When to dial 999 (Libre App)

[VioletMatilda]

Dsis is Type 1. She lives alone. We live 3 hours apart and I have the Libre app on my phone. If the alarm goes off, I call her - usually a video call to check she's ok.

On 3 occasions this year she hasn't responded to repeated calls and her blood has continued to fall. I have dialled 999 when her blood dropped to 2.8 or 2.7 and a paramedic in a car has been there quickly.

Today her alarm went off mid morning and when I called she was asleep in bed, not feeling well. She took jelly babies and I saw her blood go back up. Two hours later it went off again. I called again and again she was asleep in bed. This time she seemed to think my call was a continuation of the previous one, and she was saying "I told you, I've taken jelly babies." I ended up shouting at her to drink Lucozade, so she got up, but then got distracted by her cat. More shouting and she eventually drank Lucozade, but her blood dropped to a low of 2.3. I stayed on the call till her blood was back up to 4.

Should I have dialled 999? She was breathing, conscious, and speaking to me, holding her phone so that I could see her, but she was confused.

I know that 2.3 and losing consciousness is an emergency, and in this case she wasn't losing consciousness, but is the threshold higher when the person lives alone?

Hypos should never be treated solely based on the libre readings, you should always fingerprick before treating as libre can say you’re low when you’re lying on the sensor, or it can underpredict where your reading will go (because it’s estimating your blood sugar to make up for the lag in interstitial fluid) and the lag can mean libre shows you’re still low when you’ve already fixed it and blood sugar has risen

why is she having so many hypos? Are they real ones verified with fingerpricks? What is she doing to change her medication to prevent them if they’re real? Why hasn’t she set her alarm to a higher number and been fingerpricking and treating before she’s low? I know about it when I’m at 5 and use the direction arrow and knowledge of what insulin I have on board to avoid the hypo in the first place that’s the whole point of having the libre. Can’t remember the last hypo I had

I live alone, have T1, and have never had anyone follow my blood sugars, never had to call an ambulance or had one called for me, and most T1s I know haven’t either. Sounds like your sister might need to take more control?

I also have T1 and live alone and your DS does need to either adjust her insulin doses or have a bed time snack to prevent hypos.

I had the same issue myself tonight, hence why I am on this forum at wrong o'clock!

I can not give advice on insulin doses but I will tell you what I will be doing to prevent another nocturnal hypo for myself, as a hint.

My next injection of background insulin will be reduced by 1 unit tomorrow evening but I will monitor my blood glucose over the next 36 hours, after this dose change before I make any more changes and the reason for this is it takes about 3 days for the dose change to take effect.

I know it is background insulin that I have to change and not quick acting because the duration of my quick acting insulin from tea time is 4 hours and that as now passed.

This advice was given to me on a DAFNE course, by trained DSNs.

What your DS does is her choice, she may prefer a bedtime snack.

Its a tremendous responsibility on you to be monitoring your DS blood glucose, I understand your concern is for your DS wellbeing and she is very lucky you support her.

My DH has T1 and now that he has his pod plus libre plus finger prick he rarely needs help with a low. Previously with just finger prick he often needed me to fetch snacks. This is even though I hear the alarm (I ask if I can help and it's no, so I roll over and go back to sleep).
(He always has a bedtime snack. Usually wholemeal toast and jam if you're interested!)

How many hypos is your sister having? She definitely needs to speak to her diabetes team about better management. Also, if she has had more than 2 hypos which have needed help from another person, she needs to let the DVLA know and she might lose her license.

Like a PP said, the Libre isn't always accurate. I had a 2.8 this morning when I was still asleep but a finger prick said it was 5.8 so it was just a compression low from lying on my arm.

Did your sister follow up her jelly babies and lucozade with some complex carbs? If I have sugar my glucose readings rise rapidly but also crash down quite quickly without some complex carbs on board.

Thank you for all the replies!

On all three occasions I've dialled 999 in 2026, it has been in the morning before she woke up (once at 4am, once at 7am, can't remember the other time, but about then). The paramedics found her asleep in bed each time (or just awake because of the sound of them coming into the house - she has a key safe so they can let themselves in).

Yesterday was similar, but because she wasn't feeling well she was asleep in bed mid-morning and at lunchtime. My calls woke her both times.

I don't think there's an issue with her driving, because if she's up and about, her blood sugar is under control.

@NoisyMonster678 Its a tremendous responsibility on you to be monitoring your DS blood glucose.

I sleep with my phone on my bedside table, but yesterday during the day I spent an hour gardening, with my phone inside. If she'd hypo'd then I wouldn't have heard the alarm. That gave me a real fright. She was asleep and wouldn't have woken without my call. I don't know why her own alarm hadn't woken her. I actually woke up at 3am this morning thinking her alarm had gone off, but it was just a nightmare!

@Gingerkittykat Like a PP said, the Libre isn't always accurate. I had a 2.8 this morning when I was still asleep but a finger prick said it was 5.8 so it was just a compression low from lying on my arm.

I can see a graph of the past 24 hours on my phone, and if I can see that her blood has been steadily dropping over several hours, I don't think that's a compression low?

Yesterday the graph showed the first hypo, a sharp uptick after the jelly babies but then a sharp down again to the second hypo. This seems consistent with her being asleep and not feeling well, being woken by my first call, taking a couple of jelly babies but going straight back to sleep without taking any carbs and then crashing again.

The underlying problem yesterday was that she wasn't feeling well. She was up at 16 at 7am and 8pm yesterday and 7am this morning, with the hypos at 10.20 am and 12.10 pm yesterday - if she's well she has a fairly smooth line but it all goes wrong if she's unwell.

I'm unclear whether I should have dialled 999 at 2.3, due to the fact that she was talking to me about the cat, but not regarding drinking lucozade as urgent.

I'm very grateful for all the advice!

I am in the same position as you OP. I have. no advice for you but send my sympathy. Type 1 diabetes is a bitch and ruins families lives.

I would say she should of done a finger prick, my sons on dexcom and I know it's not always accurate so I imagine libre is similar. That said my son wakes up confused sometimes too but it's because he's been jolted awake rather than the hypo making him confused. I don't think you were wrong to call 999, I would do the same in your shoes. 999 would rather check than deal with dead in bed syndrome.

Anyway get behind crushing t1d foundation, they are funding the quickest route to a cure and cutting out all the middle men costs.

There is a problem with her driving, if she’s needed help 2+ times then she has to stop driving and declare it to the DVLA

there are two questions on the form regarding help with lows

Q5. Have you had any severe episodes of low blood glucose, whilst awake, in the last 12 months?

Q6. Have you had 2 or more episodes of low blood glucose in the last 12 months where you needed help?

These sound like a yes, because you’re helping her and they’re not all whilst she’s asleep. You had the one where she was awake and talking about the cat and you had to help her

Then it also sounds like she fails this question too, because she wouldn’t have a 2.3 for example if she had good awareness, she’d have fixed it long before that point

Q4. Do you get warning signs of low blood glucose?

Thank you, @PotatoFan I didn't know that.

I think she would answer "No" to Q5, because all the severe episodes have happened because her alarm didn't wake her. I don't think there have been any when she has been awake.

But Q6 - her medical records will show that she's had paramedics responding to a 999 call three times in 2026, and there was one in late 2025, can't remember which month, but I think it was less than 12 months ago. And yesterday would have been a fifth, although I didn't dial 999. I suspect she wouldn't count yesterday, because I'm not sure how aware she was.

She'd answer "Yes" to Q4, as she's very aware providing she's awake.