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What steps would you take if you had a glucose reading of 80 mg/dL (4.4 mmol/L) before you planned on going to bed, with no bolus insulin on board?
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I would consume some carbs because right after I lay down, my BG drops. It happens every night and it’s not a compression low. It happened when I used Medtronic and it happens now with Dexcom. I have gotten out of bed to test with a meter and it always shows that I’m low. If I stay up, my BG could stay steady for hours but once I lay down in bed it will drop.
I would consume some fatty carbs with protein. If this occurs, I usually have walnuts with a small amount of ice cream.
If I was on 80, I would take a small squeeze of honey that I keep with me at all times. Chances are that if I’m on 80 there’s a good chance I could drop lower, and the alarm on my pump would be going off constantly. I have Tandem X2, Dexcom G6 Control IQ. But, my alarm still loves going off when I start getting down toward 70.
I would be fine with BS of 80. But do have a dexcom that would alert me of BS below 60. Also usually wake up at least once during night and check my Apple Watch.
I would set my Medtronic 770G on a 1/2 hr temp basal, which would beep when done, waking me up. If my bg was still at 80 or below, I’d drink a mouthful of juice.
I would would fixed me Turkey sandwich
I would eat two jelly beans and go to sleep. Unless I had insulin on board from a bolus – then I might eat more carb to compensate. My CGM will alarm if my BG drops further.
I said that I would eat some carbs, but it really depends on other factors, like what I’ve eaten and when, and how my BG has been behaving previously. If I’d had a soft landing after a normal dinner and my BG was stable, I’d probably go to bed without eating anything and rely on Control IQ to manage things.
I would have a Yasso bar frozen yogurt (best medicine in the world) and go to bed happy!
Eat carbs.
Unfortunately, the body keeps score, not the machine. Much more irritating are the normal BG at bedtime, then several hours later the low alert alerts—a doom loop of intense irritability. 😖
I would eat maybe 5 to 10 grams of carb before falling asleep. That should be enough to keep me from dropping too low or spiking.
It depends, the context of the question is paramount: what’s my sought after level, what’s my BG been like that evening? I don’t mind being in the 80s or 90s, though when I first got started, once went below 90 I tended to continue the decline to a low. I’ve not got my pump settings tuned better and have learned from experience. I have a G6 CGM and would note the direction of travel, if on a steep decline, then treat with some carbs (10-15 max), might stay up a little longer to see if resolves; if a small decline with no carbs on board, probably a small amount of carbs (4-8?); if level or slightly increasing, probably nothing.
If my trend arrow on Dex was straight I would do nothing. If trend is downward treat then sleep.
If the Dexcom arrow was flat, I’d just go to bed. If it was going down, I would eat one glucose tablet. A Dexcom low alarm would wake me up, so I don’t worry excessively.
I would consume carbs and set an alarm to awaken me so I could check glucose.
I would stop my insulin and eat a small carb snack.
If the profile is flat, do nothing.
If I’m trending down, take a half carb or one carb (1g raises me 35mg/dL).
If trending up, wait a half hour to make sure I level off under 95.
What do you eat that is only 1/2 a carb or 1 carb?
Snack!
That’s about what I aim for when going to bed.
My CGM low alarm is set at 80. So, I would eat a few carbs so that my alarm doesn’t continue to go off. Then go to sleep. If my BG gets to 80 again my CGM will alarm and I will determine what to do at that point.
I would set a temp target on my Medtronic insulin pump for 2 hours.
Now that I have the Tandem IQ I don’t worry about it anymore. 🙌
Basically I would do nothing and go to sleep. However, If my Dexcom integrated Tandem X2 with BIQ pump shows a downward trend, I might have a few glucose tabs or a 1/2 cup juice. My target bg is 80, if I have been 80 with a flatline for a while, and I have no IOB on board then off to bed I go. If I have FOB (food on board – having eaten recently), I would go to bed.
I’d eat carbs, the amount depending on what and when I ate dinner and most importantly the direction of the G6 trend arrow. Tandem X2 Control IQ seems very quick to stop basal insulin and that often results in a a rebound high. I do my best to prevent that. Often one glucose tab (4g) will be enough to keep be at a level in range, allowing me to sleep without having to deal with alarms.
I would eat a couple of jelly beans and go to bed.
Nothing, assuming that’s a Dexcom reading not a finger stick meter. Meter reading tells you nothing about trends, so I might be more concerned, depending on what I’d had for dinner, whether I’d had to guesstimate a bolus etc. But 80mg/dL with a reasonably flat curve would be fine. Even without Control-IQ, which would be easily able to adjust my basal if I needed it.
I cannot fall sleep with a BG below 110-115. I would eat about 3 Skittles. Anything more would put my BG up so high my pump would beep about the high sugar. Once woken up, it is hard to fall back to sleep. I use Tandem IQ
Too many human and equipment factors are presented in this question so a factor of safety must be added.
I would do nothing if my blood sugar was steady and not much or any insulin on board. With control IQ the basal rate would have been ratcheted down as the blood sugar approached 80 so there should not be a problem. Dexcom will alert me if I get below 75. I have found with experience if I were to eat even a small amount at this number, my blood sugar would then jump up higher than I want. The exception to this would be if for some reason I was quite active in the evening.
My answer was to do nothing. With the Tandem Tslim pump and sleep mode (Control IQ mode), I know that my basal insulin will be managed by the algorithm and if it starts to dip it will decrease insulin delivery and if my bg rises, it can increase insulin delivery to account. I very rarely wake up outside the range of 95-115.
But the key for me is, you need to go to bed with no IOB and have no food onboard trying to raise you BGs.
I may watch it for a 1/2 an hour, or eat just one or two sweet tarts or jelly beans, or something super low carb with a tinge of protein, such as a jelly bean with a few nuts.
It depends. If I didn’t exercise then I’d just go to bed with my blood sugar at 80 assuming no insulin on board. My basal drops to .425 and lower starting at 11PM through 4AM keeping me pretty stable throughout the night.
Assuming I exercised, then I’d eat a couple of slices of an apple with peanut butter before bed time. And, I’d check my blood sugar during the night because my muscles sure like to release stored insulin when I’m sleeping.
I would take a quick carb with protein- a few chocolate m&m’s then drink 2-4 oz of Glucerna as my BS usually drops despite only 5 units of basal insulin.
At bedtime, my pre dinner bolus of Humalog will have expired after 4 hours. My long acting Lantus (glargine) will keep me in normal glycemic range overnight with Dexcom 6.
It would depend on the CGM trend and the Loop prediction curve. If steady and no prediction to go lower, I would do nothing.
Is this a “trick” question??? Why on earth would anybody save the newest, most raw beginner T1 diabetic do anything but grab a portion of carbs, if, if they were in the least bit concerned? [Sic. WHY] Any reading in that range is unworthy of ANY concern, fear, paranoia to any degree. At 80 I would/could go straight to sleep no problem at all
With BG of 80, you also need to check if BG is rising/falling, consider if you’ve been moving around a lot in the hour before bedtime and your basal from bedtime till middle of the night. For stable BG of 80 with no IOB, I would breathe a sigh of relief and go to bed! 🙂
Sometimes it will go higher & then I go to sleep. Otherwise, I watch to see & eat if necessary.