#NightScout. Possibly the best tool to manage your diabetes, not “just a monitor” #wearenotwaiting

#NightScout. Possibly the best tool to manage your diabetes, not “just a monitor” #wearenotwaiting
#NightScout. Possibly the best tool to manage your diabetes, not “just a monitor” #wearenotwaiting

Nightscout.  A wonderful tool for monitoring blood glucose levels remotely. Allowing carers and parents to see what’s going on with their children/protected family and friends.

But, it’s so much more than that. What am I talking about? I’m talking about what’s possibly the best tool for visualising your diabetes care on the planet and enabling decision making in a way that others can’t. And how is that?

Well, let’s take a look at the graph below. Sorry, it’s not the most helpful period of time, but it shows up a huge amount of information:

Starting with the bottom, we can see the last couple of days worth of data. In this sector, if I have multi day issues, let’s say early morning hypos, I can see them showing up, there and then in front of me. I have instant evidence there is something not quite right there, and I can go away and look at the data surrounding that. But what of that data?

Well that’s where we move to the upper section. I’m showing the six hour view of blood glucose, which shows the CGM trace providing a clear increase in bg that I tried to manage with the correction doses I used, plus the amount of carbs and the bolus that went with breakfast, all in line with the blood glucose readings. This is important because, rather than just being a record, it gives a clear indication of action and then response to the action. It will also display Combination boluses, allowing direct correlation between CGM data and how you split a “multi-wave” or “dual-wave” bolus. This is incredibly useful piece of information and allows much better understanding of the benefits of and how to use this pump tool.

In the period I’m showing, it also clearly demonstrates what happens with an overnight hypo and the elevated glucagon response, not only at the time, but for hours afterwards, and even in response to food in that period!

Secondly, I am able to see the basal level that I was running. This can be fed (with the right pump) directly from your pump set up, or it can be manually entered. Equally, it can picked up from something like OpenAPS or HAPP, which is how I use it. Why is this important? For two reasons:

  1. It gives a clear indication, if you have a lot of temporary basal use, that you probably need to review your basal rates and an indication of by how much.
  2. It enables you to see the impact of existing basal rate clearly and obviously, so that you can determine if changes need to be made and what the acting time of your basal is.
A vast array of further information, including Exercise and finger prick tests also can be shown up on the graphing tools. In addition, the top right displays useful real time information regarding IOB and COB. These are not as important (in my opinion) as the graphical data, but a reasonable number of people will find them useful.
Then of course, you have the reporting back-end which gives you data that is as good as anything else out there.
These factors together give a huge amount of insight into what happens when you do x, y or z by leaving you with a clear, graphical display of what’s happening. As more of these processes are automated, the better this becomes.
By combining all of these together in one place, NightScout gives, what is in my opinion, the first complete data set for managing your diabetes, and more importantly, an open source toolkit to allow better and further automation of data collection. Diasend is trying, but the realtime nature of NightScout gives it huge benefits.
The only slight detriment is the mobile phone app. It is an encapsulation rather than a native app, but that only requires one enthusiastic phone dev to fix it and we can get an Android and iOs app that is aesthetically a little better!
What does all this data set-up mean? It means that I now use HAPP and xDrip as my data entry points. All my data is stored in NightScout and that the remaining apps and tools that I’ve used in the past are basically redundant for me. This has become the way I manage my diabetes. And all for one very good reason:
Everything is available at a single glance and that’s the way I like it!


  1. That looks really helpful to me. Do you think there would be room / benefit to integrating activity level data, e.g hr or body movement, the kind that can be obtained from smart watches?

  2. As there is a function in the care portal for adding exercise manually, having a mechanism for adding it automatically from the many apps out there would appear to make a lot of sense. Exactly what is important would be an interesting question though.

  3. I'm about to start building this for my 11yr old son who was diagnosed with T1 in June. I'm curious how you've got on with it, and what the neoprene sleeve option ended up looking like?

  4. I moved on to a Medtronic 640G pump, so my focus changed. I'd cut the neoprene out but never made it into a wearable. It would have fitted like a phone armband. The tricky bit is making sure that you've access to the USB charging port to keep the battery charged.

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