This is good to hear about being able to crawl to carbs- I always imagined having a seizure or passing out and not being able to move. Thank you!
I used to wake up when low. Now I don’t. Which was proved when I wore a continuous glucose monitor and showed three straight nights of blood glucose readings in the 50 mg/dl range. No need to freak out, just made changes to basal insulin.
As always, this group gives great advice on 1) taking the fear out of lows, 2) having glucose handy, and 3) checking blood glucose levels if you do awake during a night-time low, but … don’t those severe night lows give you huge rebound blood sugars later?
Extreme volatility in blood glucose levels puts much wear-and-tear on nerves and blood vessels and may have more to do with the development of complications than we realize, even with good A1Cs.
Thank you so much! I haven’t yet tried the glucose tabs (for the same reason, I love candy and once I start, I can’t stop!), but I’ve been close. I might try a little piece the next time I think about it and I’m low, or near low.
I keep tubes of glucose gel on the nightstand. If you aren’t up to chewing the glucose tablets, you can swallow the gel.
I prefer fruit punch flavor 
Smarties work great too!
I would increase my bed time target to 130 (which we do for my niece if we feel tired; we get up a few times every night to check, but if we feel tired we run her higher, just in case we sleep through the alarms). I would also try a product called “Nite Bites” there are others that were specifically created for hypoglycemia or mix 2 tablespoons cornstarch into yogurt before bed, which will do the same thing as the Nite Bite. If you are low overnight, you reduce the long acting insulin or the basal on a pump. The rule given to us initially is if you have one low reduce Lantus, and if you have a pattern of three highs, increase it. Same would hold for a pump. Usually, if you go low during the night, your liver will kick in glucose and you will have a rebound high blood sugar and be high the rest of the night. If you have had lows during the day, your liver must replenish it’s glucose stores. In this case, take extra precautions and run your target a little higher still, maybe 150, eat the snack, or set your alarm to 2am to check your blood sugar (or have Mom do it). This is also true for exercise; if you have had a lot of exercise during the day. For both lows and exercise you must replenish your glucose stores. We still always check during the night to catch lows and highs, as she is not stable at night. But she has been 50 more times than I can count and even 20 a few times and she has been fine. Knock on wood, nothing has ever happened. And you will be fine, just take the proper precautions.
keep some skittles in your pocket. Keep a jolly rancher in your hand. BETTERR yet, wear a candy necklace. And no more fear of high blood sugars! Blood sugars are just numbers to help you make better decisions next time. I’d rather be high then low, being low is quick and dangerous.At least highs are manageable
i slept through a a low the other day. In my dream i was treating it with some delicious double choco cookies. I woke up all yucky and was very disappointed i didn’t have the cookies to fix my low! Darn dream, tricked me again.
With eyes closed I start to see lights or stars when it is going slightly low you can pop a few glucose pills beats going to the fridge where you will eat all the contents. My main problem at night is highs at 10 mmol/L I tend to have vivid dreams and then I can hear my heart pounding in my ear which makes it horribly difficult to fall back asleep. Lately I have been injecting insulin in the dark when this happens and it does help to fall back asleep.
Dont worry too much about nightime lows your body will let you know if it thinks you are going very low. Try to recognize what you see with eyes closed and what you feel when you are low. This help build low awareness. You will certainly not die unless you drink a whole bottle of scotch before bedtime then all bets are off.
First of all, you won’t fall into a coma from lows. Worst case scenario, you’ll get a seizure, which will then cause your liver to excrete tons of glucagon and you’ll wake up/come out of it when your BG is high enough to allow you to do so. You’ll probably feel a bit sick to your stomach, your head might hurt and you’ll definitely be very confused for the first hour or so, but you will not fall into a coma and you will NOT die. I’ve had dozens of seizures in my sleep from this exact reason. They’re pretty scary, no doubt, but I just wanted you to know that you won’t die from them. The most important thing to remember is DO NOT GET UP - because that’s when you can fall and get hurt really bad (I did once and needed surgery to repair my shoulder - another time I fell and broke my two front teeth!). You’re really smart to keep glucose tabs next to your bed, but you might also want to get gel because it’s easier to get into your mouth and just swallow without having to chew. 9 times out of 10, you’ll wake up from the sweat alone (I do)… but as someone mentioned, I think you’d be a great candidate for a CGM - I have one and while I have had a couple of seizures while using it, it has helped me tremendously. It also helps to make sure you have NO insulin on board right before you go to bed. You have to remember that your BG is bound to drop when you are fasting/not eating all night. Also, if you are taking Lantus, it does peak a little bit. You might want to take it in the morning instead of night… or at least have a 15g of carb snack right before bed (I used to have a cup of milk and a graham cracker - something light like that) just to ensure your BGs stay up there. Good luck!!
Danny.
It is a good feature to feel the low comming. Also when I am lying down I can feel if the BG is above the normal range with heart pounding in the ear. Quite accurate too.
i think you dont need more advices
just dont think about it.i was like you but it’s
ok.
i red your blog…since you are getting a pump
you may considre a CGM
wich what my endo decided to do before i
get a pump
and have good luck
I have had more sleeping low blood sugar episodes than I can recall. Usually I just stagger to the closest carbs, wherever they may be.
My younger brother, who was diagnosed with T1 at 30 was just found dead in his apartment. He struggled to control his T1 for a long time and I suspect it had something to do with his demise. I have been searching for information regarding low sugars while sleeping.
Do you know where you got the idea you might not wake with a low? I only recently heard about it being an issue. Mind you I have been doing this for 30 years now and it hasn't take me out yet, for what that is worth!
Oh Dean, so sorry for your loss.
My Mother-in-law was a nurse for all of her life, she handled hundreds of type1 Diabetics. She said that she had come in to work many times in early morning shift and found T1's dead from an apparent low overnight. Low BS is dangerous, day or night, but at night you are not aware enough of the issue to cover it with carbs, and your system may not be able to provide enough glucagone on it's own.
With pumps, you are much less likely to have severe low's unless your Dr is proscribing for something that he may or may not have direct evidence for your case. My Dr insisted on prescribing higher doses during early morning as it is the 'new fad' for care for T1. Well, I personally have always had the opposite, I have always been extra low in the mornings, I tried it his way for 3 days, woke up with low sugars all 3 times. So, I changed the basal to go lower in the morning with a higher bs goal as well. No more issues for me.
Each diabetic is different, each absorbs or not, his/her insulin at a different rate. Some are super sensitive others require extra insulin to get the same results in lowering sugar. No one can follow all the different formulations and must adjust to how their own body reacts.
Long acting insulin types have ALWAYS been a problem for me, my rates of absorption have never been close to the 'norm'. I have always had lower bs in mornings, so I must force any new Dr I get involved with to LISTEN to me when I state something about how I react. They do not, can not, know how my system will react just because they have x-years of training and/or experience. If they refuse to actually listen to me, I find a different Dr. It is MY life, I have lived it for the past 51 years... Not them.
Where I live near Scranton, PA, the Dr's up here think they are gods, and if you don't do exactly what they tell you to do they will walk away from your case... well, turn-a-bout is fair play, if they refuse to hear/listen to my responses to their inquiries, then I refuse to deal with them and find a different Dr that still has a soul left inside somewhere.
Hi Dean, I'm very sorry for your loss.
I do worry about sleeping lows also. When I first got out of the hospital, I was waking up in the 40's- my basal was way too high. I still get them, but not as much now. I think ala was causing more and I reduced my morning basal again. Most of my bad lows have been while awake due to errors. I usually wake up around the 50's and I have never felt unable to treat it, but I keep candy/juice all over the place just in case. A bell by the bed sounds like a good idea. I often eat some nuts and cheese before I sleep to help stop lows while asleep. If I had a pump I would lower my basal.
I agree, we're all so different, we just need to do whatever works best for us.
Thanks everyone. I only heard about this recently. I suppose I have always known it was a possibility. Though for me, lows at night have always woke me up, usually with a very uncomfortable feeling that sends me to the closest food I can find and ultimately with a high sugar by the time I wake up, if not sooner. Just always figured my body would wake me with that instead of just drifting off, but suppose there are worse ways to go. He was only 43 though.
Dean, can you talk with your doc about getting a CGM?