If you’re a type 1 diabetic

[RibNSaucyArseCrack]

Or live with some who is.

can I ask, how often do you wake up in a hypo?

My husband does quite often and it’s exhausting for both of us. He can get a diabetic review for another few weeks as they’re dealing with a covid backlog. He had tried adjusting his long acting but can’t seem to crack it. We have a young baby and an older child so I’m often stuck looking after all 3 of them in the morning while trying to get the kids ready to do the school run. Husband gets really confused when in a hypo and hurts himself so I can’t leave him with the baby. I’ve had to cancel my trips away and I’m so worried about going back to work because he’s the one who is supposed to be home looking after them as he doesn’t start work till 2pm.

any advice? Thankyou

It sounds like a pump may be a better fit? I was forever trying to tweak my long lasting insulin when on injections and it made very little difference.
On my pump, I have lots of different rates set as 'background' throughout the day and night. I was never going to crack it with injections.

Also, does he have a cgm or libre? They are free on prescription so if he doesn't have them, definitely get them. The libre has been a game changer. It even now alarms when going low or high. So be can catch the hypo before it happens.

I still have hypos sometimes overnight. But they are much more irregular.

He has only just got a libre, and it’s definitely improved things. He never checked his blood sugars before where as now he does it all the time! I want him to get a pump but he’s always been quite resistant to managing his diabetes so we will have to see. I think it would change his life though.

Husband is T1 and wakes with a night time hypo maybe every 4-5 months so reasonably rare. He has a snack of crackers and cheese before bed , and recently has started setting an alarm for 2am to wake up and check his sugars. He now pretty much does it without fully waking up. His main problem was high morning readings but it also means that if its low he can grab a fudge finger from tge bedside table if he needs it. Does the hospital consultant he goes to have a diabetic nurse ? Ours does and he can ring at any time for advice and support.

DD has a pump & CGM. The CGM talks directly to the pump & (in theory) stops delivered insulin if she's heading towards a low. Hoping to move soon to tech that will also deliver extra insulin to stop highs, too. CGM also communicates with my phone & I have it set up with super-intrusive low alarms to wake me up in case she goes low overnight. I've only had to get up once in the last few weeks.
So - your DH maybe needs to look at more tech!

Is he using a freestyle libre to monitor his BG (also now available on the NHS for all type 1 patients)? If so you need to look for patterns and work out what is creating the hypos, is it on days when he is eating certain things for dinner etc. A lot of diabetics on MDI need to have regular meals and snacks at certain times, having a snack before bed might help.

Is he doing his long acting injection before bed? If so he might need to look into slitting the dose to a night and morning injection. Pumps are much more readily available on the NHS now, has he spoken to his DSN about getting one?

Honestly there is no way to stop them completely but if he is having them every night he must be feeling terrible, he needs ro put a plan together with his dsn.

My husband is the same, been diabetic for 40 years and does want a pump as he’s afraid he’ll pull it out or it will be uncomfortable and disturb his sleep.

@RibNSaucyArseCrack how is his health if he hasn't been checking his blood glucose, and hasn't been trying to manage his diabetes?

I pretty much only hypo at night, it’s from too much lantus (my long acting insulin). The penny finally dropped with me recently to slowly cut back and it’s been months since I’ve had a hypo at all. If he’s using a long acting insulin small tweaks to his dose may help - 2 units at a time max. Give it a day or two and if he finds he’s waking with high sugars put it back to his normal dose. I went from hypo’s during the night then high sugars in the morning to no hypos and blood sugars of about 4.5-5.0 for the first time in my life.

I’m also hesitant about insulin pumps there have been deaths because a pump has malfunctioned and given all the insulin in it in one go. Until I’m told it’s my only option I’m not having one. I’m still stuck with finger prick testing though, been on the list for one now for two years (thanks covid) and desperately chasing up an appointment to get one.

DH has type 1, he very rarely has hypos, the last proper/ bad one would be about 3-4 years ago.

He usually wakes up when he starts going low, the feeling wakes him up and he has a tub of lollies on his bedside table so he’ll eat a couple of those and go back to sleep.

He got a libre 2 at the start of this year and that has improved things too. He has the low/high alarms set to go off early enough that he doesn’t go too far out of his ‘green’ zone.

I have it linked to my phone too just in case.

Having the extra data showed him where he needed to make some adjustments and he’s found having a bowl of porridge before bed means his sugars will stay stable through the night and he rarely wakes in the night now.

He doesn’t have a pump and has no interest in getting one either! They’re very expensive here though and not covered unless you’re on the very top tier of a select few health insurance providers.

Amazingly he’s just had his first blood test done in years and he’s in perfect health. I have no idea how. He doesn’t eat hardly. He’s so thin.

Oh that’s terrifying! Maybe I won’t push him for a pump then. Waking up next to his body is literally my biggest fear :(

Yes he does feel tired all the time. He says it’s because he works so much, which he does, but he doesn’t seem to understand that he will be much less tired if he looked after his blood sugars. He’s gone from being high all the time to now low a lot more.

AFAIK there has been one case of a pump malfunctioning and causing a death and they're still investigating whether it was user error or a pump issue.

I was a bit reluctant to get a pump before I had one, but the freedom it gives you is worth it. If I m going low I can turn off my insulin for a while instead of having to eat something when I'm not hungry. I can do spontaneous exercise without having to remember to adjust my insulin hours before. Plus it also calculates the bolus and correction doses down to 0.01 units so I have much better control then when I was on MDI.

Yes, deaths caused by insulin pump malfunctions are incredibly rare – they get reported in a high-profile way precisely because they are so rare.

As for hypos in the night, DD1 used to get these every night. She literally didn't sleep through the night between the ages of 7 and 11. But I never do, and nor does she now she is an adult. In most cases this will be because he isn't managing it properly (sorry if that sounds harsh), but all the suggestions here about splitting the long-acting insulin, having a snack before bed, considering a pump and so on are worth trying.

Thankyou I’m going to keep trying to get him to snack before bed. When I had gestational diabetes I found that helped lots with me not having hypos in the mornings. Getting him to eat is a nightmare though!