Whiney post about the 2am BG check

So, how long did you do a middle of the night check for your child. As I'm sitting here typing this whiney post, I will tell you that I'm in no way comfortable with not doing it yet, but still have whine and cry that "I AM SO EXHAUSTED!" I am a hardcore nightowl, but I don't think I have recovered from the exhuastion that the trauma of his diagnosis and hospitalization caused and then we were home doing the 2am check and 6:30 before bfast check. I think my nightowl is dead! :smileysad: I have been taking naps *gasp!*, pretty unheard of for me and all I really want is to sleeeeeeeeeeeeeeeeeeep. WaaaWaaa.



Just curious how long everyone did it, I'd do it forever to keep Kelly(my son) safe, of course.



Thanks friends!

 

13 yrs on and I'm still doing it .... CGM with alarms could give you a break..

 

Nearly 10 years, still doing it. Stubborn low last night. A few nights ago both girls were low. One has a CGM, one doesn't (yet). CGM was a game changer for us.

It's ok, whine away, we're the only ones who really understand it. LOL, I was whining to my husband last night about it. It's like having a baby that never grows up.

 

I'm guilty of only doing overnight checks off and on. More recently, I've been having issues with super low (30's) BG readings around 10PM-midnight, so I've been having my mom wake me up to do a quick check before she goes to bed (around 11-midnight). If I'm not having any major issues, I don't schedule any middle of the night checks unless I am specifically verifying my basal rates.

I think the night check is putting my mom's mind at ease though. She knows what my BG is before bed and what I plan on doing for that reading instead of being left to wonder what is going on (she rarely knows of any of my other BG readings -primarily only the ones that are super high or low). In the event that I do experience a really bad low at 10PM that causes me to go unconscious, at least her noticing that something is up at 11PM would be a lot better than if she only were to notice at 7AM.

 

Consider looking into a Dexcom/CGM. That helped to ease my mind.

That said, we did not test every night. After we settled into a routine and knew his reactions fairly well, we only did sporadic testing. During football season, illlness, any wonky bedtime numbers, always tested, but after a time it became apparent that we had to prepare him for living away from home since he was diagnosed so late in his teen years.

I've noticed a trend on these forums that those diagnosed very young tend to have kids who don't mind their parents managing their diabetes, those diagnosed in their teens tend to have kids who tend to be more in charge of their own management. This was VERY true in our case. After a time he did not want night checks and we came to some agreements about how to manage overnights. If he had a good nighttime number, had no illness or crazy stuff going on, his basals were generally working all day, we let him sleep. Once he got Dexcom it was much easier (on me!).

3 short years after diagnosis my son went off to college. So it really was necessary for us to identify how he'd manage on his own. For us that meant allowing him to determine his overnight routine and giving him the reins early on. You are still in the early days so testing overnight is wise. But for me and my family, it was not necessary every single night.

There are those who will feel that our way of managing is risky. But I'm not how you prepare them to leave the home any other way. It's scary though. There are still nights I wake up and worry, and he's been living away from home 2 years now.

 

p.s., don't discount the toll daylight saving time change has on your body. I'm always very bleery the week of the change, so some of the way you currently feel may be an adjustment to that.

 

at a minimum, we wake up every night to check the cgm. most nights, we do at least one bg check with maybe some kind of treatment, and many nights we do several.

however, every endo and cde our daughter has seen has told us we don't "have" to monitor her over night to this degree unless something unusual is going on, usually with a useful reminder that our mental health matters too. the thing is, we've found our dd's overnight numbers to be so unpredictable that almost every night feels unusual to us, so we've never felt comfortable stopping the checks.

imo, this is a totally personal decision and you will figure what is right for you and your child over time.

 

We were told to do 12am and 4am coming out of the hospital, but when they established that his numbers were very stable overnight, the endo said we could skip them. I usually do the 12am and if it's even the slightest low, I do a 4am as well. Luckily, he's been running steady as a rock overnight (130 at bedtime and 90 in the morning), so we very rarely have to do the 4am check. I've met T1D parents who think we're crazy for being so lax on nighttime checks, but this is what our endo told us to do. I guess it's a honeymoon thing...

That being said, we're getting ready to order a DexCom. Should make life a lot easier.

 

Night checks are probably needed more in the honeymoon because there is still endogenous insulin. We checked pretty consistently, but not every night, right after Dx until we got the Dexcom. Now we check at midnight when we go to bed (we are also night owls!) and again at 6 am. Until basals were dialed in we would often proactively juice him <150 at 12am so we could get some sleep. Now that he's a beautiful flat line at night thanks to careful basal testing we are more confident. Yes, relying on the Dexcom is using technology as a crutch, but I think the alarm clock could just as easily fail and a glucometer isn't all that accurate either, plus he could go low at 3am instead of 2am, so we have made our peace with it.

 

If your child is willing to wear the device I would seriously investigate CGM technology.

 

We switched to Levemir at night and I can really count on it compared to the old NPH. If I am confident her number is good before bed and there isn't any other things to be aware of as others have pointed out (extra activity, illness, etc.), we sleep through the night. I shoot for the higher end of her range at night to allow for any slight fluctuations through the night.

 

We discussed the Dexcom Share with DS and I think we had him at "...and we'll need to get you an iPhone..."

 

Every night, multiple times a night for 8 years. I guess my question would be, why would you stop checking at night? CGM's are a great tool because they are basically doing the checking for you. But they are still being checked. In my opinion, just because the numbers are where you want them at bedtime, and just because nothing "unusual" happened during the day, that is no guarantee that numbers will not go low or high for the 8-10 hours they are asleep. And if your child doesn't wake up when they feel low, you could have a serious problem on your hands. Yes it sucks being tired, but there are some things that suck worse.

 

When we were first diagnosed, we were told to do the 2AM check just for the first couple of weeks.

But we have never stopped to do a 2AM check since. I think we are at a point where doing a 2AM check helps us sleep better for the rest of the night.

Last night, our dexcom alarms had my husband up doing a check at around 3AM, then again at 4AM. We ended up having to feed her 12 carbs at 4AM. She is typically running high at night time lately, and we usually up the basal, so these lows last night were unusual, and we have not had to feed her at night time in a long time.

In the beginning, we kept thinking that we will be stopping doing the 2 AM checks, but we are so used to this now. Perhaps you will grow used to this night time routine too.

 

My son was dxd about 18 mo ago and currently we check before I go to bed at night around 11pm. If that number is in range and no active insulin on board we don't test again until 7am. If he is sick, lots of evening exercise, high at 11pm then will test again 2-3 hrs later. This happens maybe 1-2 times per month.
I am posting because from reading this board I beat myself up for a long time for not testing every night multiple times a night. But each family needs to decide on a case by case basis with their DM team what makes sense and is safe for each child. For my child at this age we feel comfortable with not testing every night and we all sleep well and he usually wakes with BGs in range. His endo supports our plan and he does not use a CGM. He is still in a honeymoon with TDD of insulin around 10-12 units at 85lbs and 11yo.
My take home message would be to do what works for you and your child, don't feel pressured to test or not to test based on other people's experiences or situations. Each child is different and each parent's level of comfort with testing or not testing at night is different. Do what works best for you, there is no one right answer. The best answer for you may change over time too.

 

First post here. Been at this for 8 months with my 5 year old. I have been stalking this site for the same amount of time! Thank you to everyone for the past 8 months for helping me and my family navigate through this!

I just wanted to comment here. My son wears a Dex. Has really changed things for us. We rely on that on most nights. If we have to give him insulin right before bed, or in the middle of the night, then we will set an alarm for about 2.5 hours later just to check him. But if he hasn't had any insulin since dinner, and his number is good at bedtime, then we rely on the Dex. Last Sat night was a stubborn high and we were up 3 times in the middle of the night. Such is life with diabetes. We feel comfortable at this point that we can pretty well predict what will happen over night. Of course that is likely to change as he grows up.

I thought this comment is spot on: My take home message would be to do what works for you and your child, don't feel pressured to test or not to test based on other people's experiences or situations. Each child is different and each parent's level of comfort with testing or not testing at night is different. Do what works best for you, there is no one right answer. The best answer for you may change over time too.

This disease - while manageable - is tiring, frustrating, annoying, and many other words I can't say. I think it is so important to find the level of comfort for yourself and go with that. I find this topic of night time checking to be a hot topic amongst the community. I was at a function with other T1 families and someone had brought this topic up and one of the people made it sound like parents who do not check every night, multiple times, are negligent in their duties. It really rubbed me the wrong way. I always found the T1 community to be so understanding and compassionate. After all, we are the only ones who truly understand what this is like to live with this everyday. I was really taken aback by the judgemental aspect when it came to this topic.

Sure, there is some risk in not checking every night. There is still risk even when you do check. The entire disease is a mine field of risk. This disease stinks. There is also a much greater risk something bad happens to my son during the car ride to school in the morning. I think you have to live life, and make the best, most informed decisions for yourself and your family.

 

I am with some of the other gals, My son's numbers have been so stable over night that we have not done checks, unless he is not feeling well, we have had to correct a high close to bedtime and he has active fast acting insulin on board or has been had a stubborn low. He usually has a solid snack if he is below 130 before bed.

Last night we inserted our first dexcom sensor. WE calibrated at 10pm. You have to do 2 BG's from separate pokes, one said 125, the other 135. WE popped that into the dex and it said 128 arrow down. He had a good snack. I monitored through the night from my share app and he his arrow was straight the whole time...it was pretty cool.

Have been addicted to the follow app all day.

 

Welcome mikegl31!

 

Just passed the two year mark here - we checked at first for a month or so, then stopped unless we felt it was necessary. Then started again a couple of months later at my daughter's request (when school let our for summer). The first three months of checking at her request were the worst for me. She was honeymooning and as G*d as my witness, we went 90 days with no overnight issues. Every check was a decent number. I wish I could get those nights back. Eventually, during the next school year, honeymoon fizzled/puberty starts (never sure which) and the checks began to result in some crazy numbers. By November of that year, she had a dexcom.

Stopped physically pricking her finger every night the day she got her dexcom. I respond to dexcom alarms, so I don't mean to say that I sleep through the night often (far from it), but I don't schedule a finger prick. If I wake in the middle of the night, I always check the number via nightscout on my phone, but if dexcom says she's good - then in my sleep deprived opinion - she's good.

 

Every night for 3 years until we got our Dexcom about a year ago. It's great only getting up when you have to and at a time when you need to rather some random time.