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Late night low

SweetAndBendy

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On nights like this, I'm really grateful to have access to a CGM and a pump that communicates with it. Hubby and I were just thinking of going to sleep when I got a warning of sinking blood glucose levels. I'm currently at 4.0 with downward arrow, something I'm definitely not going to sleep with even with the Medtronic 640G at my side. I'm hungry anyways and am in fact beginning to feel low as well.

 

Now 4.0 isn't very low so I would have eaten something for it even without my CGM and pump, and I always test manually just before sleep anyways to make sure that I'm at a safe level to go to sleep on. But one thing I wouldn't have gotten without the CGM is the arrow, I would only have seen 4.0, but not in which direction my glucose is heading, is it going up or down or is it level? Now I know it's going down, and since I'm already 4.0 and with a downwards trend, the Smart Guard in my pump has kicked in and suspended the basal until my glucose reaches a pre set level again, at which point it resumes insulin delivery. And yes, it suspends at a higher level at night than it does in daytime, simply because it's easier to manage a hypo in daytime than at night.

 

But if I had been asleep now and didn't have my CGM and pump that responds to it, or didn't have a CGM at all, then I could have woken up with a nighttime hypo quite soon, with the risk of having all day tomorrow ruined by a nighttime hypo.

 

As I'm typing this I'm feeling slightly shaky and still heading downwards but my mind is still fairly clear so I don't need to hurry to eat something, and thanks to the pump being suspended I'd likely be fine without eating as well, if it wasn't for the fact that I have some IOB still from a snack earlier and *hangs head in shame* must have taken a little bit too much insulin for it :rolleyes: Right now it's probably the IOB that's messing with me since I keep sinking. But oh well... Things like this happens sometimes, it's just the good old life of living with type 1 diabetes!

 

Now for the big question... What to eat to bring my glucose back up again? :lol: A sandwich and glass of milk? Some cereals with milk? Some candy and nuts? Juice and nuts? I know what I do NOT want at least: GLUCOSE TABS! :wacko:

 

It's taken me about 30 minutes to write this down, as I started writing I was at 4.0 and now I'm down to 3.2 and really beginning to feel hypo... Darn you IOB!

 

Note to self: Remember to set Smart Guard to kick in sooner if having IOB as you're wanting to go to sleep :unsure:

 

Now I really have to eat something! Sandwich and milk it is!

 

Kinda having a diabetic fail tonight :blink:

 

 

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I had to look up IOB (insulin on board - on your pump, that is, no?) - but very educational and a good read.  Thanks!  

 

 

(Not to make it sound trivial, because it absolutely is FAR more complex system, but as I was reading, there were flashbacks from decades ago involving Ogata's Modern Control Engineering book.)

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IOB on the pump is great! It's easier to see whether you need to correct a high or low or if you can just leave it. If you're high and still have IOB your pump may say that you need 0.0 units to correct that high, while without the IOB feature (like on MDI) you may have taken a unit or two and ended up low later instead. And if you're low and have no IOB you can sometimes just leave it if it's just slightly low and not OMG I'M HYPO kind of low, but with IOB you'll need to eat or you'll definitely hypo. 

The pump telling you if you have insulin on board, and it enabling very high precision with small doses is probably the best things about being on a pump :lol: 

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