Sharing ideas on reducing/avoiding night time lows

Becky Stevens mom · #1 03-30-2010, 02:58 PM

Ive always felt that knowledge is power therefore shared knowledge is even more powerful. We all have a fear of night time hypos so I wanted to start a thread about some ideas on reducing the risks of nighttime lows. These are things that people have tried that have worked or things that you may have read about that have been recommended.

Some things that we've done over the years with Steven are:

Steven is on lantus and gets one shot per day right now. We give that shot at night around 8:30. This way if hes had a very active day I will cut back on his basal shot, sometimes by as much as 2 units if hes been very active.

With the good weather Steven is going to be out alot more and active more including after supper so I will cut back on his bolus insulin for supper if hes going out after. Activity really affects Stevens BGs and he will have delayed hypos from it often

Speaking of delayed hypos, if Steven is real active during the day I will be very cautious about giving him much humolog for supper or his bedtime snack as it will cause him to go low early in the night. Hes gotten up several times at 10:00PM to tell me he felt low and sure enough was in the 60s or 70s even though he'd been over 100 at 7:30 snack

We have always given Steven a bedtime snack since dxd. He was on NPH for 4 years and had to have something to catch that peak that happens with NPH. I still give him 1/2 cup of low fat ice cream. If hes been very active during the day I will increase the snack and add a couple peanut butter crackers or a handful of potato chips. Things like ice cream and chips digest slowly so they dont make BGs spike and hopefully will keep them from dropping.

In Dr Ragnar Hanas's book he recommends mixing raw cornstarch with milk for young children. The cornstarch breaks down very slowly. I would imagine this mixed with some chocolate or strawberry milk would be really tasty.

If Steven has severe lows we tend to run him higher for a few days including at night in order to allow his liver to recupe what it may have lost during the low

Bam · #2 03-30-2010, 03:34 PM

This is a very good post. My son is the same way. It has been almost 3 years since diagnosis. Milk use to work great now it doesn't so I'm interested in finding something new.

GaPeach · #3 03-30-2010, 03:35 PM

Pay close attention to the nighttime BG check. Give consideration to IOB, type of food last eaten (Is is slow to digest?), time of last food intake, amount of bolus, day's level of activity, etc... THINK it through - and make a decision as to whether or not the BG is acceptable. A target range is only good when you weigh in all factors.

Set an alarm to check BG again.

joy orz · #4 03-30-2010, 04:08 PM

Quote:

Originally Posted by Becky Stevens mom

In Dr Ragnar Hanas's book he recommends mixing raw cornstarch with milk for young children. The cornstarch breaks down very slowly. I would imagine this mixed with some chocolate or strawberry milk would be really tasty.

We've done this. But we mix it with sunflower seed butter. (peanut butter would work too) I just weigh it out on the scale so it's not much more than 10 carbs and mix it up and give it to her on a spoon. Fat, protein and cornstarch do the trick. BUT we've gotten some stubborn 300's from this as well. Hard to find the right mix.

Great post by the way!

hold48398 · #5 03-30-2010, 04:21 PM

Our only way to reduce nighttime lows is:

-testing at midnight & 3am, every night with no exception (no cgm)
-keeping the target range at 130 for the nighttime and 150 for a new site
-correcting conservatively when in doubt
-using a reduced basal rate when in doubt

I know that the key to a good A1C is to get the nighttime basals set appropriately but I am more inclined/comfortable to be aggressive with Mia's targets during the day and keeping her at a slightly higher/safer range at night..at least until we have better, more reliable technology available.

MyAngelEmma · #6 03-30-2010, 04:23 PM

Becky, when you talk about giving a nighttime snack such as icecream and peanut butter crackers do you bolus for these or are they uncovered?

Becky Stevens mom · #7 03-30-2010, 05:10 PM

Quote:

Originally Posted by MyAngelEmma

Becky, when you talk about giving a nighttime snack such as icecream and peanut butter crackers do you bolus for these or are they uncovered?

Im sorry, that is a good question. It all depends with Steven. If he is over 100 I will give him 1/2 unit. If over 150 I will give him 1 unit. There have been times when he is under 100 or even higher that I dont dare give him anything as the humolog will just slam him. Especially if hes been very active, the activity seems to drop him as quickly as insulin does . We usually test at 1AM or 2AM and his BGs still havent risen that much even if I dont bolus for the snack at 7:30

RosemaryCinNJ · #8 03-30-2010, 06:13 PM

Amanda gets ice cream ...1/2 cup ..yes I do bolus for it ..but if I use Carb Smart by Breyers I dont..

KarenRI · #9 03-30-2010, 09:47 PM

Becky,

My son thinks you are the best!

His BG's have been very stable all evening 85 - 120. At bedtime he was 88. A bit too low for bedtime....He's always gone for a juice box at bedtime if he's on the low side of his normal range. But lately, the juice box will bring him up, but then he drifts back down again.

So, before he could get to a juice box, I handed him a 1/2 cup of low fat ice cream. He looked at me in disbelief. LOL! I burst out laughing at the look on his face!

What? Ice cream?? Now?

Yep. Sugar, with a bit of fat and some protein. Let's see if it keeps you from dropping.

Mom, you're the best!

(No, not me. Steven's mom).

Thanks for starting this thread. It's a helpful one!

Becky Stevens mom · #10 03-30-2010, 09:48 PM

Quote:

Originally Posted by KarenRI

Becky,

My son thinks you are the best!

His BG's have been very stable all evening 85 - 120. At bedtime he was 88. A bit too low for bedtime....He's always gone for a juice box at bedtime if he's on the low side of his normal range. But lately, the juice box will bring him up, but then he drifts back down again.

So, before he could get to a juice box, I handed him a 1/2 cup of low fat ice cream. He looked at me in disbelief. LOL! I burst out laughing at the look on his face!

What? Ice cream?? Now?

Yep. Sugar, with a bit of fat and some protein. Let's see if it keeps you from dropping.

Mom, you're the best!

(No, not me. Steven's mom).

Thanks for starting this thread. It's a helpful one!

Oh no

just dont tell the endo

I hope it helps to keep him from dropping