My daughter is 19 and finishing her second year of her nursing degree. She lived in residence the first year and this year was in a house with 5 other nursing students, which she really disliked. We are about to sign a lease for an apartment where she will be living alone much of the time. She loves the idea of having her own space where she can live a more healthy and mature life. However, I am having a middle of the night worry session about her living alone with her T1D. She has a tslim x2 with control iq soon and a dexcom and I follow her religiously. Can anyone give me some tips and ways to keep her safe - especially overnight? I’m a worrier, but we feel strongly that living outside of party central will be so much better for her all around. She may have a roommate, but nothing confirmed. Any ideas appreciated - especially ones that can peel me off the ceiling!!
The Dexcom had a Follow app so family can see the numbers of the CGM, as well as get notified for lows, as well as other changes.
Oh yes, I’ve been following her since she got set up with dexcom. I was thinking she could set up a dummy follower on an extra phone and keep it plugged in in her bedroom with the alarms set at full volume in case her phone volume is turned down too low to wake her.
An iPad can be aesthetically attractive option. We have a higher number than usual of tech devices, and although I often recycle or give away old equipment, I usually repurpose my iPads. Right now, I have one on my stereo to use as an alternate remote and app controller, replacing one I bought back in 2011 and only recycled last year.
I think if she has a dexcom she’s going to be fine. It will alarm loudly at 55 and it can’t be silenced.
The only thing I would add to the mix is having a follower who lives near her.
A friend or a mentor or something like that.
When you are far away and she doesn’t answer her phone you might get anxious.
If someone lives near by and can stop in, it would be some peace of mind.
I somehow lived alone many years from 20 to26 when I got married. There was no cgm
My daughter will start college next year. She’s not diabetic but I still worry a lot about her.
It’s kind of normal, most of us make it through.
Well, I must say this is a perfect parent worry!!! My parents were worried sick when I went away to school in 1980 with no technology. Of course we trained everyone on my dorm wing on what to do and what to look for.
Now, with all this technology this is so much easier. Your worry will never go away. I still worry about my older kids! But as long as she is cool with you monitoring her remotely and there is a trusted neighbor who has a key in case you get numbers that worry you and the neighbor can go check on her.
But with her new technology, she should be fine. This is how she has to live now. It’s her disease and she needs to handle it. I will say, since using a CGM, I have not had to have anyone help me with a low.
So, take a deep breath and be happy she is moving on with her life! It sounds like you have raised her to be a responsible adult. I think you both got this.
You sound like a good Mom
Just read through the discussion, and only thing I can add is that I live alone, and my Mom follows my Dexcom data. I sleep with glucose under my pillow so it’s right in reach, and I have a landline telephone for which only my Mom, Dad and Sister have the number to, and are ONLY to use it if they can’t reach me by cell. We often have to turn our cell volumes off in today’s world, and also cell’s can die or break at anytime. The landline is for these types of situations. I’ve had mine ring middle of the night and I slept through my dexcom alerts, and my cell was on silent so I only awoke to my Mom’s call on the landline. It was like $75 for the phone, which I keep right beside my bed, and I think it’s like $10 per month for the landline number.
My Mom and I try to find the balance between letter her be as involved as makes her somewhat comfortable, but giving me the space and independence to handle everything on my own, as if I don’t do that and rely too much on her I’ll be in a bad way without her. One thing we agree on: she’s not allowed to call or comment on the highs, only the lows to which I don’t respond/correct within whatever time frame I chose on my Dexcom share (I think it was like 15 mins or something, but I can’t remember and it’s just what works for us). This way I don’t feel judged or have the urge to stop sharing if I don’t want her to see the highs, etc.
Good luck!! I think she will be fine:)
For those who are using a pump but are not using a form of loop or are not using a pump that has basal rates integrated with their CGM, there is a simple thing you can do to help provide a safety net for nighttime.
It’s pretty easy to setup.
Nighttime/sleep time is the most dangerous time. You can be low and not wake up. And without an integrated pump, it will keep feeding you basal.
Here is what you do.
Pick a time when you should always be awake. So if you are working or in school, let’s say for this example that you think you should always be awake by 8:00am.
Setup your basal rates to be turned OFF from 8:00am to 11:00am. (Or whatever the lowest basal rate on your pump is. Like for the older version of OmniPod, the lowest basal rate you can set in a program is 0.05 units per hour.)
Create a 3 hour extended bolus that matches your basal rate. To make the math easy, let’s say your basal rate is 1/2 unit per hour. You would create a 1.5 unit extended bolus that lasts 3 hours. That is the same amount of insulin over the same time. It is the same rate as your normal basal.
So when you wake up at 8:00am, you hit your 1.5 unit extended bolus that lasts 3 hours. Most pumps have alarms, so you could even set an alarm on the pump to remind you.
This extended bolus is basically your basal for 8:00am to 11:00am!
What happens if you don’t wake up because your BG is too low and you are in a dangerous hypo-sleep?!? Well, you won’t hit your extended bolus (basal), so you at least won’t be getting any basal during that time. And it will be for 3 hours, which should help you get back to somewhat normal BG.
Pretty simple to setup. The only thing to remember is to do your extended bolus (basal) when you wake up. And if you set the pump alarm, you won’t forget it. And eventuality it becomes a habit and is easy to remember. And in cases when you don’t wake up, at least your won’t be continuing to feed basal into your body.
That’s awesome advice for pumpers Eric!
Have to admit I’m here scratching my head how anyone thinks pumping makes them safer unless they’re a virtuoso like you… but as long as people believe that they need to know the tricks like this
An alternative option that I use on pump is auto-off. This lets you set a number X hours, and if no button presses during last X hours, you get alert and pump stops all delivery.
I did this on medtronic 523/723 pump, and now do same on Tandem X2. On Tandem, it is set up under alerts. I set mine to 12 hours, although may set shorter/longer time in some situations.
Since many use “aggressive” pump settings for better bg limits, the X2 pump may give excessive basal when dexcom is not providing bg value. (C-IQ would normally decrease basal IF it knows bg is trending low).
Anyone know how Loop handles this??
I wish X2 had option for a default basal setting when no cgm bg available.
I use a free app called Sugarmate. It can be programmed to follow your CGM and also programmed to call you when you are low. It is the first alarm that I get as it alerts you to a predictive drop, and not just a low. Well worth the few minutes it takes to install and set up.
If I understand your question, Loop falls back to the settings programmed into the pump when Loop fails (Loop turns red) like when the BG data from the CGM stops or Loop loses communication with the pump.
The Loop will turn yellow after a 5 minute communication gap with the pump or CGM and then red after a 15 minute gap in communications.
Loop works by setting 30 minute temp basal rates for the pump and it can set a new 30-minute temp basal rate as often as every five minutes.
If the Loop turns red, it no longer sets any temp basal rates but the last temp basal rate Loop set before the red Loop will time out after 30 minutes. Then the pump just acts like a stand-alone pump.
The regular (non-Loop) OmniPod has this too.
But unfortunately instead of just stopping insulin delivery (which would make sense), it deactivates the pod.
So then in addition to whatever other troubles your low caused, you also have to activate a new pod too.
That’s a bummer!!
I do like and use the auto-off setting, but fortunately have only had it shut down a couple times when I overslept. (Eg, no button presses on pump during past 12 hours, particularly with early dinner and no evening snack.)
However, now with checking Tandem screen for cgm bg, I doubt I will get a false alarm.
The OmniPod auto-off setting seems like such a lost opportunity for a great feature. Don’t know why they didn’t just make it turn off delivery instead of deactivating.
And yeah, it’s hard to imagine going 10 hours without some interaction. Unless I’m in trouble.
But I guess auto-off is still another option for the concept of the post.
If she ends to drop which I do then suggest she makes sure her BS is at a certain number before bed. If I am not at 130 I snack before bed.
I don’t understand what you mean by this. The X2 will infuse whatever amount that your basal rate is set to be when your CGM is unavailable.
Yes that’s right. You set all your basal rates. The algorithm makes adjustments when you enable it. If it loses connection w cgm it defaults to the settings you originally made.
So let’s say you are SLEEPING, and basal profile is .8, but currently CIQ reduced to 0 due to cgm dropping. (Maybe you had a very active day).
Then pump loses cgm, and returns .8, and now BG goes lower and you may pass out. Auto-off will kick in to hard stop all delivery, when X hours passed without pump button press. Then with less/no insulin, bg should start to rise.
It’s most helpful for those living alone or travels frequently staying alone in hotels.