Talking to your doctor about your nights

Most people judge how their diabetes is going by their A1c. Sleep and overnight glucose come up far less often.¹

Clinicians also tend not to raise it. In interviews with doctors and nurse practitioners about the challenges of diabetes care, none named nighttime management as a major one without being asked.²

That doesn’t mean the night is fine. 79% of adults with type 1 diabetes on multiple daily injections and CGM say diabetes interrupts their sleep at least occasionally.³ It means the conversation rarely gets that far.

• Your CGM report for the last two weeks. Most CGM apps can show your typical day as a single chart, often called an ambulatory glucose profile or AGP. The overnight hours are on it.
• The number of times you wake up. That includes to an alarm, to treat a low, or to use the bathroom. A rough count per week is fine.
• Whether you go to bed high on purpose. 31% of survey respondents purposefully go to bed high to guard against overnight lows.⁴ It is common, so mention it.
• What you want from your nights. Most people put avoiding lows first, then waking up at a glucose level they are happy with.⁵

• What does my overnight time in range look like, separately from my day?
• Are my high mornings caused by something that happens overnight?
• How often am I going low while I am asleep?
• Is how often I wake up something we should look at?
• What options exist for people who want to keep using pens?

Overnight time in range, explained

A sentence like "my days are fine, but my nights are hard" is enough to start. So is "I wake up three times a week to alarms."

If time is short, lead with the night. Daytime numbers will come up anyway.

This page helps you start a conversation. Decisions about your insulin belong with you and your care team.