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Night Time Lows

Discussion in 'Parents of Children with Type 1' started by andy18, Jan 7, 2013.

  1. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

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    Living with Type 1 is but a series of never ending "unpleasant chores" - you can accept that and do what needs to be done and get on with life, or you can look to avoid it and let D run the show. I tell my kid, "You can manage your D or you can let your D manage you, which do you think is better?"
     
  2. Brenda

    Brenda Junior Member

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    First of all, technically speaking, a BG of 66 mg/dl is NOT considered hyplogycemia; 60 mg/dl and below is considered hypoglycemia. But, since home meters have a 20% or so accuracy issue, a reading of 66 could be 58 or 72 (not exact math by me).

    Secondly, nighttime checking is one of the most heated debates. Most endos who do not recommend it DO NOT LIVE WITH DIABETES 24/7! Food, exercise, menstrual cycles, puberty, phase of the moon, you name it, can affect one's BG. In my opinion, I would NOT stop those middle of the night checks, even if your child is using a CGM. Of course, you can probably skip the blood check if you are comfortable with the 2 a.m. CGM reading (trial and error, experience, etc. are factors here). That said, if you can manage it, have someone else help with this so you do not become unable to function in your daily routine. Of course, if you are a single parent, this may not be possible. Maybe you check every night, maybe only nights after basketball. Personally, I recommend you single parents check every night your child goes to bed with either a low BG that was treated with food or nights that you have given extra insulin for a high. During the honeymoon, you should not be giving too many corrective doses, but if you do, you really need to check later. Work with your diabetes team about corrective dosing, don't try it on your own until you are more comfortable with doing this. BTW, you should read the popular blogs by adults with type 1 (ex. Six Until Me, Scott's Diabetes, etc.) to see what they do overnight. As for others, check every night if you can manage it. I'm sure others will chime in because there are so many issues, such as "My child wakes every time and is tired in the morning" or "I don't want to turn on the light" or "What about the sugar I give; do I need to worry about their teeth?" or "What do I do if their BG is just a bit high/a bit low/etc.?"

    There may be studies about nighttime checking. If I can find some, I will post them.

    About forearm and such checking, see the CWD page on Alternate Site Testing at http://www.childrenwithdiabetes.com/ast/
     
  3. DsMom

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  4. khannen

    khannen Approved members

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    My daughter hated night time testing at first. Eventually, she just slept through it and didn't even know it was happening. I just used a small flashlight. It became part of routine care. It's not optional in our family! I told her it was needed to provide the best care for her and we've found ways to work with it. She can even drink down a juice box in her sleep and never remember it the next morning.

    She now has a cgms so we're not actually testing overnight. However, there are often nights when I need to make adjustments..correct a high, give a bit a sugar, use a temporary basal for a few hours. Without those overnight numbers, none of those issues would have been caught. Just because one doesn't eat overnight, doesn't mean blood sugars will be stable for eight hours. I remember fighting stubborn highs one night just because she had horrible nightmares. The stress alone made her bg skyrocket.
     
  5. Christopher

    Christopher Approved members

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    I don't think you should ever stop testing at night. It is the only way to know what your child's blood glucose level is for the 8-10 hours they are asleep. I have been testing Danielle every night, multiple times a night for the past 6 years. I have caught MANY lows/highs that I would have missed had I not been checking.

    In the begining it was very tough because she would wake up every time. After a while she started sleeping through it and it was much better. I use a headlamp and can be in and out of her room without disturbing her in about 30 seconds.
     
  6. quiltinmom

    quiltinmom Approved members

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    I didn't read all the responses, so sorry if this is a repeat.

    This is how I would respond to this situation. (Run it past your dr first, of course!)

    The Lantus is bringing him down too much, so it sounds like you need less Lantus.

    Then, you may need to adjust meal ratios in order to compensate for the lowered basal. It will take at least a few days to know if you need to do this.

    Ideally, you shouldn't need to feed him during the night if your insulin is right. If you have to treat a low, you treat it, of course, but if it's a pattern, you can think about adjusting insulin doses.

    I don't test at night routinely, but if there's a problem or i'm trying to figure out what's going on (i.e. what time of night he drops/rises) night testing is necessary. It's okay, in my opinion, to start testing at night for a while, then stop once you get it figured out (until next time things start getting wacky, lol). I know a lot of people think night testing is always always necessary, but.....you have to make your own decision on that one.

    As for the sleep disruption of the child/siblings, I've found that they soon get used to it and stop waking up. I test by keeping a nearby light on and door open (which is how they always sleep) and I usually have enough light for testing. Or bring your phone in with you and that will give off some light. :) DS sometimes says, "what? You tested my blood last night?" He even says this when he has given himself a correction for a high. I find it amusing. :)

    Good luck!
     
  7. ecs1516

    ecs1516 Approved members

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    12 years in. Still have to test in middle of night sometimes even with CGMs. CGMs can alert you to lows or highs but you still have to check when they go off. Especially if they are reading a high BG. Diabetes never sleeps. I feel either I have to get up and check or have a CGM watching for me. But, CGMs can alarm and drive you crazy too some nights.
     
  8. pianoplayer4

    pianoplayer4 Approved members

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    Hi, I can't fully answer your question because it really depends on the person... but the general answer is.... it never stops=( I'm 17 and doing all my own care. I have a cgm and so I don't usually have to ste an alarm... but its rare that I sleep through the night with out at least one alarm... as your child gets older (I'm sorry I didn't notice how old your kid is) you might be able to slak off once in a blue moon (sometimes when I was a younger teen and hated getting up every night my mom and I would agree to not correct a slightly high number {180ish** and just sleep through the night... but it was rare)

    unfortunately waking up at night is just a reality for the rest of life with diabetes.... I'm sorry
     
  9. Heather(CA)

    Heather(CA) Approved members

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    Lower his Lantus by one unit. and make sure you give it to him in the bottom EVERY time :) That will fix it :)

    I don't test my son every night, just after sports during an illness, or if my gut is telling me to. At times this means every night but not as a rule. He has had D for almost 10 years. You should talk to your Endo about testing at night and when. And most importantly, trust your gut.
     
    Last edited: Jan 10, 2013

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