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How do you teach your teen to wake up

Discussion in 'Parents of Teens' started by Lakeman, Nov 5, 2014.

  1. Lakeman

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    Expect might be too strong of a word. Hope might be better. Understand the importance of night time checks when needed and be responsible.

    I hate to see blanket rules applied to everybody. Some people might be stable enough that they rarely need night checks. Others might need them every night. And others still might just need them less frequently or only when circumstances dictate.

    At a minimum one should have a system in place so that when checks are needed they happen. My sister in law has type 1 and on a few occasions her husband discovered her to be very dangerously low at night. I don't know the details but he was her plan. Now she is divorced and I hope she has some other plan.

    If at our teens find themselves sleeping alone that plan will need to include the ability to self-monitor one way or another. I personally would not trust that most people will feel lows while asleep and be able to respond to them every time.

    Being able to make good predictions about how safe a night is going to be will be important. Checking on the nights when needed will be important. Alarm clocks, CGM's, assistance from others...whatever tools sit takes should be used.
     
  2. sszyszkiewicz

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    I think (hope) in a couple of years, with Nightscout/Share and whatever comes next, those suffering from T1D will be able to have a small network of people that can reliably (like 99% of the time) help with this task.

    T1D is semi-random. I think thats what makes it such a nutty disease. Sure 95% of the time if you go to bed say at 130 you "should be" fine. There are all of these rules of thumb, a list of exceptions, and then the dreaded unknown. Once you accept the unknown exists, it boils down to the fact that you just need to know the number and move on.
     
  3. Mish

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    I think the difference is that our kids are growing up with it as part of their diabetes routine. Just a regular part, an expected task, like any other diabetes task. They might do it, they might not. But where it wasn't part of your "ritual", it is part of theirs.
     
  4. GChick

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    I think that was well said and "fair". Its not important to follow someone else's routine, as long as you are taking care of things when they need to be taken care of.

    While I might even have more "hiccups" than I might like at night (one is too much, but is still generally very uneventful)... At this point in time, I'd have to say even while on Lantus, night-times were/are just some of my most predictable times and so I'm more relaxed about testing then than any other time of day.

    Others don't exactly have that luxury especially as kids, when they can still be bouncing all over the place at night. I'll even admit that night checks as a kid while still living with the parents could be a "more" expected (if it suits the situation/person/family) ritual than I came off sounding like it should be.

    For me, I just found that once all the growth spurts were out of my system, and I found an insulin regimen that worked for me (for the most part) there's just less "going on" at night so you can relax more... no eating, no exercise, little stress, little temperature variations etc.

    With my now being on a pump, there are even more variables that I have control over so that even if my last check before going to bed is a 60... I can still feel comfortable with going to bed at that number without ~having~ to eat anything or test later (just make other adjustments). However, if I am high... I will usually at least make sure its coming down successfully before going to bed and if I have to wake up to pee, I'll of course check then.
     
  5. GChick

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    As long as she is not doing absolutely horribly, cut her some slack. I remember around 18 being my roughest time with diabetes and it wasn't even for lack of trying (hmmmm maybe I should rethink my prior comments about testing at night while in college, maybe that IS the ideal time to be doing it????). It just seemed like nothing worked the way it should.

    Anyway, if she's trying, let her slide. If she's not.... well, I guess there's only so much you can do there too.
     
  6. Christopher

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    I would be interested to understand what you mean by a “network” of people who would help someone with Type 1 wake up to check their bg? It almost sounds like you are suggesting that they rely on other people outside of their home to monitor and alert them during the night. To each their own but that is not something I would ever think would be a good idea.

    I would also caution against your statement that 95% of time if you go to bed with a 130 you “should be” fine. I don’t see how you can come up with that percentage and that it applies to all people with Type 1 diabetes. I would discourage people from thowing around meaningless statistics that may confuse or lead people to believe something that is not proven to be true.



    Similar to some other parents here, I am happy to check my daughter several times a night and not make her get up to do it and deal with a high/low. After doing this for 7+ years, I am comfortable that she knows how to manage her diabetes correctly (although at 16, actually DOING it doesn’t always happen). I would rather she get a good night’s sleep so she can function properly at school. Teens have enough to deal with as it is, and I am ok with taking this one thing out of the mix for her. Once she is out on her own, either at college or when she is an adult, I will really have no control. I can only advise her what I think she should do (CGM, etc) but it will be up to her to manage it herself.
     
    Last edited: Nov 7, 2014
  7. Christopher

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    If that works for you, then great. But I would caution anyone else that going to bed with a bg of 60 without treating it (eating something), is a dangerous practice. It is also important to remember that most of the members on this site are parents of children and that practice would not be a good idea for them. I would recommend that a child with a bg of 60 at bedtime treat the low, test 15 minutes later and if they are still not coming up that they continue to treat until the child's bg is in range. I would also suggest that they re-test a few hours later, in case it is a stubborn low that needs more attention.
     
    Last edited: Nov 7, 2014
  8. sszyszkiewicz

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    No arguments from me Christopher. I am just saying that with improved technology a PWD will not be as "alone" as they used to be at night. By the time my son is off to college the remote monitoring capability will be quite reliable. So you can have a small network of people that can back the PWD up. You are correct that there are no real percentages when the word "should" is in the sentence, which is exactly the point I was making.
     
  9. GChick

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    Yes and agreed. My apologies for making such a statement as it was far from meant as a suggestion of being "OK" for anyone else's care, especially kids.

    But I do find forums a useful place to hear how others deal with things, even if not mainstream, so sometimes I unfortunately do not filter myself enough for forums particularly targeted for children's care... as sometimes the "unusual" comments are what I sometimes look for myself.

    Just to be clear I'm not even saying that I would always myself go ahead and go to bed with that number, just that with the ability to turn basals way down/off for a time, that I ~could~ from time to time if the situation dictated that it was ok to do so (ie: if lows weren't a running theme for that day and I could "explain" the low within reason etc).

    Personally, due to the pump still being "new" to me in comparison to the rest of my life without it, I tend to treat with food/drink most of the time anyway, as that is what is ingrained in me (and also slightly faster for moderate lows such as a 60 and much faster for very low lows). But I do appreciate the option.
     
  10. KatieSue

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    Thank you - it's what I'm trying to do, not always successfully, but she does need to have it come from within so to speak.
     
  11. Jordansmom

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    I really don't understand why you think this is a bad idea. I'm not a "network of people", but I do back up my DD at night with the Dexcom Share while she is away at college. The second night we had it she went low and treated early in the night. I was up and watched the trend for a while. I'm not sure if she was watching or not. She leveled out and was steady so it looked like she was fine for the night. Later she dropped again. The Share alarmed at my home at 65. I texted her to see if she was up. When she didn't respond I called her. She answered her phone. I asked her if she was treating. She said "I am now." On the Dex she went down to 48 before she recovered. Not sure how low she really got. I also have no idea if she would have woken up on her own in the next few minutes or not. Odds are she would have been okay without my call. She survived the first year of college without my back up. But who cares what the odds are? She's alive and didn't have a seizure.

    Kerri Sparling from Six Until Me has her husband or mother watch her Dexcom numbers when she is travelling or if her husband is travelling and she is sleeping alone. Why is any of this "not a good idea?"

    Do you think people with the Dexcom or with someone else watching their Dexcom are any less likely to feel their lows or wake up from a low in the night by themselves?
     
  12. sugarmonkey

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    We don't have a CGM and its very unlikely in the near future either. DS can be very unpredictable at night, so I really need to test him every night. As an example, Thursday night he went to bed at 10, what should be a good number. At 5.30am I checked him and he was 2.3. He probably wouldn't have got up until about 10am, so if he didn't test overnight this could be really dangerous. Nights like this are a frequent occurrence for him. Since he's talking about moving out in the next few months I would hope he would test overnight at the moment. He says he will. If and when he gets a bit more stable overnight, he might be able to stop this so much. A lot of adults he knows tell him he'll stablise overnight when he's older. We'll have to wait and see what happens, as the people who say this are also people who don't routinely check at night, only if they wake up naturally, so who really knows how stable they are.
     
  13. Christopher

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    I was simply trying to understand what they meant by "network of people". I thought he meant other people who use the night scout or something and that seemed odd to rely on strangers. If you monitoring your daughter at college works for you, that is great.
     
  14. Mimikins

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    Quite frankly, my parents don't know what's going on most of the time -especially at night. They only know I'm high if I am drinking a lot of water and complaining of being high, and they only know I'm low when they see me gorging on glucose tablets. If I did a random night check and something is really concerning (primarily ketones), I will wake one of my parents up and notify them just in case I cannot fix the issue and require medical intervention. Otherwise, I might update them on what occurred whenever they wake up.

    Up until very recently, my nights have been very stable, and I only did night checks if I had to do a late infusion set change, woke up in the middle of night needing to pee and drink galleons of water, and if I was low. Within the past three-four days (curse a very late or missing Aunt Flo), it seems like I have become a lot more insulin resistant, and I have been consistently up around 11-3AM treating persistent nighttime hyperglycemia and very high fasting BG's. Until my insulin sensitivity returns to normal or I can temp rate without wide variations in my BG and wake up around 100 fasting, I am scheduling at least one midnight check.
     
  15. MomofSweetOne

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    I now rely on Dexcom and only test as necessary. An adult friend said she tries not to have IOB at bedtime and then relies on Dexcom, but she'll set an alarm if she's had unusual exercise. This is what I anticipate my daughter will do.

    As far as waking, we're in the working on it camp. I want her to sleep because I don't want her constantly tired and her schoolwork being affected, but I also have the concerns about greater independence away when she wakes to neither low nor Dexcom. What we've started doing is designating her being on night duty on selected nights that she can sleep in the next day. We had an older receiver with a funky screen, so she sets those alarms to 80 & 200, and I reset the alarms on the normal receiver to 60 & 300. That way she has back-up if she doesn't wake but the first, primary alarms are in her room, not mine, though my guess is that I would wake to them from her room. Our success rate? Every night she's had "night duty" has been a no-alarm night, so I have no idea!! (I do joke that more nights should be hers if that's what happens. :)
     
  16. Megnyc

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    I'm an adult who has had diabetes for almost 12 years. I have used CGM 99% of the time for the past 7+ years. My parents (or another adult) used a baby monitor to hear my sensor and also checked me every few hours every single night for the 8 years I lived at home with diabetes. Until I was 17 and left for college I had no responsibility for nights except for at sleepovers and on relatively frequent trips without my parents.

    That said, I don't do regular night checks. I keep my dexcom alarms on 60-180 at night. But for a high I will usually correct when it alarms and then raise the high alarm to at least 300. I find few things more infuriating than being woken up by a high alarm. It is very rare I go a night without an alarm. I think I might be a bit unusual in that if I wake up during the night I can fall back asleep instantly so it is a bit less annoying than if it took me time to fall back asleep.

    I don't know any adults who set regular alarms and I am pretty sure I am the only one I know who actually keeps alarms set on my sensor at night. The most brilliant, accomplished, and responsible adult with type 1 I know uses the MM CGM and keeps the alarms off at night. She actually tried my dexcom for a week over the summer and hated it because the under 55 alarm would wake her up and she would be like 60 which she is fine with (for the record she is a physician).

    I'm not sure why someone was criticizing the use of remote technology but while I find the notion horrifying for myself, I think it will probably be the answer for a lot of young adults who have grown up using CGM. My younger brothers are at boarding school and I imagine if one of them had D my parents would use nightscout and contact their "house mom" if they were low and not responding to a phone call. That could be pretty easily adapted for use in a college setting.
     
  17. Ali

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    I am a 40 plus year T1 who forever set an alarm clock to check at night and now that I have been on a CGMS since they became available has the alarms set for 65 to 130 24 hours. The only time I turn my alarms off is during a live performance. I also alarm nightly and eat or if looking like I am going to stay high get up, check and correct. I can not believe you and I are the only adults who do this. It may not be common but I believe there are plenty who do this. :) Ali
     

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