Continuous Glucose Monitors Help Type 2 Diabetes Patients Spend Five More Hours a Day in Healthy Blood Sugar Range

From news.cuanschutz.edu

By Julia Milzer

Continuous glucose monitors (CGMs) could transform diabetes management for millions of Americans with type 2 diabetes who don't take insulin, according to findings from new research published in the New England Journal of Medicine.

The clinical trial found that adults using CGMs spent approximately five additional hours each day within their target blood sugar range compared with those receiving routine care. Nearly twice as many CGM users also achieved an A1c level below 7%, a common treatment goal for people with diabetes.

CGMs use a small sensor worn on the body to continuously track glucose levels throughout the day and night. This allows patients to see how their blood sugar responds to food, physical activity and other daily habits, potentially helping them make more informed decisions about managing their diabetes.

“An estimated 20 million adults in the United States have type 2 diabetes and do not take insulin, and despite advances in treatment, many still still do not reach glycaemic targets,” said first author Tamara Oser, MD, professor in the University of Colorado Anschutz Department of Family Medicine. “Over time, elevated blood sugar can increase the risk of serious health complications, including heart disease, kidney disease and vision loss, so it’s important we continue to improve care for everyone with diabetes.”

Tamara and her co-authors also found another significant finding: CGM users experienced significantly greater improvements in A1c, a measure of average blood sugar over approximately three months. The difference between the groups was 0.9 percentage points, greatly exceeding the threshold generally considered clinically meaningful.

Largest clinical trial of its kind

The study included 283 adults across 22 U.S. primary care practices who were followed for 26 weeks. It’s the first large-scale, multicentre randomized controlled trial to evaluate the effectiveness and safety of CGM in adults with type 2 diabetes who do not take insulin.

Unlike smaller previous studies, this trial exclusively enrolled patients receiving diabetes care through primary care practices, where most Americans with type 2 diabetes are treated. This approach makes the findings particularly relevant to everyday clinical care.

Reshaping treatment recommendations

The findings provide some of the strongest evidence yet for this population, which has historically been under-researched.

Currently, the American Diabetes Association's Standards of Care cite Level A evidence, the highest rating supported by rigorous clinical research, for CGM use in patients receiving insulin. However, recommendations for people with diabetes who don't take insulin are supported by Level C evidence, reflecting more limited research.

The researchers hope these new findings could help close that gap by providing robust clinical evidence that CGMs improve blood sugar in this population.

“We hope this research will help strengthen national diabetes care guidelines and expand insurance coverage, making this technology more accessible to the millions of patients who could benefit from it,” said Oser, who is also founder and director of the Primary Care Diabetes Lab at CU Anschutz.

For now, the authors suggest people with type 2 diabetes who don't take insulin should discuss the use of GCMs with their primary care providers as part of their diabetes management.

Key points:

• Continuous glucose monitors (CGMs) helped adults with type 2 diabetes who don't use insulin spend five more hours daily in their target blood sugar range.
• Nearly twice as many CGM users achieved an A1c below 7%, a common diabetes treatment goal.
• The 26-week clinical trial included 283 adults across 22 U.S. primary care practices.
• Findings could strengthen diabetes care guidelines and expand insurance coverage for CGMs.

https://news.cuanschutz.edu/news-stories/continuous-glucose-monitors-help-type-2-diabetes-patients-spend-five-more-hours-a-day-in-healthy-blood-sugar-range?hs_amp=true

 

 

Type 2 diabetes monitoring: Blood sugar tests and health screenings

From mcpress.mayoclinic.org

If you have type 2 diabetes, measuring your blood sugar level, also called blood glucose level, is a useful way to track the status of your condition. But because high blood glucose can cause issues in your heart, kidneys, and even your eyes and feet, the best management strategies include additional tests to check for complications.

Keeping up with recommended testing and understanding test results empowers you to make informed decisions about your diabetes care. By working alongside your care team to refine your diabetes management plan, you can take steps to improve your health and happiness.

Blood sugar monitoring tests for type 2 diabetes

When you eat, your body breaks down the food into glucose, a type of sugar that fuels the cells throughout your body. The glucose enters your blood and gets into your cells with help from a naturally occurring hormone called insulin.

All types of diabetes stem from an issue in the interaction between blood glucose and insulin. If you have type 2 diabetes, your body doesn’t make enough insulin, can’t use insulin effectively or both. This causes glucose to build up in your blood. If your blood glucose level is too high too often, it can cause issues throughout your body.

There are a few methods for measuring your blood glucose level. Each serves a unique purpose. Using them together can create a clearer picture of your diabetes.

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The A1C test measures blood sugar levels over time

The A1C blood test offers an overhead view of your average blood glucose level. “It’s a nice barometer for a three-month period,” explains Jessica R. Wilson, M.D., M.S., an endocrinologist and diabetes expert at Mayo Clinic in Jacksonville, Florida. The A1C test’s broad perspective is most useful for diagnosing diabetes and determining whether changes in your diabetes management plan, such as a new medicine or exercise routine, are affecting your condition.

The A1C test is sometimes called the glycated haemoglobin test. This is because the test doesn’t directly examine blood glucose levels. Instead, it measures what percentage of haemoglobin, a protein in your red blood cells, is coated with sugar in a process called glycation. The more glucose there is in your blood, the more haemoglobin gets glycated.

Any factor that influences your haemoglobin can interfere with A1C test accuracy. This can include having low iron, kidney disease, a low red blood cell count or a gene that influences the shape of your red blood cells.

If you have type 2 diabetes, the American Diabetes Association (ADA) recommends getting an A1C test at least twice every year. The best A1C test result to aim for depends on your age and diabetes history. An A1C result of less than 7% is a common goal for adults who have diabetes. If your A1C results are lower than this benchmark, “there’s a lower risk of eye damage, kidney damage, nerve damage and other complications,” Dr. Wilson says.

A blood glucose meter: A “snapshot” of blood sugar levels

While the A1C test is an important tool, people who have diabetes also need a quick way to check their current blood glucose levels. Using a blood glucose meter enables you to independently and accurately check your level within seconds. 

To use most blood glucose meters, you first insert a test strip into the device. Then you poke the side of a clean fingertip with a small needle, called a lancet, to release a drop of blood. When you touch the test strip to the blood, the meter shows your blood glucose level on a screen.

“The challenge is that doesn’t tell you how long it was at that level,” Dr. Wilson says. Everyone’s blood glucose levels naturally rise and fall throughout each day. Seeing a high or low result on a blood glucose meter could indicate that you took a snapshot during a natural swing. Or it could be evidence of a sustained issue. With a blood glucose meter, the only way to measure your level over time is to repeat the test throughout a certain period. This can be inconvenient and time-consuming.

Continuous glucose monitors track blood sugar throughout the day

Efforts to fill in the gap between the A1C test’s big picture and a blood glucose meter’s snapshot led to the development of the continuous glucose monitor. This device estimates the glucose level in the fluid between your cells, also called interstitial glucose, over time. The level of interstitial glucose is usually similar to the glucose level in your blood.

A continuous glucose monitor includes a tiny sensor inserted under your skin. The sensor transmits data to a receiver or your smartphone, which allows you to review your estimated glucose level minutes after the measurement was collected.

Automatically gathering a set of data points allows both you and your care team to build a clearer understanding of how your blood glucose changes throughout each day, Dr. Wilson says. Pairing a continuous glucose monitor with a log of day-to-day events — such as eating, taking a medicine or exercising — can help you optimize your diabetes management plan, especially if you’re using insulin therapy.

Like other glucose measuring tools, continuous glucose monitors aren’t always accurate. Compressing the sensor, which may happen while you’re sleeping, can cause the device to falsely indicate low blood glucose. Certain medicines also can affect readings.

Why is screening for type 2 diabetes complications important?

Measuring blood glucose is critical for tracking diabetes. But because type 2 diabetes can affect many parts of the body, testing for other health risks is just as crucial.

Dr. Wilson recommends that people who have type 2 diabetes start screening for complications as soon as they’re diagnosed — even though that may seem premature. “Most likely, there’s already been a period of time during which blood glucose was higher than the expected range,” Dr. Wilson says. Testing to detect any emerging issues can help you and your care team “get on the front end of it.”

The ADA’s current recommendations for people with type 2 diabetes include guidance for the following areas:

Heart and blood vessel health

People who have type 2 diabetes often have a higher risk of cardiovascular disease. The ADA recommends getting your blood pressure measured during every routine clinical visit, or at least once every six months. A lipid panel, which measures your cholesterol and triglycerides, is another important test for heart health. The ADA recommends getting a lipid panel when you’re diagnosed and at least once every year after.

Kidney health

Kidney disease also is common among people who have type 2 diabetes. The ADA recommends testing your urine albumin-creatinine ratio (uACR) and estimated glomerular filtration rate (eGFR) to check your kidney health at least once a year.

Nerve health and peripheral neuropathy

High blood glucose can cause nervous system issues. The ADA recommends an assessment for peripheral neuropathy by a healthcare professional after you’re diagnosed with type 2 diabetes and once every year after.

Eye and sight health

To monitor any vision issues, the ADA recommends having a dilated and comprehensive eye examination by an eye doctor after you’re diagnosed. Getting checked once every year helps your care team catch emerging issues.

Foot health

The ADA recommends an annual foot health examination. If you have a high risk of foot issues, a foot doctor might be able to offer specialized care.

https://mcpress.mayoclinic.org/diabetes/type-2-diabetes-monitoring-blood-sugar-tests-and-health-screenings/

USA: FDA Clears First Over-the-Counter Continuous Glucose Monitor for Children

From fda.gov/news-events

June 12, 2026: The U.S. Food and Drug Administration today cleared for marketing the first over-the-counter (OTC) continuous glucose monitor (CGM) for children, Dexcom Inc.’s Stelo Glucose Biosensor System, an integrated CGM (iCGM) indicated for people two years of age and older who do not use insulin. The FDA previously cleared the Stelo Glucose Biosensor System OTC for individuals 18 years and older in March 2024.

“Children deserve access to the best tools available to manage their health," said Center for Devices and Radiological Health Director Michelle Tarver, M.D., Ph.D. "Today's clearance reflects the FDA's commitment to fostering innovation for paediatric patients and supporting the safe and effective use of medical devices where children live, learn, and play.”

Prediabetes is increasingly impacting children in the United States, placing millions at heightened risk for progressing to Type 2 diabetes. OTC CGMs can play a critical role in addressing this public health concern for paediatric users who do not use insulin. By providing real-time glucose data, these devices can help paediatric patients and their caregivers build greater glycaemic awareness, track patterns in response to meals and exercise, and make informed adjustments to support healthier long-term outcomes and quality of life.

The product is indicated for children, including those with diabetes, who receive oral medication to manage their condition and people who want to understand how diet, exercise, and other lifestyle changes affect their glucose levels.

The Stelo Glucose Biosensor System uses a wearable sensor, paired with an application installed on a compatible smartphone, or other smart device, such as a parent’s or caregiver’s smartphone, to continuously measure, record, analyse and display glucose values. Each sensor lasts for up to 15 days before it must be replaced, although sensor wear time may be shorter in paediatric users than in adults due to several interconnected physiological and behavioural factors. The app displays glucose measurements and trends every 15 minutes. Users and their caregivers should consult their health care provider before making any medication adjustments based on the device’s output.

This clearance is an example of the FDA’s use of real-world evidence (RWE) to support regulatory decision-making. Dexcom and the FDA used previous clinical study data from both paediatrics and adults, along with RWE derived from real-world data on current iCGM use among both groups, to understand expected device performance in paediatric users over the full 15-day wear period.

Participants in the previous study reported mild adverse events including local infection, skin irritation, and pain or discomfort.

For children, the device should be used under the supervision of an adult caregiver. Importantly, this system is not for people with problematic hypoglycaemia (low blood sugar) because it is not designed to alert users when this potentially dangerous condition occurs. This system is also not for people on dialysis. People with a history of disordered eating or eating disorders should talk with their health care provider before using Stelo.

This clearance is also aligned with the FDA’s Home as a Health Care Hub Initiative, which focuses on advancing the development of innovative, patient-centred devices that fit more seamlessly into people’s daily lives at home.

https://www.fda.gov/news-events/press-announcements/fda-clears-first-over-counter-continuous-glucose-monitor-children 

Getting the Most From a Continuous Glucose Monitor With Type 2 Diabetes

From everydayhealth.com

If you have type 2 diabetes, you’re likely very familiar with A1C tests, which measure the average amount of sugar (glucose) in your blood over the past three months.

However, A1C isn’t your only option for tracking your blood sugar levels: Continuous glucose monitors (CGMs) have moved beyond type 1 diabetes care to being an important tool for type 2 management as well. People with type 1 or type 2 diabetes who use a CGM tend to have a lower A1C and more steady blood sugar.

Understanding CGMs

At first, CGMs were prescription-only and used by people with type 1 diabetes, a condition in which the body doesn’t make insulin. However, CGMs are now recommended for people with type 2 diabetes, whose bodies don’t make enough insulin and are resistant to it. You can even buy over-the-counter versions without a prescription.  

In fact, the 2026 American Diabetes Association Standards of Care were updated to reflect the fact that CGMs are now recommended as soon as type 2 diabetes is diagnosed. They’re also recommended for anyone previously diagnosed who could benefit from keeping a close watch on their blood sugar levels, including those who use insulin therapy, and those on other treatments that can cause low blood sugar.

“Updated studies show how valuable CGM is to anyone with type 2 diabetes,” says Amy Hess-Fischl, RDN, CDCES, president of health care and education for the American Diabetes Association. “Those with higher A1Cs can greatly benefit from CGM because they can now see the cause and effect of their meals and make adjustments quickly to have a big impact on reducing A1C.”

The Power of Instant Feedback

Real-time alerts from CGMs can help you adjust your diet, medication, and activity levels to prevent blood sugar fluctuations that can lead to complications like damage to your nerves, kidneys, blood vessels, eyes, and other parts of the body over time.

This real-time feedback is particularly helpful with meals, Hess-Fischl says. She describes a patient who had overindulged during a meal he loved, then received an alert that his glucose was rising higher than usual.

“Instead of getting mad at himself for being human, he took a 20-minute walk and it levelled off his readings,” Hess-Fischl says. “I was so proud of him, because that is exactly what CGM can do — instead of feeling helpless or defeated, he made a positive behaviour change.”

It’s not just about food choices though.

Stress and sleep, which are often interconnected, can also impact blood sugar levels. Cortisol, the stress hormone, triggers your liver to release more glucose into your blood. When you don’t get enough sleep, your body reacts as though it’s under stress. As a result, you may find that you wake up with higher morning blood sugar than usual.

Meanwhile, exercise can lower your blood sugar for up to 24 hours or more after a workout, since it makes your body more sensitive to insulin. Certain medications, like statins (used to lower LDL, or “bad,” cholesterol) and immunosuppressive drugs (like corticosteroids, used in arthritis treatment), can cause changes in your blood sugar too.

“Before CGMs became very popular, most of our focus was on looking at the A1C, which only really showed trends and average,” says Pouya Shafipour, MD, an obesity medicine physician at Providence Saint John’s Health Center in Santa Monica, California. “CGMs show the exact timing of your glucose levels and the relationships to food, sleep, stress, exercise, and medication, which is really empowering for both patients and doctors.”

Tracking Your A1C

A CGM uses something called the glucose management indicator to estimate your A1C, without the need for a blood draw. This is a formula using the average of your glucose readings over about two weeks.

Keep in mind that this is only an estimate, so it may not exactly match your actual A1C. But for most patients, consistent monitoring removes the anxiety of quarterly blood work by providing a daily running average, Dr. Shafipour says.

“Instead of waiting every three to four months to go to doctor visits and guessing or worrying about A1C, they have a tool to see if they’re in range most of the time,” Shafipour adds.

Understanding the Data

CGMs include your current glucose reading, plus a trend arrow that shows if it’s rising or falling. This helps you see how certain lifestyle choices or medications are affecting you. Meanwhile, retrospective data summarizes all of your readings for a big-picture view of your glucose levels.

The main metric to focus on is time in range. You should aim to spend more than 70 percent of time with your blood sugar between 70 to 180 mg/dL, which correlates loosely to an A1C of 7 percent or below.

You’ll get a report with a curve that shows all glucose readings in a 24-hour window. That helps you spot patterns like post-meal spikes and overnight drops, and swings that could point to inconsistencies in how you take your medicine.

“Learning the trends and using the reports takes time, but with practice, it is easy to see how the real-time data can help make positive, lasting behaviour changes,” Hess-Fischl says.

Sharing Data With Your Healthcare Team

Remote monitoring with a CGM allows your doctor to make more nimble changes to your diabetes regimen, like medication adjustments, in between physical appointments.

The data can also help you have a more productive conversation with your doctor, says Hess-Fischl.

Questions to Ask Your Doctor

• What are my goals before and after meals?
• Why am I experiencing low blood sugar (readings under 70 mg/dL) at certain times, and how can I prevent it?
• How can I reduce the swings between high and low (glycaemic variability)?
• When do we need to consider adjusting my medication or insulin based on these trends?
• How often should I be confirming CGM readings with a finger stick?
• Can we create a plan for when to contact the office versus when to manage high or low readings myself?

The Takeaway

• CGMs are now recommended for everyone who is newly diagnosed with type 2 diabetes.
• You can use your CGM data to better understand how diet, medication, exercise, stress, and sleep impact your blood sugar levels from day to day.
• Sharing this data with your healthcare team allows your doctor to make adjustments to your treatment plan in between physical appointments.

https://www.everydayhealth.com/type-2-diabetes/using-continuous-glucose-monitor-with-type-2-diabetes/ 

11 Ways to Sleep Better With Type 1 Diabetes

From everydayhealth.com

Getting a good night’s sleep can be a challenge for people with type 1 diabetes. From navigating blood sugar highs and lows to equipment alarms and device discomfort, there’s plenty that can interfere with quality rest. 

Poor sleep isn’t just frustrating — it’s linked to suboptimal blood sugar management. People with type 1 diabetes who have poor sleep quality are more likely to have greater glucose fluctuations and more episodes of high and low blood sugar levels.

Fortunately, there are strategies for addressing the sleep problems that people with type 1 diabetes often face, to help ensure that nights are as restful as possible. 

1. Adjust Your CGM Alarm Settings

People who have a continuous glucose monitor (CGM) can set alarms that alert them when their blood sugar is too high or too low. However, these alarms can be disruptive to sleep.

Paediatric endocrinologist Kristin Arcara, MD, clinical codirector of the division of paediatric endocrinology and diabetes at Johns Hopkins Children’s Center in Baltimore, says that adjusting overnight alarms can help ensure that your sleep is interrupted less frequently: “Some CGM devices allow you to customize settings to make them different for daytime and night time.” 

It’s important to talk with your healthcare provider about how you customize your alerts for overnight use, she says, so that you can avoid alarm fatigue while remaining aware of blood sugar highs and lows.

2. Snack for Glucose Stability

“If your blood glucose levels are within target range but tend to drop overnight, having a snack that includes a quality carbohydrate and protein can help keep blood glucose levels steady,” says Toby Smithson, RDN, CDCES, senior manager of nutrition and wellness at the American Diabetes Association. 

But be careful with late snacks, because they can have the opposite effect: Too many carbohydrates can spike your blood sugar overnight, and snacks that require insulin can risk overnight blood sugar lows and roller coasters.

“The snacks that are better suited for bedtime are the things that are better suited for the rest of the day: fibre, protein, healthy fat, and complex carbohydrates, as opposed to high-sugar foods,” says Dr. Arcara.

3. Try New Device Locations

Not every CGM or insulin pump location is equally comfortable. It may sound like common sense, but if your device is uncomfortable overnight, consider putting it in a new location on your body.

“You have to consider how you sleep,” says Arcara. “If you sleep on your right side, don’t put it on your right arm, because it’s going to go off all night.” 

Your manufacturer’s instructions will tell you which parts of your body your device can attach to. Some people with diabetes choose to ignore these guidelines and stick their devices to different parts of their body, though this can’t guarantee optimal results.

“Devices are approved for certain sites, but patients certainly go outside of that and use them in different sites,” says Arcara. “It’s important to figure out what works for each patient.” For people who use an insulin pump and a CGM that communicate with one another, it may be helpful to put both devices on the same side of the body, she says. 

4. Don’t Overtreat Compression Lows

If your CGM has ever woken you up with a low blood sugar alert that didn’t make sense, you may have experienced a compression low. “Compression lows happen when a person puts weight on the CGM,” says Smithson. “For instance, if your CGM is on your upper arm and you’re sleeping on your arm, you may receive inaccurately low blood glucose results.”

If a compression low wakes you up, it can be tempting to reach for your bedside juice and go back to sleep. However, since these lows aren’t true lows, consuming fast-acting sugar will cause your blood sugar to rise — possibly way out of your target range — only to set off another alarm.

“If you get an alert for a low in the middle of the night ... and it doesn’t match how you’re feeling, it’s really important to do that finger stick,” says Arcara. “If it’s actually low, treat it, and repeat the finger stick in 15 minutes.” If the finger stick reads normal, go back to sleep.

5. Beware of the ‘Pizza Effect’

Sometimes, meals high in fat can lead to delayed blood sugar spikes, often occurring hours after eating. If you have a rich, starchy meal like pizza for dinner, it could result in blood sugar highs that present after you go to sleep, leaving you unable to respond with exercise or insulin. 

Pay attention to how different meals affect you. “Monitor glucose trends with what you eat, to understand which foods or combinations of foods affect your blood glucose levels,” says Smithson. 

If you’re using an insulin pump with automated insulin delivery, your system should take care of these blood sugar elevations automatically. Insulin pumps that aren’t connected to a CGM also allow you to preprogram doses of insulin if you know your blood sugar is likely to rise after bedtime.

If you’re not using an insulin pump or are not comfortable trusting those features and you plan to splurge on a richer meal, consider eating it earlier in the day, which could preserve your ability to react to subsequent blood sugar changes. 

“The approach might be different based on each person,” says Arcara, noting that some people may decide to avoid certain foods altogether, while others may choose to enjoy them only occasionally. 

6. Take a Tech Vacation

The constant barrage of information, warnings, and decision-making that sometimes comes with using diabetes devices can be emotionally draining or overwhelming. “For some people, taking a break from diabetes technology is helpful, although taking insulin and checking blood glucose levels is still required,” says Smithson.

If you want to take a tech vacation with type 1 diabetes, you need to be comfortable with giving yourself multiple daily insulin injections and testing your blood sugar via finger sticks.

For some people, the solution may be simpler. “If you’re feeling like you want a pump break, talk to your provider,” says Arcara. “Maybe a different pump would work better for you. Maybe taking a look at your continuous glucose monitor alerts would work better for you ... it really depends on what it is about the technology that’s causing you stress.” 

7. Strategize Your Exercise

While exercise can help improve sleep quality, people with type 1 diabetes need to be careful, as certain levels of activity can lower blood sugar levels both during and after a workout. Lowering blood sugar is usually one of the primary goals of diabetes management, but you still need to take care that a day of heavy exercise doesn’t drop your levels too low overnight.

“Having [an] idea of what your body does and how your body responds to different activities can help you make a proactive plan to avoid any issues with blood sugar overnight,” says Arcara. 

For instance, people on injections may decide to decrease long-acting insulin on nights that they exercise. People using pumps and automated insulin delivery systems will have special settings designed for exercise. “Turning that on while you’re exercising and leaving it on for a few hours afterward might be a way to avoid hypoglycemia overnight as well,” says Arcara. 

Timing exercise for the morning may also help, since evening and afternoon exercise may carry a greater risk of low blood sugar at night.

8. Keep Hypo Snacks Nearby

Like any time that you have low blood sugar, hypoglycemia that happens at night requires prompt treatment, but that can be tricky if what you need is located several rooms away from where you sleep.

“The last thing you want to do if your blood sugar is low and your brain is starving for energy is get out of bed and walk downstairs to the kitchen, because that’s not a safe thing to do sometimes,” says Arcara. 

Instead, it’s helpful to keep something to treat low blood sugar within easy reach. “Keep fast-acting glucose treatments like glucose tabs, hard candy, or juice boxes near your bedside,” says Smithson. 

9. Fine-Tune Your Basal Dose

If you’re frequently waking up to low or high blood sugar, it may be time to tweak the amount of basal insulin you’re using.

Basal insulin is the insulin that your body uses in the background over the course of a day, regardless of whether you’ve eaten a meal, to keep your metabolism running as it should. An insulin pump delivers a constant small trickle of insulin to serve as basal insulin, while those on injections use long-acting insulin that’s formulated to become bioavailable very slowly throughout the day.

Work with your provider if you think you need a change to your overnight basal rates, says Smithson. “It’s trial and error with finding the best basal rate for each person,” she says. 

“Depending on the pump system, there are different strategies you can use to ask the pump to be slightly more gentle with your blood sugar overnight,” says Arcara.

10. Switch to an AID System

An automated insulin delivery (AID) system allows your CGM and insulin pump to communicate with one another, with the goal being to keep your blood glucose in your target range, says Smithson. “It takes some of the constant thinking and adjustments of insulin dosing out of the picture, especially overnight when you should be sleeping,” she says.

For some people, an AID system can make sleep much better, since it can help prevent low blood sugar overnight and generally keep blood sugar more steady.

“Probably the most appealing feature of the automated insulin delivery systems is the overnight blood glucose management,” says Arcara, as they can decrease how often patients have to wake up in the middle of the night to address blood sugar.

11. Do a Safety Check as Part of Your Bedtime Routine

Needing to change an insulin or CGM site in the middle of the night can easily disrupt otherwise healthy sleep. 

A quick bedtime check of your status and diabetes equipment can help you avoid unnecessary overnight interruptions. “Have a routine of making sure that everything is in a safe spot for you to have a great night with your diabetes,” says Arcara. Before falling asleep, she suggests checking the following:

• Blood sugar level
• Insulin pump charge or pump battery level
• Insulin pump reservoir
• CGM status and time of expiration

The Takeaway

• Adjust CGM alarms for fewer night time interruptions, and place devices on parts of the body that you don’t sleep on, to prevent discomfort and compression lows.
• Stabilize overnight glucose with high-protein, high-fiber bedtime snacks, and be wary of the “pizza effect,” where high-fat meals cause delayed blood sugar spikes long after you’ve fallen asleep.
• Strategize the timing of exercise to avoid delayed hypoglycemia, and work with your doctor to adjust your basal insulin dose or pump settings on days when you’re more active.
• Establish a bedtime safety routine that includes checking all of your diabetes equipment and your blood sugar, and keep fast-acting glucose treatments like juice or tabs right next to your bed in case of an overnight low.

https://www.everydayhealth.com/diabetes/ways-to-sleep-better-with-type-1-diabetes/