[type1rachelle]

I have to second the recommendation of the pump and CGM. I've had T1 for 14 years now, and as I gained tighter control, I started to experience extreme lows in my sleep, many times to the point of being non responsive or actually having seizures. a few points to mention:

1) make sure you have a glucagon emergency kit and everyone you live with knows how to use it if they need to. my husband has used glucagon on me about 4 times in the last 6 years and it's saved me from having a seizure. Also, keep juice or a glucose liquid or gel near your bed - NEVER get up and go to the kitchen for something to eat/drink if you're extremely low because you risk falling and injuring yourself. I've done this a few times before I learned my lesson - all 3 times resulted in seizures - I've dislocated my shoulder, tearing my labrum and needing surgery, I've cut the back of my head needing 8 staples and suffering an awful concussion, and I've broken my two front teeth, needing root canals and crowns - it's a very painful and expensive lesson, be safe.

2) a pump is a great tool because you can customize the basal rates - so if you consistently have issues with lows in your sleep, you can program it to give you less insulin while you sleep. it gives you more flexibility because it's hour by hour in terms of basal patterns you can set and change, not the 24hr Lantus option which has a definite peak/plateau for many hours which, if you get it wrong, you have to correct with more insulin or food.

I'd like to point out that I've never met a T1 who went on the pump, regretted it and went back to injections. I know it's not for everyone, but it's very easy to disconnect any time you need to, and it's very discreet - keep it in your pocket, nobody has to know you're wearing one. I would urge you to at least try it - and if you don't like the tubing, you can always opt for the Omnipod option which is an all in one unit and you use a remote to control the rates.

3) you are a VERY good candidate for a CGM - these things were specifically created for people like you and me who frequently go low in their sleep, are unresponsive or have seizures. Medtronic has one that's integrated with the pump, but I've tried it and didn't like it at all - not very accurate and the sensors hurt A LOT. once I switched to the Dexcom, I could finally have confidence and start getting a full night's sleep. You set the low and high parameters and the thing vibrates and beeps if you're falling outside your range. I keep mine on my bed table and it wakes me up if I'm going low. It's important to note, however, these things don't take the place of your BG meter - you still have to calibrate it with fingersticks and you absolutely have to confirm a high or a low before correcting. this is because it measures the glucose in your interstitial fluid, not your blood, and there can be a 20 minute lag. I'm currently on the Dexcom Seven, but am upgrading to the G4 next month, and from what I hear it's about 30% even more accurate so I'm excited!