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Night Time Testing Question. What do you do?

Discussion in 'Parents of Children with Type 1' started by andiej, Feb 5, 2014.

  1. mom24grlz

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    I normally test Ashleigh every 3 hours at night. The last four to five nights I've been having to get up a lot more often. she's been going low at night. I've been doing some reducing but just haven't found the right amount yet.
     
  2. glko

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    I appreciate the input from others and hearing what works for you. My response is not meant to say this is what others should do, just what works for us at this time. That may change in the future. The original poster has a child new to diabetes as well so, like us, may be in the honeymoon phase. I share what we do to show that not EVERYONE wakes multiple times each night to test. Initially when I began visiting this site I felt guilty that I wasn't doing this or that or the other thing and I usually get a good night's sleep as does the rest of my family. But I have given up that guilt, along with guilt over lots of diabetes related things, and realize that diabetes is a marathon and we need to work with our endo and care team to find a plan that will keep our son safe and healthy and all of us sane.

    Although I am years away since my ds is only 9yo I wonder for those with teenage children who still wake at night to test their children what plans to you have once your child is in college or moves out? Do you think that they will set alarms to test or do they all use CGMs? How practical has it been to transition this to your teenage children and how accepting are they of it?
     
  3. andiej

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    Thank you all for your feedback. To those that asked, yes my son is honeymooning and his levels are normally pretty stable day and night. On the odd occasion he has a low or higher reading before i go to bed, i will wake and test again at 2am and on one occasion i tested again at 4am. For now this works for us, and I hope it will continue but I'm aware it could be totally different once the honeymoon ends. I think glko has a valid point, and one i wonder about, what happens when teenagers go to university etc...it's a long way off but something I do think and worry about.
     
  4. Christopher

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    Understood. And I agree, there is no point in feeling guilty about how you manage your child's diabetes in relation to what other people do. We all have our own style and comfort level, and that changes depending on where you are in this whole journey.

    As for your question, at the point my daughter is in college or has moved out of the house, the way she manages her diabetes will be up to her. I am hoping very strongly that she will be using a CGM. If not, I hope that she will set an alarm and check at least once at night. It is a big burden and I feel for her and all the other young adults who have to deal with it. I am comfortable that I have given her the tools and skills to assess what is going on during that particular day (food, exercise, menstrual, etc) to make good decisions about testing at night.

    I have had people tell me that I am doing her a disservice by not making her set alarms and wake and test in the middle of the night now. I disagree and this is why. As I said above, she knows how to manage her diabetes. She has the tools and the knowledge. And she is going to have to deal with this her entire life. So if I can ease her burden a bit by letting her get a good night’s sleep, I am happy to do it. I would rather her focus on her school, extracurricular activities, etc and function at the best of her abilities. Burnout is a very real and dangerous side effect of having diabetes and I want to do everything I can to help her avoid it. As long as I know she can manage this disease on her own, I am fine with helping her where I can.
     
  5. Sarah Maddie's Mom

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    To the teen questions.

    I check her at night, and use a CGM so that I can try and capture 8 hours of something close to glycemic stability. It's a 1/3rd of the day and when it works it both improves her A1c and helps her feel better when she gets up and gets her off to a good start for the day. But equally important, I'm teaching her to understand how the hours before bed impact overnight numbers. She knows that practice, then dinner, then shower and site change means paying closer attention at night. Knowing this she begins to put the pieces together for herself in terms of what she eats and how long she showers and how to read her pre-bed number within that context. More than anything it's this critical thinking process that she's learning, so yes, I do expect that as she moves closer to college (she's 16) that she will begin to take over more of the overnight management, be that checking, planning or reliance on her CGM.
     
  6. MomofSweetOne

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    What you are not yet experiencing is how management gets incredibly harder when puberty hits. The nights aren't calm. The basal needs increase and decrease by huge amounts, at least in my daughter. I'm told that things typically get easier around 16 and then again at 18. I hope, hope, hope that my daughter doesn't have to experience the nighttime management that I'm doing the vast majority of nights, that there will be patterns that repeat, etc. In the meantime, her brain is still developing and she needs sleep. So do I, and we're trying to find a balance between both of our health.

    If you read Christopher's and Sarah's posts above, they are right on for finding the balance between now and letting go IMO.

    The hardest part is when others judge why one's 14 year old is not expected to take such responsibility on yet. At this point, my daughter's management skills are good, but it's hard to even shake her awake on the occasions that I do need her awake and I'm not at the point I'd be comfortable with her sleepy judgement. Neither do they realize that our teens are almost always constantly "on" doing the work their teen's body does automatically.
     
  7. Andy'sMom

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    This April is Andy's 9 year mark living with D and we have tested him every single night since he was diagnosed. Obviously, we went though the infant/toddler years so different challenges there, but he is now 9 years old and we still test him after he goes to bed. We don't use a CGM. Usual routine is to test at 11:00 pm and depending on the number, we may check again 2-3 hours later. Generally, if he's over 110/under 180, we don't retest. If he's high, we test again in 2 - 3 hours and correct if needed (which means, of course, another test 2 hours later). Same with lows - treat and retest throughout the night as needed. Often, if I wake up in the wee morning hours, I test again just to have peace of mind and to know what his levels are doing.
     
  8. skyblufig

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    In addition to all the day time checks, overnight we do 11p, 2a, and 5a. Usually we switch off doing the 2a depending on if dh has to work the next day or not.
     
  9. DavidN

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    Your son is 9, mine is 10. Eight to nine years from now, when they go off to college, I think night testing will largely be a thing of the past. The CGM's will be far more accurate and reliable than what is already terrific technology today, and our son's will in all likelihood be using a closed loop system for sleeping bliss (for them and for us).

    Within a year or two I'm guessing the G5 will be out and parents can remotely check on their college kids every night.

    But even if my son were going off to college next year I think he would choose to keep the G4, which combined with years of D training, would go a long way to keeping him safe.
     
  10. glko

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    I hope that you are right that technology will move forward faster then it has in the past 8-9 years to make life simpler. My dh first went on a Medtronic pump about 15 years ago and I have to say I am disappointed that the difference between his original pump and my son's Ping pump is not that great. What seemed like a great breakthrough back then now feels pretty outdated compared to what ds's iPhone can do.

    I do have comfort also that my dh went to college with diabetes on 2 shots a day of NPH and Humalog and, knock on wood, has never had a low BG needing assistance or been in the ER or hospital in DKA. He lived by himself in an apartment for several years. He is definitely NOT a nighttime tester and does not wear a CGM.
     
  11. wilf

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    It would be madness to ask or expect a teen to try to manage the ups and downs of puberty themselves. Anyone being judgmental doesn't have a clue.
     
  12. DavidN

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    The delivery mechanism itself may not have evolved a great deal over the past 15 years but I think what our kids will be befitting from, what everyone with T1D will be benefiting from, is gains in CGM technology. If CGM technology continues to evolve at the rate it has over the past 9 years then I'll be very happy.
     
  13. sszyszkiewicz

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    To that point.......check out this web page.....I love the marketing graphic...."The Revolution will be Bloodless"

    https://abbottnextfrontier.com/flash-glucose-monitoring
     
  14. Don

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    How strange that accuracy was better in the group that did not re-calibrate!
     
  15. sszyszkiewicz

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    If they were calibrating with standard blood glucose monitors....remember the number you see can be +/- 20%. So if it says 100, it could be 80 or 120.
     
  16. hawkeyegirl

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    Oh, Abbott. You're going to have to come out with something more revolutionary than that before you erase the Navigator debacle from my memory.

    In response to the poster who was lamenting that pumps haven't changed much in the past 15 years...to a large extent that's true. But I'm not sure how much more then can improve, other than a few small bells and whistles here and there. What HAS changed in the past 15 years is that we now have good, reliable CGM technology. It will be the standard of care within the next 15 years, and not using one will be akin to someone today checking their BG with a urine strip.
     
  17. Don

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    Hope you are right about standard of care in 15 years but as it is now, cost of CGM will never make it as universal as BG meters.
     
  18. MomofSweetOne

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    For those of us who haven't been at this quite as long, what exactly did happen to the Navigator?
     
  19. andiej

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    I am honestly shocked that some of you have been judged on caring properly for your teenage children. teenage years are tough as it is without the battle of Type 1 i'm sure. You don't need me to say it, you are parents who love your children dearly and what parent who did think the world of their children wouldn't want to do everything within their power to make this a little easier on them. When I went to my carb counting course there was a 15 year old boy there with his dad who had been diagnosed for 1 year, and only now they had found the time to bring him to the course, the dad didn't get involved in the course, and the boy felt that carb counting couldn't be done by him cos his mum cooks dinner. I was shocked that the whole family weren't in this together, and that a more flexible lifestyle wasn't a top priority. It showed me that not every parent is as committed to managing this thing we've been burdened with and to find a way of life as close to normal as possible for our son. As much as I hate diabetes in many ways it has brought me even closer to my son.
     
  20. DavidN

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