lives and eat a little food over the whole time the insulin is working, you are never going to get to the gold standard of 7.5.

I have lived my life for the last 40 years and have only just been given a piece of kit that proves that most of the advice I was given 40 years ago, “you’re average should be 5.6”and 20 years ago, “your average needs to be closer to 6” was unrealistic.

I hope you get things to a position where you are able to just feel healthy and are able to live life to the full.

Good luck.

Ok, not such a short response.

How are you determining she is having a hypo? The only reason I raise it is because my Libre gives me false low readings at night all the time. It turns out this is common and called “compression lows”. If you are trusting the libre then it might be leading you astray.

Other advice; make sure your wife hasn’t injected fast acting insulin for atleast 4 hours before bed. This is the time it roughly takes for it to be out of her system.