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Night time numbers question.

Discussion in 'Teens' started by Artgirl, Nov 19, 2015.

  1. sszyszkiewicz

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    I don't know. It just seems like a kid with diabetes, having low blood sugars prior to diagnosis? That just sounds weird. I am not sure how that would happen. My sons blood sugar was close to 800 (us units...100 is normal) at diagnosis, and probably was up there for a good long time (weeks) before we were smart enough to figure it out (to this day I feel horrible about that). I just never heard of a diabetic kid not on insulin with low sugars. I am not a dr. it just sounds really different. Thats all I was saying.
     
  2. Snowflake

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    Good luck! I still viscerally remember this feeling of shock and bewilderment following diagnosis.

    On this issue and a lot of other issues, it came as a real surprise to me that our life with diabetes -- and what I eventually learned online from other families -- often didn't match up with what the doctors told us to expect. T1D is a pretty unique disease in how much the medical professionals turn over the keys to patients and their families, but that also means that you'll quickly become the expert in your child's diabetes.
     
  3. Artgirl

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    I was told that it can preceed diabetes because their threshold for bg is so high that if they dip a bit it they have hypoglycemia symptoms but not actual low numbers if that makes sense.They did iron and thyroid things were good.
     
  4. rgcainmd

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    Experiencing "hypoglycemia symptoms" without a low blood sugar is NOT hypoglycemia.
     
  5. MomofSweetOne

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    With all due respect, I would fire your endo immediately. If they give advise like the above, I wouldn't trust their knowledge or competence on other T1D management issues. Name-brand or not, it's horribly inaccurate and dangerous. What BG numbers are at bedtime has little to do with what they are even 30 minutes later sometimes. We all wish nights were nice and steady, but that's not the reality of D, even for adults, though they are more stable than kids. It is not your doctor that will be affected if her advise is wrong; it is your child. Seizures can leave permanent damage.
     
  6. Artgirl

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    I have read in here other children who had hypoglycemia before diagnosis ....its not uncommon. Thanks for all your input.
     
  7. rgcainmd

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    I second this!^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

    Don't risk your daughter's health (and life).
     
  8. njswede

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    FWIW, that's what our endo told us too. We were supposed to do two checks during the night for the first two weeks and then, if things were stable, night time checks were optional.

    Everybody lived, but once we got a CGM, we noticed a lot of things were going bump in the night...
     
  9. DiabetesMama

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    Artgirl,
    When my son was diagnosed they wanted us to check for just the few weeks but then they said it didn't need to be done. So I listened to them. It wasn't a month later that my son came stumbling into my room, shaky, gray colored and was having a hard time breathing. I was lucky that night that he actually FELT that low because as we have gone on with this nasty disease, he has gotten less sensitive to the feeling. (Treating a 48 low as I am typing...) He has only woken up and come to get me a total of two times in the year and a half. Once we got the Dexcom hooked up to him, it was shocking how many lows he sleeps right through. Would those lows untreated end up in a coma or life threatening situation? I am unsure. All I know is that his well being is my responsibility and I will do all that I can to make sure he makes it through the night. If that means looking like a "zombie mom" first thing in the morning with matching bags under my eyes, hair sticking out and drool coming from the corner of my mouth, then sign me up. That night was so scary to me because I could have lost my son and woke up to a really horrible situation. WE are not trying to scare you, we just want you to realize that not all doctors are created equal. In my opinion, they have to earn my trust with my son's health, not the other way around. We are lucky and we have one of the best hospitals in the country a little over an hour away and I consider us blessed. They don't all agree, but the team that takes care of us are very impressed with what we have accomplished. His A1c was over 14% when first diagnosed, they were shocked that he wasn't in a coma! In less than 1 year, we have brought his A1c down to 6.0% and most of his A1c's have been below 6.5. So, I listen to what they say and then I do what I'm gonna do at home. Please don't take offense at some of the reactions here. They really do care and are very passionate about kids and what they are going through. We all want the best for you and your daughter. Your family is still in my prayers. Keep us informed of how it's going.
     
  10. C6H12O6

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    it seems likely from the regimen you described its not a very progressive diabetes program . is this by chance Sick Kids ? they have really high rates of putting kids on twice daily NPH which has fallen out of favor in even small community hospitals that see pediatric patients .

    its sometimes necessary to have a child on NPH during the day , but most clinics do NPH in the day and Levemir at night if NPH is necessary during the day because the child can't do their own lunch shot .


    its about a million times worse to tell a family to inject NPH at night and then discourage night time testing . sounds a lot like Sick Kids .

    The other sad part of the thing that happens at sick kids is families who they deem more capable get more modern insulin regimens , and talk of cgms and pumps happen early. if this is Sick Kids ask questions about why they chose this insulin regimen.
     
  11. wilf

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    Ok, so how are her numbers and how much insulin is she getting?

    If she is having a strong honeymoon and is getting only minimal insulin at this point then I would agree with your endo. Because in that case her body still has the tools to regulate blood sugars overnight.

    But otherwise I would respectfully disagree. Overnight measurements are part of what conscientious parents do.
     
  12. MomofSweetOne

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    http://www.ncbi.nlm.nih.gov/pubmed?cmd=Retrieve&dopt=Abstract&list_uids=17652003

    http://care.diabetesjournals.org/content/early/2010/02/25/dc09-2081.abstract

    Edited to add: Apart from the risk of DIB or seizures, what hasn't been mentioned is the affect of out of range nocturnal BGs have on the daytime education of our kids. Those out of range BGs are sometimes referred to as hyper-overs or hypo-overs and can affect the kids (or adults) throughout the next day, even after the meter again reads in range. I definitely see my daughter's ability to learn during those days being affected to a large degree by how rough the nighttime went.
     
    Last edited: Nov 21, 2015
  13. Artgirl

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    Her numbers have been between 4.5 and 10 so far average of 6.5.
    Meds are 12 Humalog
    28 Humalin N breakfast

    8 Humalog
    11 Humalin N Dinner...what can u tell me is this a lot of meds? is she honeymooning?
     
  14. rgcainmd

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    B

    Humulin N = NPH insulin. NPH is considered to be just barely shy of archaic in the T1D world. To give you an idea of how archaic, we used NPH to treat patients when I was in med school (and I'm now 57 years old); do the math.

    I strongly recommend that you take your daughter to an endocrinologist who has her/his feet firmly planted in the 21st century. Your daughter will be much the better for your having done so, and this will, in turn, lower your anxiety level. While your daughter is taking NPH, the advice you receive on this Forum (which, as an MD and mother of an adolescent daughter with T1D, I find to be EXCELLENT and worthy of my trust) will be limited by the fact that NO ONE (any of you still using NPH on a regular basis please correct me) has their CWD taking this kind of insulin.

    I know you're very new to this T1D life, but trust us here on this Forum and get your daughter off this very old insulin. Your daughter deserves better care than she is getting from her current endo. I cannot emphasize this enough!
     
  15. rgcainmd

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    Artgirl, when you say that your daughter's numbers have been between 4.5 and 10, this tells me that her BG is varying wildly, which I suspect has a great deal to do with the fact that she is not taking a far superior kind of long-acting insulin like Lantus or Levemir. With wild swings like this, I'd be checking my daughter's BG 4 to 6 times overnight (if I didn't already use a CGM that I trust). Also, when you say that her levels are between 4.5 and 10, the reality is that those are her levels when you check them. Without CGM, you don't for a fact know what her levels are in between the times you test.

    I (and I believe everyone on this Forum) am NOT telling you these things because I think you are stupid or negligent, or a bad mother. From everything you've posted, you strike me as a VERY GOOD mother who devotes her life to her children. Rather, your daughter is receiving what I consider to be extremely substandard diabetes care because her endocrinologist is clearly undereducated, is burned out, doesn't care about the well-being of her/his patients, or a combination thereof. If you feel comfortable telling us your location, perhaps some parents can chime in with recommendations on where you can get your daughter competent care for her T1D. You are very much in my thoughts.
     
  16. Artgirl

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    Wow....that's not the reply I was looking for....my daughter was diagnosed with diabetes and I took her to our local Children's Hospital where they have an entire Diabetic and Endo unit that serves over 2000 families and I trust them very much so because my younger daughter has DS and I have been going there since she was born and is now 14 and we have received nothing but the best care for her so far. I came here for encouragement only to find that I have been lectured over not doing this or that. Did I know anything before diabetes maybe a bit but now I have to learn because my child has Diabetes. Our Endo is a young, very kind and helpful professional in my eyes. I know kids that have been going there since they were 2 and now they are teens and are managing fine. I am left feeling that I have done everything wrong so far and that the people that I trust in her care have done me bad....sorry for the rant but not the kind of support I need right now.
     
  17. rgcainmd

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    Hey, did you not read my last post?!?!?

    The number one reason I come to this forum is to make sure my daughter has the best, state-of-the-art T1D care so she can live a long, happy life free from serious Type 1 complications. Support and encouragement are nice, but I'd trade that in a heartbeat for sound advice about my daughter's T1D...

    Who knows why your endo is managing your daughter's care poorly. Perhaps it is because of the very thing you have mentioned: SHE IS NEW. When I and my colleagues were new MDs, there was a frightening amount of knowledge we lacked, the kind of knowledge one acquires from EXPERIENCE. If you want to continue believing that you daughter is receiving good care from her current endo, then there's nothing I or others can say to change your mind. But regarding your current endo's expertise in treating T1D, all I can say is that, much like diabetes, there is no cure for stupid.

    Do what you will. I wish you the best.
     
  18. Michelle'sMom

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    Artgirl, my dd was on NPH for the first 7 months. That was 6 1/2 years ago, but hardly archaic. And her endo team is from a very large, very well-known childrens hospital in our state. NPH gets a bad rap because it's more unpredictable, but it also allows for a shot free lunch during school, which can be helpful for the newly dx'd who might not have access to care during school & while learning to count carbs. It's also very helpful for some in fighting a strong dawn phenomenon.

    As Christopher is fond of reminding this forum, you should rely on your medical team as the main source of info right now. No one here knows all the details of your dd's medical needs, so take the advice thst you deem helpful & ignore the rest. Your best weapon in this battle will be your confidence in your ability to learn & manage treatment, which will enable you to teach those skills to your dd. Don't let comments here degrade your confidence, especially while the dx is so recent. You're caught up in the fear of the unknown we all experience at first. Work to build confidence & positivity & don't let the critics tear you down. Hang in there.
     
  19. Artgirl

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    Thank you Michelle's mom....I appreciate your words of encouragement....today I got her first lower reading 3.8 and a bit of panic set in, she had no low symptoms and ate lunch and is fine. I also let her practice giving me fake injections and she is now doing hers on her own..in less that 2 weeks..yay for that. The Endo team did mention there would be changes to her meds and methods as time goes on and this is just the beginning stages to help us get used to this new diagnosis and treatment plus food. Thanks for the additional info as well.
     
  20. Michelle'sMom

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    3.8=68in US measurements. Low, but not terribly so. Wilf is the best source here for learning about insulin. He was a huge help to me when my dd was first dx'd.

    What sort of meal plan is your dd on right now...carbs per meal, carbs per snack etc. Does she have planned snack times? NPH has a very pronounced peak, so planning a snack around the peak can help keep BGs more steady. Also, Wilf mentioned the honeymoon in his previous post. Did your endo explain what it is & how to prepare?

    You're going to make it through this just fine. It doesn't get easier but you'll learn more & improve your skills. Just keep reading & asking questions.
     

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