So I have been using sleep mode on control IQ and I usually wake up at 100-110. My T1 pregnant friend was told to turn off control and run 60-90 at night. She is afraid of night time lows during pregnancy. I am not pregnant but curious if I should turn it off to run in a lower range?? I also am afraid of night time lows but eager to be well controlled overnight as well.
Thoughts?
I run in the 60s sometimes and I’m not worried about that.
At night however, I wouldn’t do that.
I have my ciq tweaked to stay about 100mg/dL. In sleep mode.
I don’t know why any doctor would recommend a pregnant woman to go that low, when most doctors want patients to be in the high normal range, just to prevent lows.
A couple of years ago I went to the doctor, the nurse asked me what my glucose was, I told her 80, and she rushed to get me apple juice.
I said 80 is normal and preferred. She was not freaking out, but was pretty close to freaking out.
This was not an endo appointment, so I know she prob has less interaction with diabetics.
But it goes to show you that doctors generally prefer we are over100 mg/dL so that they can feel better about themselves.
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With CIQ off, how likely is she to stay at 60-90?
I would expect more cgm alerts (if set to alarm outside of 60-90), and manual intervention, resulting in see-saw.
Agree with @Timothy, why such a tight range? What studies show that being an advantage, given also possibly more lows, and less hours of deep sleep.
Can keep sleep and CIQ on, but use alerts to try to make tweaks to stay 60-90, at the expense of interrupted sleep.
Can you tweak the settings?
Do you mind sharing your tweak? Is it running basal a bit higher? I would rather wake up at 100 rather than 110.
Here is another topic that mentions some of the setting tweaks. But each person would do it based on their own situation.
This is a hot button topic that I’m always astounded by. My tubes are tied, so I’m not the target perspective audience for this question… but if I was pregnant today, you would have to pry Control-IQ out of my dead fingers. There’s no other way I’d give it up.
It’s the high-risk OBGYNs that push these low numbers, and have for years, well before pump automation was a thing. I think it’s because they still assume high glucose variability, and if you’re aiming for that low range, there’s room for spikes without danger.
There are ZERO studies published on running in sleep mode all the time, let alone any on doing it while pregnant. This is all still quite new. I don’t think the OBGYNs understand what it can do. They just know what many of us already know… That default Control-IQ as indicated is “too little, too late.”
Few doctors really understand the constant struggle for control. They think it’s just non-compliant behavior that makes for the ups and downs, and that they can scare us into better behavior for the health of the baby. I don’t believe a single one of them can comprehend the difficulty of maintaining that range safely (while battling pregnancy cravings and a hormonal tsunami, nonetheless!), unless they’re diabetic themselves.
Sleep mode is life-changing, in my personal opinion. It enables a degree of control I never imagined possible. No, I don’t think it’s perfect, but I do think it’s far and away the best current option. If my choice were between the additional burden and stress of trying to maintain 60-90 all on my own (and knowing I would fail to maintain this range and the accompanying guilt that comes with risking another life every time I fail) or running CONSISTENTLY, safely, and only marginally higher in a still gluco-normal range with low glycemic variability… I’m going to choose the latter.
The doctor can’t show her data comparing successful births with sleep mode vs this 60-90 target. They don’t exist. The doctors know that historically pushing this range has worked out best for their patients. It’s going to come down to your friends personality and what she (and her partner) trusts in. Only she knows her fears and personal limitations, and how much faith she puts in the doctor’s experience and knowledge over her own.
I know that sleep mode gives me diabetes super-powers I don’t otherwise possess on my own, and I know that deeply enough to make such a decision easy for myself. Unless the doctor can produce some data significant enough to shake my beliefs, of course…
Has she considered DIY looping maybe instead? I’ve never tried it myself, but it does allow more custom variables (like a lower glucose target) than the current iteration of Control-IQ.
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I currently turn off Control IQ for most of my daytime hours but when I use Control IQ, I use Sleep Mode.
I have never been able to figure out settings that don’t reduce or suspend my insulin resulting in highs afterward. I can keep in a good range 85-110 or so for hours without Control IQ. One reason is that no Control IQ gives me 30 extra points (80-110) with no basal adjustments. Plus I really like the ability to do Temporary Basals because I can predict my future activity better than Control IQ.
Once in a while I forget to turn back on Control IQ at bedtime and I have better numbers without it. But I appreciate the protection from lows and think that Control IQ keeps me safer.
If you want lower sugars in sleep mode:
Decrease your correction factor/ (sensitivity)
Change your weight to 20% more than you are
Increase your basal rate by a small amount
It won’t keep your insulin from shutting off at 112, but it will kick in faster afterward, and keep you from ever getting back to 112
I am 190lbs my pump thinks I am 240. And my correction factor is 20:1 at night but I make it 15:1.
Then I change my basal rate up 10% ish . For me it’s usually .8 and I push it to .9 per hour
I would make these changes slowly so you don’t crash.
And you won’t draw a flat line like when your settings are set correctly.
I wander between 95 and 105 at night and usually wake up at 100. You will see your insulin go from zero to your highest setting.
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