FUDiabetes

First night without a sensor in 2.5 years


#1

Samson’s last G6 sensor failed at 9p last night, and his three-month supply is supposed to arrive today. We were completely out, so for the first time since April 2016, we went an entire night with no blood sugar readings from a CGM.

I lucked out; he had eaten mac n’ cheese and ice cream for dinner, which typically requires secondary boluses later in the night. We decided to just go with the protocol we’ve used in teh past and hope it worked out.

We tested about 4 times.
At 9:50 p.m.he was 121 mg/dL
At 11:30 p.m. he was 158 mg/dL
At 12:30 a.m. he was 154 mg/dL
At 3:00 a.m. he was 208 mg/DL – I decided to use the bolus wizard and gave 0.2 units
At 5:30 a.m. he was 151 mg/dL – We woke up then.
At 7:00 a.m. he was 45 mg/DL – He’s eating an English muffin now.

At night it was all mostly okay and while he was a touch higher than he would have been with openAPS and his CGM running, at night we would have slept through most of those numbers and not corrected, so this was okay.

But then it all went wonky in the time between 5 and 7, and I know for sure he wouldn’t be 45 mg/DL at 7am with a CGM.

Anyways, I’m curious for those who don’t use CGM, how often do you test at night? And how often do you think is the bare minimum to be safe?


#2

We usually test before he goes to bed at 7pm, then around 9pm and 3 am or whenever we wake up in the middle of the night. We do MDI.

Dinner is around 5pm, so the 9pm test is usually at the end of the meal bolus so the rest of the night the impacts will be either just the basal insulin or hormones.

As to safety, if there is only basal insulin on board and you did not do any crazy exercise that may cause a BG to crash, I think every 4 hours is just fine.

Ok now the old folk talk… when I was a kid we never tested at night and look at me. I turned out just fine :laughing:


#3

Ok now the old folk talk… when I was a kid we never tested at night and look at me. I turned out just fine :laughing:

I bet you walked to school 3 miles each way in the snow too, haha!
But yes, it really is amazing that people would go hours and hours with no idea of their blood sugar levels and things mostly were okay. But my guess is they’re running a lot higher than Samson usually does.


#4

@TiaG, every few weeks we spend a night without a CGM. The results vary.

  • If there is no hormone peak late evening, and dinner post-prandial is as expected, we do the same as @Aaron: test and calibrate before bed (more like 11pm), test around 2 and 5.

  • If we are recovering from a hormone peak, we have lots of IOB (it can be 15-30 units for a peak), then we may test 20 times, typically more early on. Eventually we make it through the insulin tail and only test every couple hours, but that may not be until after 3 or 4am.


#5

Yes - I used to go to bed with a bg near 140 because the evening NPH shot peak would bring me down overnight.

Back to your comment if we correct or are having problems we test more often but that is the abnormal case. The schedule above is if everything is fine.


#6

Yeah I guess in this case it was a little bit of a gamble because both ice cream and mac n’ cheese require late boluses, so they ate around 7pm and he needed a second bolus at 10pm… which is the part that always makes me nervous, to go into the night with some IOB.


#7

Don’t forget that sometimes sleep is important too, you could always trade one high night for not giving that 10 pm dose. Then your nerves would be calmed.

Also, after my son chose not to have his CGM for a week, and took a pump break for a month this summer, I am really surprised at how much confidence both of those events instilled. He now feels more in control of everything.

Of course, you are years away from needing to do this for your son, but it is worth remember when your son gets older.


#8

Honestly, having him be high all night makes me so anxious and unable to sleep. And the few times we’ve slept through high alarms, he’s had moderate ketones which makes me think something is wrong with his site. For us, spending more than about an hour or two above 250 or 300 makes me really uncomfortable because I always wonder if something is up with his site.

I do think we’ll do a pump break at some point – my thought was maybe to go on something like a Hawaii vacation ad sign Samson up for a daily swim camp – and that seemed like a good time to do a pump break.


#9

I understand, toddlers and teenagers are a world apart, but when he is a teenager, hopefully the algorithms will be there to prevent the highs. For us, 400 makes us nervous, and with growth hormones we unfortunately hit that a couple of times a month


#10

I only test at night to calibrate my Dexcom 5 unless I wake up feeling weird and that feeling doesn’t agree with the CGM reading.


#11

…So we got our sensors yesterday and here’s last night compared to the night before. So while the overnight was not bad on finger pricks, it’s sooo much better with openAPS and a CGM:


#12

As a suggestion, @TiaG - you might have another sensor fail tonight, so you end up with a backup sensor… not that I condone such things :wink:


#13

Let me answer the second question first. In my view, I think a CGM is needed to be safe. Before CGM, on MDI, I would wake up once in the middle of the night to take a measurement. And I had 2 results. One was that I would wake up a couple times per week with BG around 40. This shows that I was in danger, despite measurement before sleep, once overnight, and immediately on waking in the morning. The second result was an A1C 0.5% lower than it is now, because of all the lengthy overnight hypos.

I had a similar amount of overnight hypos a couple years ago when insurance troubles delayed my reorder of sensors for a month.

My advice is to restart sensors and transmitters when possible, with the goal of building up a surplus of supplies so you don’t have to do without. And in a pinch, know where to borrow supplies if necessary. (In my case, I’d call the CDE at my endo’s office, who likely would have a sample that I could have and later replace when my shipment arrived.)


#14

My advice is to restart sensors and transmitters when possible, with the goal of building up a surplus of supplies so you don’t have to do without. And in a pinch, know where to borrow supplies if necessary. (In my case, I’d call the CDE at my endo’s office, who likely would have a sample that I could have and later replace when my shipment arrived.)

With the G5 we were awesome at doing this – which is why we probably have three to four months’ worth of G5 sensors sitting in our supply closet. Unfortunately the G6 just hasn’t been working well for us; it’s pretty much failing by day 5 and from day 1 has one- to two-hour data blackouts at night. We’re hoping to switch to a new body part to see if that works better but ultimately will switch back to G5 for a spell if we can’t figure it out (but obviously that’s not a long-term solution as Dexcom is aiming to phase out production of G5 at some point).

In any case, yes! That’s what we aim for, we 100% always restart the sensors if we’re able to. That’s only been possible with two out of the last thirteen G6 sensors and that too, only for a day or two.


#15

I’m truly sorry to hear that the G6 is working so poorly. That is disappointing news, and I hope it gets better.


#16

image https://i.pinimg.com/736x/b6/b2/df/b6b2df1145233b4f6da1e677ecd1d866.jpg


#17

Best graphic EVER! ROFLMAO!!!