Hi, my son is now 19 and in first year at uni. Not local. He's had type 1 since age 9. Now 19. A couple of years ago he stopped waking to nighttime hypo's and qualified for a pump so is now on Omnipod and Dexcom G6 which has certainly helped the situation but isn't foolproof. Whilst he seems to be responding to hypo's a little better there are still odd times when he sleeps through the Dexcom alarm. I'm hooked up on the system to 'follow' him so I get the alarms too and respond with telephone calls to wake him or to university security to do a welfare check. Anyone else experiencing similar and any ideas re the sleeping through ?Thanks, John.
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Sleeping through nightime hypo's.
- Thread starter johnboy61
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Hi John, I noticed you don’t seem to have any replies to your questions. As I don’t have any constructive advice I thought I would reply to get your post back into circulation. I have children of a similar age and this must be very concerning for you. would be good for you to get some feedback. Hope alls well with your son at the moment and he’s enjoying uni life
Bruce Stephens
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I know there are some pumps with special features (when you also have a CGM) to protect against hypos. Presumably the Omnipod isn't one of them? (Which is a shame: surely they all ought to offer that since it's an obviously helpful safety feature?)
Unfortunately, these are usually over sensitive and turn off basal at higher levels than most of us want to run. I think the Medtronic turns off basal at 6.6 mmol/l. I understand why they are extra conservative but it has put me off adopting it.
@johnboy61 would it help if your son had a watch that vibrated or a tablet at the side of the bed that is louder than his phone?
Inka
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Hi @johnboy61 I don’t know if this is relevant to you now because it was a few years ago, but a friend who had a similar alarm which sounded and also vibrated, put it in a glass by her bed at night as apparently when it vibrated it rattled the glass sufficiently to wake her.
Does the Uni have a special system set up to help your son? That is, a fail-safe emergency procedure?
And is your son receiving help to reduce the nighttime hypos? My pump basically sorted mine. It might be that his basal rates need looking at. They can change a lot over time, and then change back again, so need frequent tweaks. It sounds like things could be improved a little if he’s having hypos regularly.
Does the Uni have a special system set up to help your son? That is, a fail-safe emergency procedure?
And is your son receiving help to reduce the nighttime hypos? My pump basically sorted mine. It might be that his basal rates need looking at. They can change a lot over time, and then change back again, so need frequent tweaks. It sounds like things could be improved a little if he’s having hypos regularly.
Bruce Stephens
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Yes, that's really important.
I think there's a mechanism making it easier for us all to sleep through nighttime hypos than those during the day, but spending time hypo usually makes awareness fall which makes that even worse. So trying to avoid the hypos as much as possible can improve awareness which may make it less likely he'll sleep through them (though that can still happen).
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FWIW, predictive low glucose suspend (Medtronic’s Smartguard on the MM640G) reduced my low-level hypos by 90%, with no real increase in high levels.
To put a bit of flesh on the bones, you set a low limit that you don’t want to go below (can be above or below 4.0) and the system sets a line 1.1 higher than that. If your glucose trace is falling and you are predicted to go below that line within 30 minutes then basal is suspended.
Of course basal suspension takes a good 30-40 minutes to start doing anything, and if your BG is falling any more speedily than a very gentle drift it will need a pretty hefty head start.
Medtronic’s suspends were a minimum of 30 mins. The tSlim is a lot happier to suspend and restart more rapidly, which can help avoid occasional ‘suspend-bounces’ (eg where food is on board and you’ve prebolused).
More recent Medtronic pumps have much more complex algorithms, with many more adjustments going on.
I really like the hybrid-closed-loop systems, and would have to think really hard to move to a system that didn’t have that integration now.
Hi Inka, Thanks for your reply, that's an idea, about your friend using a glass. He seems to wake sometimes but also sometimes after ive woken to the alarm at this end. And if he has woken to the alarm he messages me. The uni does have a 24 hr security contact for the student residences and ive used them twice, they will do a welfare check. But yes, its about tweeking and retweeking basal rates and also post food insulins , not also straightforward if eating late . I'm hoping that things will settle.
Inka
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Eating late can make things harder, but, of course, late-night eating is very much a uni thing! He could try, for example, just going with very low carb options if he’s grabbing a takeaway after a night out. That is basically just go with the meat parts (if he eats meat, of course). So, a kebab without the chips or bread element, a Chinese takeaway but just the meat with no rice. That would mean he’s not having to inject fast-acting insulin close to bedtime.
It’s a hard balance but hopefully his team can support him in making any changes needed to his insulins.
It’s a hard balance but hopefully his team can support him in making any changes needed to his insulins.
Hi Bruce thanks for your input. Omnipod doesn't allow a shutdown of insulin but of course the basal rates can be tweeked at bedtime. I'm sure my son is trying to get it right but I'm also aware that there's a lot going on in his new world. I agree that the fewer nighttime hypos he has the more sensitive he is to them and more inclined to wake up( which does happen most of the time) Obviously its those other times which are the concerning ones. This year at least he has the back up of a support team for the student accommodation. Which is reassuring to me of course as last resort.
Hi Emma, Thanks for your reply, that was really thoughtful of you ! He's getting stuck into his new world for sure. But not the greatest at keeping in touch which is a tad frustrating. Difficult for me to strike the balance between allowing greater independence and being a fussy and over-concerned parent. Thanks again.
trophywench
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Er, John. You are not allowing anything - he's now an adult so if he has a normal brain - he's taking his independence as he should. Nowt of course can ever stop you being over protective and fussy - we all take on that persona automatically when becoming parents! Gradually you only get to hear anything whatsoever when they are 'in trouble'.
By now we have several great grandchildren one of whom (5yo ish) recently tested positive for Covid, no news since, nor about all the puppies her mum's dog also recently had, nor anything about the 2yo son of another grandaughter recently having a diagnosis confirmed as we all thought he would, of autism.
The counter of the bank (originally the Bank of Mum and Dad) is widely known by all of em to be opened when necessary - so anything we can help with - we absolutely will, just as we have throughout with all of em.
By now we have several great grandchildren one of whom (5yo ish) recently tested positive for Covid, no news since, nor about all the puppies her mum's dog also recently had, nor anything about the 2yo son of another grandaughter recently having a diagnosis confirmed as we all thought he would, of autism.
The counter of the bank (originally the Bank of Mum and Dad) is widely known by all of em to be opened when necessary - so anything we can help with - we absolutely will, just as we have throughout with all of em.
Inka
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I use a pump @Amity Island but unfortunately can’t afford the Dexcom sensors so can’t help. I do think that Dexcom can have false lows too but that’s only from my reading not from personal experience.
My pump (without Dexcom) stopped my nocturnal lows because I could program exactly the insulin I needed hour by hour. This allowed me to have very, very little insulin for the period of the night where I’d previously had hypos (between midnight and 2.30am). That sorted my problem.
My pump (without Dexcom) stopped my nocturnal lows because I could program exactly the insulin I needed hour by hour. This allowed me to have very, very little insulin for the period of the night where I’d previously had hypos (between midnight and 2.30am). That sorted my problem.
trophywench
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I don't use Dexcom either so have no idea about that, sorry.
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