how did you guys deal with middle of the night/early morning hypo alerts when your significant others/family members couldn’t sleep because of it?
Also, how the heck do you fix a 3am hypo? Any advice is warmly welcomed!
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Personally, I’d recommend getting an Android phone (ie Samsung Galaxy S9+, many others work in case you don’t have one) and installing the Xdrip+ APK, this application receives the dexcom signal and allows the snoozing of alerts. As for preventing 3am hypos, it kinda depends on what insulins are being used, when they are being used, carb patterns before bed, and overall how tired you are feeling.
I also like having the android phone send the signal to a Pebble Time (a number of other smart watches work just fine too although I’ve only tested a few) watch that way it can be snoozed by pressing a watch button.
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I have the OnePlus 8 5G through T-Mobile, unfortunately it’s not compatible with the Dexcom app. So I’ve been using my old iPhone XS Max for the Dexcom app. I could silence the phone at night, but I’m just worried I’ll miss a severe hypo and that could be dangerous.
Currently on 20u of lantus solostar. I inject at 10pm before bed. I did have a steep incline from 99 to 164 last night after I had a fun size mounds (whoops, couldn’t resist) but most nights, throughout the night… I’ll have steep lows and I wake up to 45-60 mg/dl fastings. I’m sure my Endo will be able to work on this with me when I see him for my follow-up, now that I’ve given him an invitation code for my numbers. He’ll see where I have my hypos and drops and find a regimen that works better for me.
I’m also awaiting a delivery in my mail for humalog and glucagon. So perhaps with a short acting introduced I can inject less basal and that may correct the late night/early morning drops.
First thing, if you can, download the latest Xdrip+ apk and install onto the oneplus 8. In the settings, you can configure dexcom as the source and give it the transmitter ID. It’ll start picking up the signal from the transmitter. The documentation is very good so it doesn’t take too long to get up to speed. It looks like it works with Dexcom Share but I haven’t explored those features.
I’ll have to go back to my notes one when I used Lantus (I recently started pumping), but I think 10 pm is a great time to inject. My general strategy was to taper humalog doses in the afternoon until the number was at a good place before bed and their wasn’t much humalog in the system, along with making sure my body had a steady supply of small protein snacks (adjusting the BG via carbs if necessary). I’ll edit this with a few updates…
When using Lantus (these are my numbers and they’d adjust for how they were working out, yours are probably different…not exactly sure when the 10pm dose from the night before would wear off…I’m guessing it might be peaking around 3 and causing the number to drop in which case 19 might be good), I’d take a humalog dose of 2 at 5:30, 1.5 at 6:30, 1 at 7:30. Ideally, at 10 pm, the number is at a good place and the humalog is mostly out of the system. If I woke up early in the morning I’d take a small dose to counteract morning blood sugar rises.
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@Necroplasm
My husband hates the alarms as well. I’ve had the CGM for almost a year, and he’s learned to mostly ignore it, unless I don’t wake up by the third alarm. Then all heck breaks lose, and he’s there with a juice box, shaking me. Then I’m up, checking on my meter, and calibrating if its just the CGM being wonky. (That’s the only time I calibrate, to make it shut up!). I just use the dexcom app, and the only night alarm I leave on is urgent low, because that’s the only one that really matters at 4 am.
Hopefully SOs and family will learn to not freak out at alarms. But it may take a while.
(Oddly enough, I did figure out the main source of my 4 am lows, and it still baffles me. If I have my favorite bedtime snack, 2 fun size snickers, around 9 pm, I will always go low around 4 am. So I stick to 1, and I’m fine.
)
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This is all solid info, ty. I will look into xdrip+ sometime today. Will it mess with my sensor or transmitter to open the data on a new phone? Just curious as this is all still very new to me.
Will keep those numbers in mind for when I get acquainted with my humalog pens. I have been tapering down my lantus from 24u a night for a few days now, 2u at a time each night. My Endo suggested the gap of 18-24u so perhaps I shall try 18u tonight and see if my hypos are still so drastic. Will keep you all updated on this as it is very annoying lol.
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Welcome, I’m sure some of the others will hop in and have great if not better info too. Overall, it took me at least 25 years to develop an approach that I like, and I’ll do my best to convey it.
In general, the dexcom transmitter likes to connect to only 1 or 2 things. It is possible to start the session with either the phone app or the dexcom app and to switch mid session although not sure how that situation works out with their online app services (it seems like it would backfill).
This is something I write on this site a lot, but for treating lows I generally take 4 sips of this mango juice and then swish mouth out with water so the teeth are less affected. https://www.amazon.com/Langers-Organic-Nectar-Alphonso-Mangos/dp/B07FTT852B/ref=sr_1_4?dchild=1&keywords=langers+mango&qid=1623605748&sr=8-4
It helps me to hopefully raise the blood sugar by about 60 mg/dl as opposed to going high after. Some carbs make things skyrocket immediately so I try to avoid those.
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It may have very well been that dang mounds bar lmfao but I normally feel I drop super low in the wee hours of the morning. It’s weird, I didn’t wake up to my alarms either. But he did haha.
As far as urgent lows only, that was the only alarm I had set. So once it started around 5am I was already at 69 mg/dl and it just kept going off from there. It was 46 mg/dl by 7:49am and shot up a bit to about 53 mg/dl by 9am when my poor Fiancé had finally given up the thought of more sleep. I fingersticked this morning and it was accurately that low. So I do need to do some tweaking still with my lantus I presume.
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One other feature for XDrip & Android phones, you can set a silent time at night, so most alarms won’t sound unless they have been excepted.
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My wife uses earplugs (there are some kinds that are comfortable) because of all kinds of noise, but an “urgent low” alert from the CGM overnight should not be common, and it is easy to fix.
In the short term, I fix a 3am hypo by chewing a couple glucose tablets. They kick in really fast so I’m not getting repeat alerts for any significant time. I always have a roll of glucose tablets with me; that plus the CGM is what keeps me safe all day long.
In the longer term, I fix a 3am hypo by adjusting the basal so that my BG is not falling during the night. I find that I need basal adjustments a few times per year. Some of the women here report that they need to adjust the basal every month around their period. There’s a good thread by Allison on that topic.
The glucose tablets would have fixed it within about 15 minutes. And that would have solved it for the night if your basal dose is right.
With the Dexcom app on an iPhone you can set an alert schedule, to suppress all the routine alerts and only have the severe low alert sound (plus rare ones like transmitter failed.)
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While my spouse has access to my XDrip readings, she only gets alerts for rapid drop, urgent lows, and non-responsive (alerts) on her phone. It has kept me out of the ER more than once
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You’re right, those are more fun… When you have the ability to bolus.
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When I used Lantus and took it at bedtime, I almost always went low about 3 a.m. due to its slight peak, I think. So maybe consider talking to your endo about changing your dose timing?
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That’s definitely an option, I notice when I take 20u instead of 22u, my usual dinners raise me to about 150-160 mg/dl. So lowering my basal dose only seems to make it taper earlier, and doesn’t really change the lows I get - which 80-90% of the time are when I sleep in and don’t work. This morning I caught it at 68 mg/dl and I’m not even sure if that’s accurate. I didn’t get to fingerstick confirm until it read 75 mg/dl on my Dexcom, and the trusty fingerstick said 77. Which imo is a healthy fasting.
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I read through this thread kind of quickly, but have you considered splitting your dose of Lantus? I had better results when I took some at bedtime and some in the morning - not necessarily split 50/50, but whatever worked best for my blood sugars. Also you could consider switching to Tresiba, which has a much flatter/consistent peak.
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I will see if I can split the dose, that’s a great point! Unfortunately I have just received a 58 day supply of my lantus, but I will definitely ask if a different basal would be best at my follow-up with my Endo!
Unfortunately I think a lot of the change will occur when Optum decides to stop d*cking me around over my Humalog. I was recently diagnosed T1 and have no bolus insulin yet. Order says “processing” via my optumrx app, not sure why it hasn’t been readied for shipment sigh.
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I agree with allisont1 on the tresiba recommendation, I also wanted to recommend lyumjev or at least look into it if you are in the u.s. its a little quicker than humalog and seems to have a shorter lifespan (seemed like humalog peaks at 3 and 6 hours, where lyumjev is closer to immediately and 3 hours depending on your starting glucose… ). my Cigna insurance (u.s.) has the copay the same for lyumjev or humalog…your insurance might prefer another brand like novolog but the price may be the same…also with xdrip you can use different MP3 ringtones for different alarms (high, low, predicted low, persistent high, etc)which might be a little less annoying for your fiancé…
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These are all very good suggestions!
I will look into Lyumjev. Unfortunately novolog was the initial RX, not covered. Humalog is coming up $80 smh. I’m pretty sure my ins through work isn’t this crappy… I chose a buy-up plan for this reason.
I’m pretty sure if humalog costs you $80, lyumjev will cost the same… the lilly reps are being very aggressive and will probably help with optum if they haven’t already… just make sure to tell them you are on a pasta diet and use about 120 units per day so you have enough
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