2:00am check

[Chase's mom]

How long do you have to check at 2:00 am, i've been doing this for 3 weeks now. He is still in the 200s everynight so I guess I will increase his basal again at 12:00am. he has went from 0.70 to now at 0.90 and i'm thinking of raising it to 0.95 today to see if night time numbers will get better.

[Haley'sMom]

I feel your pain! When Haley started, we got up at midnight and 3am for 2.5 weeks. When her numbers came down to about the 150's for two nights, our endo team told us that we could stop. That was a very happy day!! From 8pm to midnight, Haley's rate almost doubles from her daily rate. Hang in there!

[BrendaK]

Carson's had diabetes for almost 6 years and we're still doing the 2am check :( . I think that's mostly because his body was changing so much as he grew from a baby, to a toddler, to a young boy. The last 3 months, though, his body is really levelling off and he's been the most stable ever. I hope that within a year we're all sleeping through the night...

[Mama2H]

We have checked at midnight and 3 am since the day of dx and see no end in sight :( Hailey just is not stable enough, 50% of the time she is high and 50% she needs a low treated, no matter what number she is before bed.

[Bobbie]

I remember when my daughter Emily started on the pump, we were testing her so much so we could get her settings adjusted. Especially at night. I think it took about a month or two to get them set correctly.
We still go through times when we need to test every night at 2 am due to change in her schedule.
It will get easier with time.........good luck!!

[Kaylee's Mommy]

Kaylee's been pumping for 6months now we STILL get up at 1am, 3am and 5:30am (DH gets up for work at this time anyway) she is never ever consistant.. as soon as we think we can stop something else happens, she's either sick, low, or high.. we have a hard time at night.. I'd really like a normal night of sleep but not sure how long it'll be before I get one LOL

[Amy C.]

To get the basals right, Philip is tested hourly from 1-6 am. We do this about every six weeks. In between times, he is tested at least once at night. He almost always needs something done as he is high and low. I need to figure out the pattern.

We have tested every night for about 8 years and don't have plans to stop. I would guess that if he went for a long period without needing a correction, I would consider it.

I am lucky in that my husband is a night owl and is up until the early hours of the morning.

[Hollyb]

Our team only ever suggested we night check "occasionally" and apart from that I mostly do it when we are doing basal rate adjustments or there is some reason to suspect Aaron may go high or low in the night (e.g. big bolus for snack or correction just before bed, tons of exercise the day before, sick). I've never done it hourly -- For basal rate, I try to do it two times one night and two different times the next.

It was only when I came on here that I realized how often some parents have to check. I guess we've been very lucky -- Aaron has overall been very steady at night. I think there's only been one random check in the last year and a half that was low or high enough to warrant a correction.

[Chase's mom]

Wow how many of you laughed at my 3 weeks. LOL I didn't realize that it was an ongoing thing. I can understand why though so many things can go wrong at night. It's best to find them early instead of waiting until morning.I'm so new at this and have lots of questions.

[selketine]

Stop? We get to stop at some point?:p

I think especially for young kids that pump you have to check at least once in the night in case of pump problems. Maybe older kids would wake up?

It is difficult to know when they don't need overnight checks - especially when they are honeymooning.

[Mojo's mommy]

I have always and probably will always have to check Courtney at least 2x nightly. What I don't get is why so many of you lucky parents do not have a need to check every night. Boy, are we just unlucky or am I doing something wrong:(

I have caught so many lows and so many highs thru the night time, some expected but so many not! I honestly don't think I could ever not check!

There just seems to be no stability. When you think you've got it, it all changes...

[Kaylee's Mommy]

i think a lot of the older kids may not have to check.. teenagers and such.. toddlers and young kids/babies I'm sure pretty much most of them check.. and if they don't they are the lucky ones that for some reason have better BG stability at night.. We are definitely not one of those LOL.. Kaylee is a complete guessing game.. sometimes when the meter is doing its little count down a close my eyes, afraid to look at the results LOL..

[Kirsten]

Our team told us we wouldn't need to check at night, if Griffin was between 100 and 200 at 10pm. He promptly had an off the scale low within 2 weeks of this advice at 1am in the morning. We now feel comfortable sleeping from 11pm to 6am if we've had a normal day AND Griffin is between 160 and 250 at 10 pm. You will have to find out what's comfortable for you. I CAN'T sleep, if his numbers aren't within that range at 10pm. I just get too anxious.

GL!

Kirsten

[wendyc]

You mean you still get up and test her at night???:eek:

This is what my friend said to me recently even though I've explained (several times at that) why we need to do night checks and it's something that occurs frequently. I wanted to tell her that it just doesn't smooth out to the same number every night...*sigh* some people just don't get it.

You just never know what your going to get.
Example:
Sat night,
7pm-She was w/in range at her snack time...nice we love that
10pm-110, we don't like that...get up again later
11pm-83,don't like that, treat for a potential low later
1am-125, looking better
3am-157, finally uniterupted sleep
6am-maybe not, now the other one is up and has to go the bathroom:D

In the beginning, we had to test 2x's a night for about 3 months, then went down to one time. But it was all based on what her number was when we went to bed at 10 as to if I or my husband needed to get up again. We had a stretch with 1x a night, and then went to pumping, so the testing started up all over again!

As I said, I never know what the night holds for us. There are just so many variables.
Hang in there though, it will improve.

[Twinklet]

Emily's been diagnosed almost 8 months, and we JUST stopped the nighttime testing, IF she is in-range at the 10 p.m. check and has little or no IOB, with no Combo, Temp Basal, or Extended running.

We were getting really, really burned out and exhausted from all the nighttime checks, and I was getting depressed, partly from lack of sleep. We discussed this in detail with our Endo, and she said to stop the nighttime checks with the above parameters.

We do know that we'll have periods of time where it will not be possible to sleep through the night for awhile--like when she grows and requires more insulin, basal setting changes, or if she's ill.

I was afraid to sleep through, but I feel SO MUCH better when I am able to, and more prepared to handle the disease with the day's events.

I encourage those of you who are still checking out of pure habit (like we were) to talk to your Endo's about it and see if you can come up with parameters to facilitate more sleep. Getting up frequently at night does not promote the rest we all need to deal with this disease, and can lead to early burn-out and depression.

[Elias's Dad]

We're definitely not good role models. Most of the first 5 months after diagnosis, when our then 5 year old was on MDI, we rarely tested at night. :D For the last 1.5 years he's been on a pump, 95+% of the time, we test one or two times a night (as many of you do). :eek: Although his A1Cs have gotten better over time, we never did determine whether his numbers were just as wild at night on MDI or not. As far as us parents getting enough sleep, sometimes we switch night duty or share it in a given night. Our son is rarely awoken (except on the rare occasion that we need to treat a low). Although the nurse educators and social workers have expressed to us that we shouldn't need to be up at night, the nightly variability drives our behavior.

[Barry]

I feel so lucky. (MDI since July 06).

NEVER, after the first week of D have I woke Alex to test. At 100 he eats 15 carbs at bed, below 100 he eats 30. Mornings test pretty good 80-120. Honeymoon, luck, skill, whatever...I'll take it.

[bethdou]

At first, we were told NOT to test at night, and we didn't know any different! :eek: Of course, she was running high most of the time while we were figuring out ratios and basals and all....one time in the first couple of weeks, the endo on call asked me why I was testing her at 2AM and I said, "Because I'm awake!" He told me only to do it if I woke up, not to get up just to test. He's not the endo we go to. ;)

My husband gets up for work around 3:30 and tests her then - he didn't even used to test her. I started reading (here and in books) and figured out PDQ that she shouldn't be going from bedtime to breakfast without a check. Now with the pump I *almost* always test her around 1 AM, and then he checks her around 4. Some nights I completely sleep through the alarm clock - I think it's just out of sheer exhaustion.

I have had people give me the "You're STILL getting up at night?" thing, and I tell them that on the pump it's even more important, because things can change so much faster without the Lantus in the background...

Come on, CGMS! We all need to get some sleep! :D

[Momof4gr8kids]

Julia gets checked at midnight, and then if her numbers are good, and I feel that I have her basal right I wont check, but if I am adjusting her night basal I check at 3 as well unless there is a need to check at a different time. If I wake up I usually check her just for good measure, and DH will do the same. I think it depends on what insulin you are using, when we were on lantus we had to check once in a while, but usually as long as the fasting numbers were good we just did spot checks, or did it when we really needed to, like for illness, or if she was low during the day. When DH was on NPH he'd go low at night if he didn't have a big enough snack because of the spike with NPH so bedtime check before he fell asleep was a must, but he usually only checks his b/g in the middle of the night when there is an issue. So yes, for those of us that are sleep deprived, we will sleep again......if we can get used to it again :D

[zimbie45]

On novalog and lantus, never had to check nights .... ON pump.. have every night since we started pumping almost a year ago... We too have no end in site...Charlize insulin needs change frequently.. SOOOO hopefully we will have an end one day

[joy orz]

We've got a newly diagnosed 18 month old. (12/09/07) She just can't get through the night without a low. We've tried stuffing her with big dinners, letting her run a bit high, but she still goes low at night unless we give her a bottle or some sunflower seed butter between midnight and 4 am.

Any suggestions on still checking happily, but having at least one night that we don't have to wake her up to feed her?

[jules12]

We checked in the night the first week and usually once a week just to see where things are at. As long as my ds is above 130 at 9:00 p.m. we put him to bed if not, he gets a snack. Most of the time if we do check in the night, it is due to illness, sports, or needing to change some things.

As someone else mentioned, I would talk to your endo.

[twodoor2]

Whenever we change the basal dosage, we do check. She has had a lot of stability with Lantus, so that's one of the reasons we chose the untethered method for pumping. YDMV, but theoretically, if the Lantus basals are properly set, there should be no lows or highs in the middle of the night. There could be dawn phenomenon, which raises your blood sugar, but, it shouldn't bring you down significantly IF and only IF your basal dosage is set correctly. You could drop as well if there was significant activity during the day, so that is another reason to check.

It could be different if you're using many variable basals, and if you are using 100% fast acting in your pump. I never used 100% fast acting in the pump (we use 20% fast acting and 80% Lantus in her pump), and we haven't started using the variable basals yet.

I never check at 2:00 AM unless I'm changing the basal. She stays level all night. Perhaps we're just lucky, but what I do is check 3 hours after she has her last dose of insulin. I also check her IOB, and if she's within a good range with just a small bit of IOB left, then I go to bed.

For example, if she had her last dose at 8:00 PM, and she has a 4 hour duration of insulin action, I will check her again at 11:00 PM. I know there is only one hour of bolus insulin left on board, and her blood sugar is 180, and her IOB is .15. That amount of insulin is too small to drop her significantly, so I go to bed. On the other hand, if it's 11:00 PM and she's 100 with .15 left, I would check again at 12:00, and perhaps feed her a small amount of carbs to avoid what could be a potential low.

That's what we do, it's just an example. YDMV.