Living Alone with Type 1

Hi,
I've recently been forced to live alone for the first time and with Type 1, and I'm so afraid of night hypos I think I'm over compensating.
So here's my question:
What strategies do people employ to manage night time hypos when they live alone?
Hope you can help
Felix

Hi Felix,

There are a couple of things you could look at.

One would be CGM such as the Freestyle Libre. This would show you patterns of how your blood glucose levels trend during the night so you could see trends and then look to correct them. The Libre doesn't have alerting for when you go low unfortunately, but other CGMs do. They tend to be more pricey though.

Another thing to look at could be reducing the amount of carbs in your evening meal, so that you don't need to inject as much insulin. This might lead to less hypos.

I don't see graduate next to your name, so I assume that you haven't done DAFNE. If that is the case, then I would highly recommend doing a DAFNE course because I think it would give you a lot more confidence about managing your T1D.

Hi Warwick,

Thanks so much for the speedy reply - you just getting up, down under? :-)
I did Dafne when I was first diagnosed about 7 years ago - it was awesome and I'm queuing for a refresher right now.
Lowering carbs in the evening is a good suggestion, thanks.

But I guess I'm thinking about a support network, people to check in with in the morning to say 'Hi, I'm alive!'
My fear is that I could go low in my sleep (for whatever reason) and simply not wake up.
As I'm living alone now, it could be 24 hours or more before anyone comes knocking on the door ...

Felix

Hi Felix

Do you have family members near by at all that you could set up a contact scheme with? Is there a good neighbour who could see that you have opened your curtains in the morning? Is there anyone at work who could get in touch with you/family if you didn't get into work? Do you have a good HbA1C and good hypo awareness?

My suggestions would be:

Make sure your BI insulin is correct especially overnight, always go to bed with your BG around the 8 mark.
Any planned or unplanned exercise before bed, adjust your QA/BI/eat a few more carbs.
Have jelly babies or whatever you use for hypos by your bed.
Always have your phone by your bed......even if you hypo called someone and talked confusion they would know you needed help.

Good luck

Sarah

Can you look back over your BG levels from bed to breakfast? If there are large drops, then maybe best to have some extra carbs, but also depends on level before bed. If they are roughly the same overnight, then less need to be concerned. My DSN said it's better to be a bit higher at breakfast than low overnight.

I've always lived by myself (and T1 for 12 years), sometimes drop by up to 8 overnight, other times taken QA before bed as high and gone up overnight, so it's a bit unpredictable. I now live near my sister but we don't have any regular "are you alive" protocol (at present). And I'm still here. Things can go wrong at anytime, so really just have to do the best you can.

Happy and uninterrupted sleeps,
J

Oh, thank you. I'm just realising how much anxiety I have about this.

J, 8 point drop over nite is quite big, I guess it's about being predictable and finding the right BG level before bed?

Sarah, I generally correct BG to about 8-10 before I sleep. Mostly this works fine and I wake in target, sometimes...
Do you know people who have set up support networks and what sort of problems they have encountered? I'm thinking, I can't just ask a couple of people to do this, I probably need a small team, a group who take turns so it doesn't just fall to one or two:
So below is what I'm planning, I know it sounds elaborate but I genuinely fear for my life, and even tho my control is good, I still get it wrong sometimes. And living alone means the risk of nighttime unconsciousness and even coma is that much higher.

So I find 7 people, one for each night of the week. (maybe I need 2 more to stand in when others are away?)
In the evening I text or WhatsApp the appointed person to agree a contact time for the following morning.
The next morning, I text them a smiley to say, "I'm awake, I'm alive and my BG is balanced".
If they don't get the smiley within 10 mins of the agreed time, they ring me.
If they can't raise me on the phone they either come over or call 999 or both.
I put a key safe outside the flat so that they or the emergency services can get in.

Has anyone ever done something like this, or know someone else who has, as a safety net for living on their own with Type 1?

Felix

Hi Felix

Just friends of friends who have been at University/work through the years.

The downsides are:

If you are on holiday or off work for a couple of days, having a lie in, not drawing your curtains and end up with ambulance/police bursting through your door
You forget to text.
People forget.
7 people is a lot to remember

Any chance of sharing with a flat mate?

Sarah

I would be assessing the actual risk of night time hypos occurring.....

Is the risk low and you are just anxious about it happening....?

is the risk high and if so why? what have you tried to eliminate them?

novarapidboi spot on. Assessing risk is key here: I think generally the risk is low. So the anxiety is not based on a risk assessment but on a fear, often an irrational one. I think I'm actually doing all the right things. When alcohol is involved, that's when the risk factor really goes up.

And posting on this forum is REALLY helping

Sarah, yes, flat sharing is a good solution. I'll definitely revisit that idea with some people who might be up for it.
The more people involved in a network, the more chance there is of something going wrong but the idea of a list of people who I check in with in the morning is very reassuring.

Maybe this is about managing anxiety AND risk.

Felix

Felix

There is nothing wrong with being anxious about it as long as the hypo thought is not allowing you to sleep

You'll be great at keeping yourself safe, maybe get into a routine at night (depending on your plans/activity) and things will be 👍

Good luck with everything.

Sarah