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Thread: Do Other Endos/CDE Suggest Not Testing At Night

  1. #1

    Default Do Other Endos/CDE Suggest Not Testing At Night

    I am waiting to go to sleep again because I just checked Sophie and she was 74. So we do the low dance(glucose tabs,then longer acting carbs,check again,repeat as needed). Her Endo swears we don't need to check her at night. In fact his goal is to have her checking only 4x a day and if she feels high or low. Do other Endos/CDEreccommend this? No after catching night time lows that she isn't waking up for there is no way I'm giving up night time checks
    Sarah mom to
    Ian 13
    Sophie-11 dx Nov 6 2012 TSlim G4
    Taci 7
    Leah 5

  2. #2

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    yes, many endos dismiss the need to check at night. For the life of me I do not understand why.

    The most important thing is to understand how the insulin you are using peaks, and to try and marry that to meal peak time yet when we left the hospital with NPH we had no understanding whatsoever of how those two factors worked and no, we were not advised to check her after bedtime.... sigh

    AND we were at Yale, one of the top research hospitals in the country
    Sarah
    Mom to DD now 16, dx @4
    Cozmo pumper @6
    Minimed pumper @13
    G4 @ 15


    "Happy Birthday, Dr. Banting! Now... let's eat cake! Because, we CAN!" - MCS

  3. #3

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    We are still learning,I have learned so mich more here then from the Endo/NP and the one CDE we met at jer dx.I'm reading Think Like A Pancreas,but I'm having a hard time getting through it.
    Right now we are trying to eat dinner 4 hours before her bedtime check. The reasoning behind that is we have a pretty good idea what her real blood sugar is with very little or no bolus insulin left. Or at. least that is how I understand it. Or of it is the lantus peaking,maybe change the timing of the lantus? She takes her lantus at 8pm
    Sarah mom to
    Ian 13
    Sophie-11 dx Nov 6 2012 TSlim G4
    Taci 7
    Leah 5

  4. #4

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    Quote Originally Posted by wearingtaci View Post
    We are still learning,I have learned so mich more here then from the Endo/NP and the one CDE we met at jer dx.I'm reading Think Like A Pancreas,but I'm having a hard time getting through it.
    Right now we are trying to eat dinner 4 hours before her bedtime check. The reasoning behind that is we have a pretty good idea what her real blood sugar is with very little or no bolus insulin left. Or at. least that is how I understand it. Or of it is the lantus peaking,maybe change the timing of the lantus? She takes her lantus at 8pm
    Try Hanas book, it need not be the most expensive edition, I really think it's the best Type 1 book out there.

    http://www.amazon.com/Type-1-Diabete...s=ragnar+hanas

    nasty cover - great book
    Sarah
    Mom to DD now 16, dx @4
    Cozmo pumper @6
    Minimed pumper @13
    G4 @ 15


    "Happy Birthday, Dr. Banting! Now... let's eat cake! Because, we CAN!" - MCS

  5. #5
    Join Date
    Nov 2008
    Location
    Sparks, Nevada
    Posts
    5,070

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    Quote Originally Posted by wearingtaci View Post
    We are still learning,I have learned so mich more here then from the Endo/NP and the one CDE we met at jer dx.I'm reading Think Like A Pancreas,but I'm having a hard time getting through it.
    Right now we are trying to eat dinner 4 hours before her bedtime check. The reasoning behind that is we have a pretty good idea what her real blood sugar is with very little or no bolus insulin left. Or at. least that is how I understand it. Or of it is the lantus peaking,maybe change the timing of the lantus? She takes her lantus at 8pm
    Lantus Peak is not all bad for everyone.

    MY dd has a increase in BG about an hour after she goes to sleep so we try to time that with the Peak of Lantus with her natural BG increase with sleep.
    McKenna DX 1/3/06 @ 13 months^9 YRS
    Pumping @ 18 months & Dexcoming @ 4.5 yrs
    PINGing Tethered with Lantus
    Madison DX 3/17/14 @ 5yrs thru Trial Net
    + 4 auto-antibodies


    impaired glucose at 2hr mark
    8/12 BG 166^4/13 BG 205^6/13 BG 143^3/14 BG 216
    faith trust and pixie dust

  6. #6

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    Quote Originally Posted by wearingtaci View Post
    I am waiting to go to sleep again because I just checked Sophie and she was 74. So we do the low dance(glucose tabs,then longer acting carbs,check again,repeat as needed). Her Endo swears we don't need to check her at night. In fact his goal is to have her checking only 4x a day and if she feels high or low. Do other Endos/CDEreccommend this? No after catching night time lows that she isn't waking up for there is no way I'm giving up night time checks
    I've noticed quite a few comments from parents (not just here at CWD) recently about endos encouraging less checking, & especially no overnight checking.

    It goes against common sense.

    It completely contradicts the 2013 Revised ADA Standards of Care.

    Overnight checking is a personal choice. The endos or other health care providers don't live with our kids, so they don't have the info we have about activity etc. Because of this, I wear the "non-compliant" parent label proudly.
    Mom to 15 yr old dd, dx 7/2009
    Animas Ping 2/2010
    Dexcom 7 Plus 9/2010
    Dexcom G4 11/2012
    Metformin

    Take pride in how far you've come.
    Have faith in how far you can go.

  7. #7
    Join Date
    Jan 2012
    Location
    Massachusetts
    Posts
    284

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    Quote Originally Posted by Michelle'sMom View Post
    I've noticed quite a few comments from parents (not just here at CWD) recently about endos encouraging less checking, & especially no overnight checking.
    We were told to check once a week .

    Mom to 13 yr old dd, dx 10/2011
    OmniPod 5/2012
    Dexcom G4 5/2013

  8. #8
    Join Date
    Apr 2013
    Location
    Glen Ellyn, IL
    Posts
    577

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    I don't know. I've been checking overnight this summer because one day is so different from the next (and because my daughter asked me to) and I'm not really seeing the value, possibly because of our personal situation (MDI, 5 months past diagnosis, not in the throws of puberty, etc).

    In roughly 75 days of testing, I've seen three potentially actionable numbers. One was a low in the 70's, one was a 280+ high and one was a low 100 number that I had her drink juice for because I knew she planned on sleeping in.

    Otherwise it's just an "ok, here's the number" and I do nothing with it. It might be a little high, but not worth it to correct it since (a) we're on MDI and (b), her correction factor is a moving target and I'd probably under-correct to ensure she didn't go low.

    As it stands, when school starts, I'm going to discontinue the checks and only check on nights when I think it's necessary.
    DD diagnosed March, 2013 at age 10, now 11 years old
    T:slim (Humalog) as of August, 2013
    Dexcom G4 as of November, 2013

  9. #9

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    Quote Originally Posted by mamattorney View Post
    I'm going to discontinue the checks and only check on nights when I think it's necessary.
    This is what Molly does. Because she was dx'd at almost 18, we never checked at night because she didn't want us to. She set her alarm if she had corrected before going to sleep, or if something was off. Thankfully, she wakes up when she's low (usually a nightmare or sweating) and treats w smarties. This happens infrequently and is usually due to a delayed exercise low. She did check at 2am for many nights when she started on the pump, though.

    I can understand the need to establish the night time check routine when kids are young and non-verbal, can't tell when they are low, tend to go high at night and need corrections, or just for peace of mind. It's really an individual decision! Molly had a single this past year at school. That was a bit scary, but these kids are eventually going to be living on their own and making their own decisions about how to treat the night time checks.
    mom to Molly, 21, dx 7/9/10
    Pumping with Animas Ping 11/10
    Dave, 24, non D
    Wife to Bob...great guy!!

  10. #10
    Join Date
    Sep 2012
    Location
    Toronto, Canada
    Posts
    459

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    Quote Originally Posted by mamattorney View Post
    I don't know. I've been checking overnight this summer because one day is so different from the next (and because my daughter asked me to) and I'm not really seeing the value, possibly because of our personal situation (MDI, 5 months past diagnosis, not in the throws of puberty, etc).

    In roughly 75 days of testing, I've seen three potentially actionable numbers. One was a low in the 70's, one was a 280+ high and one was a low 100 number that I had her drink juice for because I knew she planned on sleeping in.

    Otherwise it's just an "ok, here's the number" and I do nothing with it. It might be a little high, but not worth it to correct it since (a) we're on MDI and (b), her correction factor is a moving target and I'd probably under-correct to ensure she didn't go low.

    As it stands, when school starts, I'm going to discontinue the checks and only check on nights when I think it's necessary.
    That's really interesting. I guess that's why some parents feel they need to check a lot (me) and others don't. I almost always have numbers that I need to act on in the night. My son has a huge increased need for insulin in the first part of the night that requires 4x his usual basal level as well as very aggressive corrections. His bg can jump 200 points in his first hour of sleep. But then his insulin needs drop way off for the middle of the night and then rise again in the early morning hours. In short, there is just nothing stable about his numbers during the night and basal rates change drastically throughout the night. It's also why MDI, without the ability to change basal rates was an absolute nightmare for me. The pump has definitely improved things though. If I can get his numbers in range by midnight, we are usually good for the rest of the night. When his midnight check results in a high or low number though, then I know I am in for a long night. Night time checking is an absolute must for us though. I've often wondered if other CWD bg's vary so widely like my son's does at night and after reading your post I assume that everyone has different experiences.
    Mom to T, 8yrs dx: Aug/2012
    and son 11 yrs, non-d.
    Animas pump June/13
    Dexcom G4 Dec/13

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