Middle of the Night BG Testing?

[Ellen]

How many of you get up in the middle of the night to test your child's blood sugar? If so, how often and at what times do you check? Does your child generally wake on his/her own with a low?

[BrendaK]

We get up at 3am every night to check. After having diabetes for over 4 years, my son (who's 5) still does not have consistent enough blood sugars at night where I can feel comfortable not checking him. We check him at his bedtime (8pm), when we go to bed (around 11pm), then again at 3am. My son doesn't usually wake up on his own when he's low (which is why I have to check him at night) . If he's low, we give him those snack pack puddings at night. And we give him a bolus if he's high. Everything from what he ate for dinner, to the weather, to his activity level after dinner affects his nighttime levels. Good luck!

[Red (aus)]

I tested at 2 or 3 am for the best part of the first year. Since then I only test at night if Taylor is ill, has been low for most of the day or has had an extremely active day. So not often at all, maybe four or five times a year now.
Taylor has woken for lows, and other times I wake up. I guess she must be quite restless or something as she's getting low, making enough noise for it to wake me up. This year I think I've treated 2 lows during the night.
When Taylors night numbers were unpredictable, I used cornflour in milk as part of her bedtime snack and that was enough to keep her up throughout the night.

[Amy C.]

My 11-year old son is tested at least once every night. If his bedtime sugar was a little low, he is tested around midnight to be sure it came up. Otherwise, he is tested between 2 and 3 am. My husband is usually up that that hour. Otherwise, I set my alarm and test.

My son has never woken with a low blood sugar or when he was tested. The overhead light is turned on and he usually doesn't even move through the whole process. He is on injections, and barely reacts to a shot when he is high. He might wake up when he is high to go to the bathroom.

[Mojo's mommy]

My daughters sugars are so unpredictable at night. I am reading how some of you do not even need to check, I am so jealous. I must be doing something wrong!!!!! I was told just a few days ago when I was in hospital with my newborn that after her dinner time N peaks that she would not go low after that. Well, I thought I would try it and see. Took her sugar at 2am, it was 16.4, thought she would be okay. By 7am she was in the low 4s. It seems that there is no stability. Does anyone have any suggestions? She has a good bedtime snack...1 starch 1 protein if above 6 if below I give her 2 starches and 1 protein.

Thanks
Teri

[hartpukas]

We test our 14-month occasionally during the night. If she has been running lower than usual then I test her around 11pm and again at about 2 - 3am if she seemed to be low at 11pm. There were a few times that I almost did not test her for fear of being overly paranoid however last time I woke to test her she was in the low 30's and it was only about 2:30am - thankfully instinct kicks in as a parent!

What is the probability of dropping too low during sleep? I was never told to test her in the middle of the night - I just do it, probably the same reasons we all do, to be on top of where her sugars are at and to determine what she needs.

A really naive question… if you are on the pump is there an alert that will go off if you are too low? I am not sure if you need to test yourself while on the pump or if it is self-regulated.

[Amy C.]

A really naive question… if you are on the pump is there an alert that will go off if you are too low? I am not sure if you need to test yourself while on the pump or if it is self-regulated.

The current pump technology only manages the delivery of insulin and does not include the testing of blood sugar -- so the answer is, No there is not an alarm on the pump that goes off when the person is low. However, there are a couple of continuous glucose monitoring systems that are currently being tested that sound an alarm when the blood sugar is too low. These are called the Navigator and Guardian and have a separate sensor that is placed just under the skin. Even if the two (the CGMS and the meter) were connected, two inserts would need to be done under the skin. I think that sometime next year, these will be on the market. Insurance companies will probably not cover these right away.

[maverickmom (Kerri)]

I don't routinely check bgs during the night every night. I used to but haven't in a while. I will check if there has been a lot of activity (camp comes to mind, as does sports), or illness, or something significantly different than usual.
Shannon does tend to wake up when she's low.

[Melanie]

We do check our 3 year old daughter in the middle of the night. She will not wake up on her own if her bg is low so it helps us rest more sound if we just take 3 minutes and test her. We test her right before we put her to bed at 8:30 then again at 2:30.

[mischloss]

We don't normally test my son (10 years old and diagnosed in Sept.) but last Friday night I sure needed to. He accidently "double-clicked" on his Lantus pen needle and administered the 6 units twice!!! So we had to check him every 2 hours during the night to make sure his BG wasn't dipped down too quickly. Sent him to bed on a huge glass of O.J. and basically checked frequently throughout the next day and forego-ed the Humalog altogether the next day. Seems the 12 units of Lantus more than took care of any extra carbs that were in his system for meals. But that was scary. He learned a good lesson about consulting parents before he thinks something is malfunctioning. Geeeesh!!! But normally I have been told that the Lantus is great about regulating for extreme lows during the night. Seems to be working so far.

[Red (aus)]

We do check our 3 year old daughter in the middle of the night. She will not wake up on her own if her bg is low so it helps us rest more sound if we just take 3 minutes and test her. We test her right before we put her to bed at 8:30 then again at 2:30.

Hi Melanie, I definitely understand this. Taylor was 3 at dx and we checked nightly for about the first year but slowly she has become more aware of what is happening with her body and we have been able to drop the extra tests :) It is very hard when they're too young to really understand what is going on and definitely too young to understand changes in their bodies.

[nantomsuethom]

I check Thomas in the middle of the night if he has to bolus before he goes to bed.
I used to check him every night before I went to bed. If he doesn't have a snack after dinner and his bedtime bg is above 100 then I know he will be fine.
He does wake up at night if he goes low. He used to wake me up but now he corrects and goes back to bed. The only way I know is when I go through his meter to see how he has been running.

[Mik's Mom]

I'm new here and not sure if I am doing this right.. my daughter was diagnosed 6 months ago, she is 7 years old. I check her BS eveyr night at 2:30 am..

She has gone low several nights and I was thankful that I had checked her

[E~Chic]

I have always checked my daughter at 3am or 4 am, she has been low a couple of times. I have given her 4 oz of juice, to bring it up. The highs, like last night at 4am she had 209 and I did give her humalog once before when that happened and it went to a low. So I am afraid of the middle of the night humalog ...what should i do?

[Nana]

What if you give her less humalog than you would normaly?

[Amy C.]

Perhaps you should test a while (every couple of hours) to see if she normally goes down in the early hours. Then decide at what level she would need the insulin. If she is on her way down, there may not be a need for the insulin.

If she is fine in the morning, I wouldn't give her any insulin.

[redcurls3]

I am so glad to find this forum. I have an 8 month old who was dx at 4 months. We have to check his bg at least 8-10 times per day. My husband stays up until 12 to check and I wake up at 3 to check him. Because he is so small, I can't even give him Humalog unless he's over 500. The smallest unit I can give is .5 and even at 490 once he dropped to 80 by 3 am. Hartpukas, I'm glad to find another parent with a small baby. When was your child dx? I can't seem to find any research on small babies with diabetes. He is apparantly a very rare case. Even my doctors don't seem to know what to do. They say just watch the trends and adjust the insulin accordingly. Help please!

[Ellen]

I can't even give him Humalog unless he's over 500. The smallest unit I can give is .5 and even at 490 once he dropped to 80 by 3 am. Hartpukas,

Have you discussed with the pediatric endocrinologist using DILUTED Humalog? That way you can titrate down the dose and give a very tiny amount of it to more safely bring down high blood sugar.

"Humalog may be diluted with STERILE DILUENT for Humalog®, Humulin® N, Humulin® ... to a concentration (javascript:defwindow('concentration')) of 1:10 (equivalent to U-10) or 1:2 (equivalent to U-50). Diluted Humalog may remain in patient (javascript:defwindow('patient')) use for 28 days when stored at 5°C (41°F) and for 14 days when stored at 30°C (86°F). Do not dilute Humalog when used in an external (javascript:defwindow('external')) insulin (javascript:defwindow('insulin')) pump."

The other way to deliver tiny doses of insulin is with an insulin pump. YOu can find parents of other infants who've used insulin pumps at www.insulin-pumpers.org (http://www.insulin-pumpers.org).

GOOD LUCK!

[hartpukas]

Hartpukas, I'm glad to find another parent with a small baby. When was your child dx? I can't seem to find any research on small babies with diabetes.

Hi Redcurls! It is very tough to find good information on younger patients, isn't it? My daughter was dx'd in Aug. 2005 when she was 11 months. We were giving her 2.5 units of NPH at dinner and then I would test her before her bedtime snack (7 - 7:30ish) and again around 11ish when it (NPH) had pretty much kicked in and again later if she seemed to be dropping. However, since she has been walking and being a bit more active we have cut her back to 2 units at dinner and we are finding that she is not dropping the way she used to - granted this morning she woke up at 50 but she was very active yesterday evening. And since we cut back by .5 a unit we are not having to test her in the night - yet there are those times where I still test her for peace of mind.
The tough thing about testing her after she has fallen asleep is she then wakes up and wants to be up and about and I really want her to get her sleep so she can continue to grow.

[redcurls3]

hartpukas, i'm sorry your daughter wakes up when you check her. I have been blessed that Andy doesn't wake up. He stirs when I check him, but never really wakes up. He has always been able to sleep through anything though. I guess I lucked out.

[hartpukas]

I have been blessed that Andy doesn't wake up. He stirs when I check him, but never really wakes up. He has always been able to sleep through anything though. I guess I lucked out.

How blessed you are! I would probably test my daughter routinely every night if she would not wake up. On a seperate note, please feel free to email me to share ideas about babies and diabetes. My email is: hpukas@tampabay.rr.com.

[dawnegge]

My 6yr old daughter has had diabetes for a little over 3 years now and I still check her before she goes to bed, before I go to bed and in the middle of the night. She has only had 3 close calls and luckily did wake up during them but I'm always worried that there might be a time that she doesn't.

[rileysdteam]

I am just starting to have to check my son through the night. He used to be fine just being check before bedtime snack, but now his numbers are so irregular I check before snack, after snack, at 10:30 and again a little after
12.

[Red (aus)]

Taylor has been pumping for the past week so I've been up doing regular testing while we tweak her basals. The pump has kept her so steady at night. I will be testing again tonight and if tonight is about the same as the past two nights I'm back to sleeping all night and just having her test before she goes to bed.

[Whitney]

My mom usually checks my 7 year old sisters BG around 12 when she goes to bed. Considering she is still going through her Honeymoon stage she can be all over the place. My mom has me to check her at 3 am if I am awake and lately at 4 also so we can see what she is doing in the middle of the night. My sister has not woken up yet with any lows that I know of. Come to think of it I don't believe I wake up when I am low either. Then again I usually tend to go high at night not low.

[pookas]

We check Hunter every night at 2am. He doesn't know when he's low if he's awake, so a low at night wouldn't stir him. He's only had 3 lows at night so far. I've found lately he starts dropping quick about 2-3 hours after vigorous exercise, so on his karate nights, I try to give him some extra bedtime snack. We don't cover bedtime snacks unless he's over 250. For example, the other night he was 192, I gave him 3 c. of micro. popcorn and he was 155 at 2am then 100 in the morning. So it seems to work for us. The only time he feels shaky is if he's dropping quick. Anyone else have that happen? He was at 43 at lunchtime last week and said he felt fine. Go figure...

Linda-[NEPA]-Mom to:
Hunter, 5 yrs, dx'd 11/14/05 type I
Colby, 6 yrs, migraines

[Sweetkidmom]

I'm not sure whether to feel guilty....

I hardly ever test Jess at night. I was never told to, and our current doctor is happy with one "wee-hours" test a week, and even that we don't manage very often.

The reason is.... (and why do I feel as though I am justifying? Why do I feel I need to? We really are our own harshest critics, aren't we?)... that I suffer from chronic depression and for me, a good night's sleep is central to coping. Without this, I rapidly deteriorate into ... well... it's not pretty and it doesn't help the overall diabetes (or any other parenting matter) management.

If I'm awake because of insomnia, then I'll test. Jess has had 2 severe hypos, with seizures, where Glucagon has been necessary, both after parties with overindulging, overestimation of boluses, combined with several hours of swimming. I now know this to be a "Maximum-alert" situation.

At times, when I've feared her going low in the night, I have lowered her basals and rather risked her going high. This is not ideal, but there are times when waking in the middle of the night wrecks my functioning and then I've had to weigh up what is best for *everybody*. I haven't yet admitted this to the doc, as I feel it sounds so lame...

Kay
"Guilt - the gift that keeps on giving"

[zimbie45]

HI
Charlize will be 5 in a few days, we are 1 year into dx, she wakes up if she is low or high at night, so we only test if she wakes up and tells us or if she has been sick, or if she was having problems w/ her #'s thru out the day

Chandra :)

[bbdebs]

I check my 13 month old son at 7.30pm - his bedtime, 11pm - my bedtime and occasionally at 4am when he usually stirs.

He has split doses of nph at bedtime and breakfast as he's still having milk at night.

[pookas]

Kay,
Is it possible for Jess , I'm assuming the 12 year old, to test herself in the middle of the night? Maybe she can set an alarm and do it w/out disturbing you unless she's low?

Linda-[NEPA]-Mom to:
Hunter, 5 yrs, dx'd 11/14/05 type I
Colby, 6 yrs, migraines

[Sweetkidmom]

Jessie sleeps the very deep sleep of the innocents - she doesn't even wake up if I test her while she's asleep. Over time I've learned to know what situations to be alert for and to trust my instincts. In those cases I will set an alarm and wake to test her and just have a bad day that day. In other words, it's a juggling of priorities.

The first time she hypo-convulsed, I had actually fetched her from a sleep-over that I wouldn't let her stay at, and put her next to me in my bed (she was 9). After I had given her the Glucagon and all was well again, I just lay in the dark and marvelled at maternal instinct and vowed to hone mine. (The second time she was away from me, with her dad's family, but was sleeping near her sister, who woke up and gave her the Glucagon injection.)

I wanted to mention this (difficulty with night-time testing) on this thread in case there are others who don't manage to test in the night, for various reasons. It's a big difficulty for me. Thanks heavens as she gets older, it's less of a problem as she can stay up late sometimes and test, her older sister can also do it sometimes.

[shannonb]

My son is 2 1/2 and we are one month into knowing he has diabetes. They never told us to check at night unless he was sick and then we were to check every 3 hours around the clock.

I'm already a basket case at night anticipating a low, I guess checking could ease my mind but he already hates all the pokes I have to do during the day and I'd hate to wake him up to torture more...

Why do some doctors recommend middle of the night testing and others not mention it? Can it be different insulin mgt plans require more testing? We are on the intensive mgt plan with one 24hr Lantus shot and several novolog corrections during the day.

What should we do? I guess I'll ask the on call doc today.

Thanks,
Shannon

[Rebecca81]

I was diagnosed with diabetes at 11 and my mom never checked me at night unless I was sick. I have worked at diabetes camp for years and have found that some parents check their kids, others don't - either one is ok! For some parents it makes them feel better; for others, it causes more stress. If you find that your child doesn't wake up to lows, nighttime checking is a great idea. Also if your child is low before bed, you might want to check at midnight or 1am. But many of us grew up not being checked at night.

[cydnimom]

My son was just dx Sept 30/05. What the clinic told us to do was to test at 2:30 a.m. as that is approx. when the N would be peaking. If over 7.0 (126) he should be okay unless there are other circumstances like exercise earlier in the evening or illness. If he was between 5 and 6.9, then give him milk. They did not tell us to check every night, but when first diagnosed they suggested doing it just to see what his body was doing.

Because we usually don't eat supper until 6:00 p.m. I quite often don't check him at his bedtime at 8:00 because it is moot. I end up setting my alarm for 12:30 a.m. and checking him then. If his numbers are okay then I don't bother checking again. If I happen to get up in the middle of the night I do go in and check on him - I usually rub my hand up his back to see if he is sweating profusely.

Just my thoughts on this,

[sharon c]

hello just joined this forum

i test my daughter more often if she is poorly or has had a low test before bed, usually she has warning signs in the night and calls me. She has had diabetes for about 2yrs now and is 8yrs old
sharon c

[T_Adelaide]

Hello everyone- I'm new here too :)
We tested Libby at night for a few weeks after she was diagnosed, now we only test is she is ill or her bsls are behaving erratically!
We were told to occasionally test at night, however Libby wakes up every single time so we don't do it very often.

[AmberO]

We try to test around midnight. Usually that is not a problem since my husband stays up late anyways. I will do a 2am test if my husband is working nights or we've changed her nighttime basal rate. I alwants want to see where her glucose is in the late hours after a basal change or if she was lower then I like when I test her before I go to bed.

[Mik's Mom]

The only time he feels shaky is if he's dropping quick. Anyone else have that happen? He was at 43 at lunchtime last week and said he felt fine. Go figure...

Hello,

My 7 year old daughter was diagnosed in May. She too can not feel a low coming on unless she drops quickly. We have had many, many episodes where she said she felt fine, but she looked different to me, so I would test her and she would be in the 40's.

Before Christmas, she was walking out to the bus stop, and just fell. I thought she might have slipped on ice, until I noticed her eyes looked funny. I immediately took out my emergency kit and treated her. When she was still unable to even stand 5 mins later, after 3 glucose tabs, I gave her an entire juice box and 2 more glucose tabs.

By the time I treated her and carried her into the house and was able to check her blood sugar, 20 mins had past and she was only 42! So who knows how low she truly was..yikes.

Her endo said she has what is known as hypoglycemia unawareness, where she is simply not able to feel the symptoms of a low coming on, until it drops to a dangerous level.

So I am always on the look out for odd behavior, and looking at her face to see if she is pale or her cheeks are red, or if her eyes look "low"..these are signs I am able to pick up on that indicate a low.

Her 9 year old brother is also very good a detecting a low coming on, he said he can tell she is going low as she gets bratty. He use to say, "mom.. Mikayla's being a brat, you need to check her blood sugar" :rolleyes: I had to tell him that saying it that way, hurt his sisters feelings, so now he just says " I think you need to check Mikayla's blood sugar" and winks at me.

I am told that she will eventually be able to feel a low coming on, but as we are only 7 months into this, I have no idea when it will happen.

~Mik's Mom

[Mik's Mom]

I'm already a basket case at night anticipating a low, I guess checking could ease my mind but he already hates all the pokes I have to do during the day and I'd hate to wake him up to torture more...

Why do some doctors recommend middle of the night testing and others not mention it? Can it be different insulin mgt plans require more testing? We are on the intensive mgt plan with one 24hr Lantus shot and several novolog corrections during the day.

Hi Shannon,

We are fairly new to diabetes. I was told to do a middle of the night check by her endo, maybe because she is hypoglycemia unaware, where she can't feel a low coming on?

But I too was a basket case, worried about lows. For me, the 3 mins it takes to wake up and test my daughter, gives me a piece of mind and I always go right back to sleep if her #'s are okay.

A few times she was low and I had to treat her. Only once did she wake up on her own with a low. I sleep with a baby monitor next to my bed, this way I can hear her if she starts to fuss, or starts to toss and turn, both symptoms of a low in her case.

I am fortunate, that my daughter sleeps right through her finger pricks. She has no discomfort at all. I have an extra meter in the desk by her bed and a tub of wet wipes to wash her finger and it truly only takes me a couple of mins.

My daughter has been on lantus about a month and also uses novolog to cover her meals. Like with most illnesses, all children are different and require different treatment. I'd call your endo and see what he/she says.

~Mik's Mom

[Sweetkidmom]

For me, the 3 mins it takes to wake up and test my daughter, gives me a piece of mind and I always go right back to sleep if her #'s are okay.

... I think this probably describes the problem I have with testing at night very well: I have great trouble falling asleep again. I never fall asleep easily, it takes about an hour. And the following day I feel wrecked the whole day. Anyone who can lay their head on a pillow and just fall asleep should please realise how lucky you are! :)

I often feel I fall far short of the Good Control Ideal because of this difficulty with waking up at night. But I guess we just do the best we can with what we have...:(

[Boo]

I sometimes have the opposite problem when I can't sleep because I am worried he'll go low, so I'll test him, treat if needed, then go to sleep. I can usually fall asleep anywhere/anytime which I suppose can be a blessing sometimes, but also a curse (trying to stay awake while driving!), especially since I don't drink coffee or soda!

Our endo told us to test our son (10; diagnosed at age 8) in the middle of the night at least once a week. We also test him if his schedule that day was somehow different, particularly related to activity (i.e. an evening baseball or soccer game, or a day of sled riding, etc.). We always test him before we go to bed (11:00-12:00), and around 2:00-3:00 if we think he might go low. He is not yet on the pump...we hope to do that soon.

[shannonb]

My endo told me about The Guardian today..currently only avail in certain states and only for 18+ years but coming soon for kiddos. I am getting this the second it is available so we can all sleep better. It alarms at night when you go low (or high). I hope it doesn't take too long to come to market here! Anybody else know about this?

http://www.minimed.com/products/guardianrt/