Hypos at night.

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AlicePalace

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Hi I had a hypo last night it went down to 3.6 around 5am I didn't wake up and it scared me a bit as it has happened a couple of times before.
My question is does anyone else find that when you have had type 1 diabetes for a long time you don't realize when you have hypos in the night?
 
Did you fingerprick to check it wasn’t a compression low @AlicePalace ? Sometimes if you press on the CGM, particularly at night, it can give a false low. Also, what do you have your Low alert set at. It’s best to set it around 5ish so you get warnings of low in enough time to ward them off.

You ask about hypo unawareness - how are you during the day? Do you feel hypos as they approach?
 
No. I was asleep and didn't wake up. Sometimes I don't notice them during the day but my pump usually alarms I didn't hear it go off last night
 
What do you have your Low alarm set at? Do you use a phone or the Dexcom receiver? I’ve got a receiver and it always wakes me, but I imagine phones could lose the signal. I also have my Low alarm set to repeat.

Hypo unawareness is a thing. You can help preserve your awareness by making sure you keep the times you drop low to a minimum. I make sure I stay at 5 or above to keep my awareness sharp. It works well.
 
The low alert is set at 3.8 I have it set to repeat and the urgent low soon alarm. I use my phone they are all on it just didn't wake me up last night
 
I recommend setting the Low alert a little higher @AlicePalace 3.8 is already below target, meaning you’re about to go hypo. The idea of the alert is to help you ward off the hypo before it happens. My G7 Low alert is currently set at 4.8.
 
AlicePalace said:
No. I was asleep and didn't wake up. Sometimes I don't notice them during the day but my pump usually alarms I didn't hear it go off last night
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Are these hypos that you don’t notice during the day checked with fingerpricks? You need to be really careful, if you are genuinely having hypo unawareness you must immediately stop driving and report it to the DVLA as well as getting help to regain your hypo awareness.
 
I think it is not unusual for your body to go a bit lower whilst you are asleep before it wakes you up than during the day when you can obviously spot the early warning signs like your vision going a bit blurry or your legs feeling wobbly. Lying down with your eyes closed and only semi conscious, you are unlikely to be aware of these signs, so not waking up until you are a bit lower is perfectly reasonable, however in my experience sensors often report levels as being lower than they actually are when checked against a finger prick and as @Inka mentioned, they can also suffer from what we call compression lows where, if you lie on the sensor for any length of time it can compress the tissue under it that it is sampling and cause a false low. Usually this will show as a sudden dip on your graph usually followed by a rebound about half an hour after you release the pressure rather than a slow steady decline which is more typical of a genuine nocturnal hypo.

As @Inka says, setting your low alarm higher would be a very wise move. One of the advantages of CGMs is that they can help you avoid hypos rather than alerting you to them oce they have happened. My low alert is set to 4.5 and that works for me but some people find 5 or even higher works for them.
 
Lucyr said:
Are these hypos that you don’t notice during the day checked with fingerpricks? You need to be really careful, if you are genuinely having hypo unawareness you must immediately stop driving and report it to the DVLA as well as getting help to regain your hypo awareness.
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No I haven't tried checking it with fingerpricks. I don't drive at the moment.
 
Inka said:
I recommend setting the Low alert a little higher @AlicePalace 3.8 is already below target, meaning you’re about to go hypo. The idea of the alert is to help you ward off the hypo before it happens. My G7 Low alert is currently set at 4.8.
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rebrascora said:
I think it is not unusual for your body to go a bit lower whilst you are asleep before it wakes you up than during the day when you can obviously spot the early warning signs like your vision going a bit blurry or your legs feeling wobbly. Lying down with your eyes closed and only semi conscious, you are unlikely to be aware of these signs, so not waking up until you are a bit lower is perfectly reasonable, however in my experience sensors often report levels as being lower than they actually are when checked against a finger prick and as @Inka mentioned, they can also suffer from what we call compression lows where, if you lie on the sensor for any length of time it can compress the tissue under it that it is sampling and cause a false low. Usually this will show as a sudden dip on your graph usually followed by a rebound about half an hour after you release the pressure rather than a slow steady decline which is more typical of a genuine nocturnal hypo.

As @Inka says, setting your low alarm higher would be a very wise move. One of the advantages of CGMs is that they can help you avoid hypos rather than alerting you to them oce they have happened. My low alert is set to 4.5 and that works for me but some people find 5 or even higher works for them.
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Yea I think I might change the low alert to something a bit higher.
 
AlicePalace said:
My question is does anyone else find that when you have had type 1 diabetes for a long time you don't realize when you have hypos in the night?
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For sure, yes. As I understand it, it's not unusual for people without diabetes to go to ~3.5 sometimes during the night and if that happened during the day they'd notice.

So as others said, set your alarms a bit higher so you get woken up sooner.
 
Like @rebrascora says, it's not unusual for BG to drop when you lie down and essentially "de-stress" (happens to non-diabetics too). I drop 3 mmol/L every night between 11pm when I go to bed and 3am when I hit 3.5 mmol/L give or take. Interestingly, I thought reducing basal might help but it still happens when I leave the basal out completely. So I just chew on a couple of wine gums and go back to sleep, but you'll need to find your own balance as everyone has a different background of meds, exercise and stresses.
 
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Yea I have a lot going on at home at the moment as well it's been stressful which hasn't helped my bloods neither has the heat
 
AlicePalace said:
Hi I don't normally as I used to have good hypo awareness it just sometimes I don't wake up in the night. I am autistic too.
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You still need to fingerprick for hypos even if you have good awareness. CGMs aren’t accurate at out of range levels, and they don’t keep up with blood glucose when it is changing direction after treating a hypo. So you need to fingerprick when you feel low or when cgm says your headed low and again after you fix it.

Whilst you say your awareness used to be good you’ve also said you aren’t feeling hypos during the day any more so it can’t be good any more and I can’t understand why you aren’t fingerpricking for them
 
Lucyr said:
You still need to fingerprick for hypos even if you have good awareness. CGMs aren’t accurate at out of range levels, and they don’t keep up with blood glucose when it is changing direction after treating a hypo. So you need to fingerprick when you feel low or when cgm says your headed low and again after you fix it.

Whilst you say your awareness used to be good you’ve also said you aren’t feeling hypos during the day any more so it can’t be good any more and I can’t understand why you aren’t fingerpricking for them
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Yea that could be a good idea. I wasn't told that I had to do that
 
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