A word of caution here, the giving of direct medical advice or instruction is not a good idea and is a violation of this sites Terms of Service. The decision to start or stop any medical treatment is a decision that should be left to a diabetic and his or her doctor.
this is one scary disease, just sayin'. so, i'd suggest as others, set your DEXCOM at 100 and to ATTENTIVE, PUT IT RIGHT ON YOUR SIDE WHEN SLEEPING. Something like this happened to me too, the other night...and I'm not really hypo-unaware. I dropped nearly 80 points overnight (and sometimes MDI basal can be just as difficult to figure out as a pump, once it's injected, it's in there and one can't change basal rates). I have my dexcom set at 85 at night, at attentive and also set my alarm for 3AM as I can't figure my levemir out, still. Anyway, I too slept right through my alarm and 2.5+ hours worth of my dexcom buzzing, vibrating at me when I finally woke up, I had dropped 80 points from high 140's to 69 and I too did not wake up and felt like I was on sleeping pills. scared the heck out of me and I wasn't even really low YET. Please see an educator or your Endo and get this under control How LOW are you going, what are you at bedtime, are you bolusing before you go to sleep, correcting, etc..? What does the data from your Dex tell you, are you dropping at a certain time during the night (where you can make adjustments on your pump). Sometimes if one drops low in the middle of the night they'll have a rebound high, is that happening? I change my dexcom high and low alerts all day long, it's what it's for. Set the single arrow alert too, use all the alerts possible and set the dex for maybe 100 at bedtime.
huh, medical suggestions and advice is given on nearly every post on here, the one above about basal rates and pumps is all about advice.
https://forum.tudiabetes.org/topics/first-post-basal-testing-burning-me-out?commentId=583967%3AComment%3A3313635&xg_source=msg_com_forum
that's why we come on here. we, as t1's have to use discretion, care and speak with health care professionals before making true changes...but that's what this site is about, help, guidance, suggestions, no?
Wow. I'm sorry you're going through this. I think what I would do is lower overall insulin and have a less sugary snack at night before you sleep. Just run higher at night maybe, but not 250? I almost always have cheese and some nuts and tea before I sleep so as not to go low. Maybe you can get an alarm clock that is super loud and vibrates your bed or something like that if even your dog can't wake you.
Material on this blog is provided for informational purposes only. It is general information that may not apply to you as an individual, and is not a substitute for your own doctor’s medical care or advice. Sorry, Stemwinder. No editting option.
Wait! I'm confused. I'm not even sure if you are going low at night, Anagantios, or if you are just worried that you will. Let me re-phrase that Administration, IT HAS BEEN MY EXPERIENCE that I did not recieve adequate education on how to manage my pump BEFORE I was on one and it almost killed me.(Sorry,Anagantios, thats why I was digging at you for for more information about why you wanted it, just want to make sure that you weren't getting pushed into purchasing something that wasn't a good fit and could be damaging to u.) I BELIEVE that some of those docs are right when they say that an insulin pump is designed for a particular personality type - a vigillant one. Anagantios, u just don't seem to be that hyper-vigillant, type A personality that tends to really like a pump.
not my intention to argue or 'fight' with anyone. i just have never seen this posted by an admin before and was surprise. most of us are here, on this site, for advice, support, suggestions and are darn grateful for all of it. frankly, i've seen more advice given by an 'admin' then what was suggested on here. so, again, i was just surprised.
I know. I'm just teasing ya. I thought the song was funny/applicable because it talks about doctors and getting sued. LOL.
What an interesting conversation!
With a Dexcom, a lot of people online report that they put the receiver into an empty glass on a bedside table, so it rattles more loudly. If I'm getting lows at night, I will try turning my basal down a small increment at a time. To me, this is much easier with a pump, as you can just dial it back with .025U increments until you get the result you want. With MDI, I presume it would work the same way but I went from R/NPH to pumping and have only used Levimir for 3 days. It worked OK, I just tested a lot and seemed to have guessed about right. I didn't make any adjustments, just shot and went but I'd figure out the TDD of basal/ 24 as an hourly rate and adjust it by a very small amount. When I did MDI, I used a lot of "geez, I was high yesterday, I'd better have, hmmm, how about lucky 7 more units and we'll see what happens" scenarios which didn't work too brilliantly. Or at least was very exciting.
Hi Tu,
My 2 cents - if your pump is not setup right, then either fix it or stop using it until it can be fixed, perhaps until you can arrange an appointment with an educator.
My suggestion would be to try a tool like ManageBGL for a period of time, which can help you see the expected effect from your basal+bolus insulins, and help you determine which ratios/basals need to change and in what direction. You can also import CGMS data and compare the predictions with the actuals.
Good luck, and please do it soon!
Simon
Sarah I'm sorry but it seems that you have misunderstood the purpose of my post. The free flow of information is vital to Tud it's what makes it a great place. It is how this advice is given that makes a difference.
As an example I could relate how I handled a situation and give my experiences but it would be wrong of me to tell another person to take specific actions because I do not have full knowledge of their situation, this is especially true if we are taking about prescribed treatments. It is better to say this is what I did or this is what I might do rather than saying you should do this.
I agree, I have fears and concerns with pumps also after reading more about them. Some people do very well with them though, and I would really like the ability to adjust or completely shut off my basal. But I feel even if I could tolerate one I would be more likely to make a big blunder with a pump, which would terrify me.
Anagantios, I think your lows are pretty severe and I would get some outside help asap. I recently watched a youtube video posted by a young pwd / type 1 who suffered a low where she was unconscious and lost and entire day. Fortunately she woke up, somehow managed to treat herself and called for help. She was very lucky though really to have survived it- she was alone at the time with her husband being out of town.
Pretty excited about this ManageBGL. Might be just the thing. Thanks for recommondation.
That is disappointing to learn that your dog is unsuccessful in waking you up while you are asleep/unconscious. You may be having seizures during some of these times.
"Hypoglycemia unawareness is when you lose consciousness without ever knowing your blood glucose levels were dropping or that you were showing other symptoms of hypoglycemia. It tends to happen to people who have had diabetes for many years, but it doesn't happen to everyone. It is more likely in people who have neuropathy (nerve damage), people on tight glucose control, and people who take certain heart or high blood pressure medicines." (ADA)
I am also Hypounaware but I don't totally agree with the first sentence. I test my sugars frequently and correct when low or high. I do feel vague symptoms at around 2.4(43 mg). I have had countless lows and seizures, some severe, especially when I was young. I do not fear lows as much as I am concerned about highs however. It could be because when I was 8, I overheard some ladies talking about me. Saying, "That poor Girl. She'll probably lose her legs to amputation and her kidneys will stop working." That same year I also heard my Optometrist tell my Mom that I would probably be blind by age 19.
You have received some Good information from the TuD Members above. I make sure my BG is in a favourable area before I go to sleep. I drink mostly sugarless drinks(water, coffee, tea, mineral water with lemon or some other concoctions)during the day and evening. In doing this, I have to wake up to go to the bathroom once or twice during the night BEFORE I get too low or too high, since I correct at that time if needed. This is automatic for me, so I am able to easily fall asleep most times.
Wishing you success in finding the right solution for you. It requires more careful experimentation.
Hey Terrie,
Do you think you are hypo-unaware because you are more fearful of highs than lows and tend to run lower(due to loss of limb-thing)? I think I have always hated highs more than lows and as a result tended to run lower. I think I have spent too many years hyper-controlling the highs, which has led to a pattern of unnecessary lows. When I had no knowlegde of the 'dosing algorithm' and I was just making guesses about effective doses, I preferred to error low. I also had this idea, since I was 16, that running high gave me seizures. Turns out, my Doc says it works kinda the opposite (low = higher probability of seizures).
What do you think about this? Whats your experience?
Hey Tu,
I think of myself as "well controlled" because I have only had one or two certain diabetic hypoglycemic events where I lost conciousness...that I can remember. But, I can distinctly remember skiing the run that they used for the Men's Olympic downhill four years ago, with a blood sugar of 12. I'd never even seen a reading of 12. Didn't know it was possible. Thought meters just read, "LOW.' Anyway, I felt a little winded, but otherwise just fine. Thats not right. Thats not "well controlled."
Hey Anagantios,
I dont really care for managing my numbers and when I was on an insulin pump, it really became an issue where I was concerned for my saftey. The best thing anybody ever did for me was tell me that there was an algorithm for making dose calculations and explain in to me (I'm in the US, where we call them Nurse Educators). I really wish I'd spoken to one at 5 year intervals after diagnosis. Honestly, Anagantios, I was never gonna survive on an insulin pump. But, I got other chronic health conditions. YOU will be WAY better off if you just figure out what your basal rate should be. Having any luck? Dont leave me hanging! Your not gonna go back to having room mates r u? Thats the worst!
Hi Mohe!
I’m not much afraid of lows since I always survived them and grew up not knowing lows caused complications and death. Except the time I was severely overdosed in the Hospital which caused me damage. So ya, I was more fearful of highs since I’ve heard so many complications from them plus death at 25 or 30 when I was young. On the other hand, I always strive for the preferred range which has changed through time but of course due to whatever, it would hit low areas to.
I think long term Diabetes is the main culprit for my Hypo unawareness but yes the lows through the years didn’t help any. I don’t understand why it took so long to get the unawareness. I had a lot more lows for the first 35 years especially before the age of 25. It came on slow. I was wondering how I could be a 2.5(45) and still feel perfectly fine with one symptom or none at all, when before if I was low at least 3 symptoms at 3.8(68), so I could correct it. I had no clue what Hypo unawareness was at the time.
I’ve been keeping my sugars somewhat higher through the last while(on and off again through the years) for a few weeks at a time. I’ve finally noticed some vague symptoms again(sweating and lightheadedness). I test and I'm low. Before, when I lost all the normal symptoms when low, I would get a slight buzzing in my temple areas which indicated that I should test. I thought it was odd but it was always right.
I kinda feel the same as you and have had similar experiences. Always more nervous about the highs. I feel like my body naturally corrects for the lows, a bit. I can really feel the lows better when I'm running higher, but naturally adapt to them and loose symptoms when Im running lower. The body sure does adapt, doesn't it. Amazing how it takes care of itself.
I was on shots for 25 years and have been on a pump for 12 years, and I can't see how pumps are most dangerous than shots. I had much worse lows on injections. Hypoglycemic unawareness as a side effect? I don't think so. I would definitely lower the basal rates, and maybe begin by aiming for a target of 150 or so. Running borderline low for much of the time can cause hypoglycemic unawareness. Try for a higher target for a while and see if hypo symptoms come back. And definitely make it a priority to see an educator.
NO!! Horrible advice. Pumps are not VERY dangerous. They are no more dangerous than any other means of administering insulin.
Stupidity, carelessness, negligence -- these things are dangerous. They can kill you with insulin no matter how you get it in your body.
You low issues will only be more difficult to control on long-acting analogs instead of a pump.
Terry nailed it: Work on getting a correct basal program dialed in. If you're not sure what to do, plenty of advice to be had here, but the support folk at the pump manufacturer are very helpful when needed, and your CDE (if you see one) can also help with this.
I'd add to that adjustments to your CGM, and then strategies to make sure you are awoken by the alarm. Specifically, move your low alarm to 90-100, so it goes off well before you're actually in hypo territory. Put the CGM in a drinking glass on your nightstand -- much louder rattle from the vibration.
And, since it's a low alarm, it'll go off many times before you actually are in hypo territory with the higher setting.