Discussion in 'Parents of Children with Type 1' started by bandmkolb, Oct 5, 2011.
Oh. Thank you.
I agree parents should not be made to feel like a bad parent if they don't check their child at night. But nowhere in this thread have I seen anyone say that. This has been a very good discussion, so I am not sure why you are bringing that up?
As for feeling like they are putting their child at risk, if you do not check during the night, you ARE introducing an element of risk in your child's care, in my opinion. But as you pointed out, risk is all around us, crossing the street, driving in cars, etc. We each need to determine the level of risk we want to tollerate in caring for our children.
But diabetes doesn't know what time it is and it doesn't care. If you feel not checking during the day is neglectful, then I would think the same thinking would apply at night?
Not sure why you would bring up DIB, but since you did, yes, that is a very rare, but very tragic thing that is possible. As for the A1C, it is important to me to strive for a good (not perfect) A1C and part of doing that is managing her bg level at night. Catching and treating the high and lows that almost always happen during the night is very important to me.
If people have children that stay in range all night, then that is fantastic for them. I believe they are the exception, rather than the rule.
I would think as an adult my daughter will have her own expectations of herself and mine will not really come into play. I hope to teach my daughter that managing her diabetes is, unfortunately, a 24 hour a day job, and that she will need to do the best she can to balance her life, her work and her diabetes all at the same time.
I think the endos suggest this because newly diagnosed children feel their lows with greater regularity. I always checked my DD, but in hindsight, I could have taken it easy on the night checks in the first couple of years while her hypo-awareness was good. All the reasons posted above are why I at least check at 12am and 3am and also at 1:30am if sports are involved.
Dawn-effect can raise low blood sugars by morning, so without checking, you may not even know the child has been low in the night. This affects their ability to feel lows in the daytime.
A message I heard repeated at the CWD conference in Toronto was "Check your child at night" and Jeff repeated it again in his closing comments.
My wife went almost 2 years before she could sleep through the night. If she is gone I could not sleep and was up, 95% of the time Kaylee was fine but when she was 55 at 2 am It freaked us out. We just never trusted ourselves to let it go. Learning to count carbs, sickness, to much insulin, to much play the list goes on as to what might have contributed to a low but we watch it. The pump has helped us regulate her BS and minimize the lows. I now think back and realize that guessing where 1/2 of a unit is on the syringe is crazy. When you have a tiny body getting small doses of insulin, it is easy to make a mistake and the margin of error is that much higher.
I still get up at least once a week and check on her, not sure why but I do. My wife is up twice a week.
Not every night, but often. I didn't use to test often for a while, but I've caught scary lows sometimes, so I try now to wake up.
I think it is important to be aware that there are many ways of managing diabetes and not to label those different ways as "crazy". Many people have good success using syringes and dosing via 1/2 units.
Well, you've kind of implied it by the "not checking during the night is the same as not checking during the day" comment,and also again here. Again, I am not feeding my son meals at night and not bolusing. He is not riding his bike in his sleep and I am not checking him. Yes, lots of things happen at night...but it is NOT the same thing. My son has 3 basal rates at night that we are consistently tweaking...and I do check at least several times weekly. Again, I am comfortable with the numbers I see when I check, when I become uncomfortable, I check more often and make a change. Not to brag, but his last A1c was 6.4. Not perfect, but pretty darn good. New parents should not be frightened into thinking this is the only way to go...getting up every 2 hours. I just felt that saying no night checking is the same as no day checking is overly dramatic and could freak some newbies out. It did not sound very accepting to me.:cwds:
I bring up DIB because I think it might be a big motivator for some parents to check a lot at night. Frankly, I check mainly for my son's safety. He is not in range all night...but I just want him to be safe.
If parents need to check every 2 hours, that's great. I wouldn't imply there is something wrong with that. Parents need to do what they feel comfortable with.
I was simply sharing my philosophy on checking at night. I in no way implied or said that anyone was a bad parent if they didn't check every 2 hours. I don't think it, I never said it and I never implied it. Period. I am not sure where you get that I said that people need to check every 2 hours.
I would never try and frighten anyone, newly dx or doing this for 10 years, into checking at night. People need make their own decisions on how to manage their child's diabetes. Hopefully they come here, read about other people's experiences and thoughts and then, because they are adults, they can make up their own mind on this topic.
You seem to be taking this very personally, describing what you do and trying to justify it, and I am not sure why. This isn't about you. And it isn't about me. It is about the general topic of testing at night and the decisions we all need to make as caregivers.
Clearly many people, especially newly dx people do not know about dib syndrome. By bringing it up here, you may have actually caused them to be freaked out and frightened, the very thing you are accusing me of. Kind of ironic. That said, I think it is important for everyone to be aware of things like that, but not to let fear influence their management of diabetes.
We all have very strong feelings about this issue and I think I have been pretty even handed in my remarks. I gave the OP some things to think about, and I shared my opinions, but in no way did I ever make any judgmental comments about the OP or anyone else.
If you look back at my posts and threads over the past 4 years you will see that I am a very strong advocate of newly dx parents and try and be as supportive and helpful as I can to them.
(By the way, that is great about your son's A1c, you are clearly doing a great job managing his diabetes.)
Well, we were told by our endo to only check at night for the first few days after we came home from the hospital. It wasn't until I found CWD (which luckily was right when we came home, thanks to a pamphlet we were given in the hospital) that I realized the need to check overnight. Then again there are so many things I've learned here that I didn't learn from my endo, but I digress....
As others have said, you wouldn't go all day without checking, so I couldn't even imagine going all night without doing so. Irregardless of whether food was eaten or level of activity, BG still needs to be checked at night. And not out of fear of my child dying, but because it is not healthy for numbers of be too high or too low.
Ok here is what I want to know. Why would it be necessary to check for the first few nights, or a few nights for first few weeks, but not necessary to check every single other night? How are the docs who are giving this advise able to pick and choose which nights checking might matter? That makes no sense to me. Why shouldn't we stick with a safe routine for more than a week?
I would like to know the answer as well, lol! Same thing with our CDE (doesn't work at the practice anymore, thankfully!) that said we didn't need the blood ketone strips, but SHE was the one that said we were to read the Pink Panther book cover to cover and guess what? They recommended the blood ketone strips! She gave us the rx!
This is why I will be forever grateful for CWD. I have learned SO much here! :cwds:
My DD Endo also said I don't "have" to check every night only a few times a week... I wake up usually just about a minute before my alarm on my cell goes off. I just do, my DD just turned 2 and her numbers can be crazy so I just feel it is necessary at this stage of the game. However my husband hardly EVER checks his BG in the night. Every once in a while we wakes from a low, checks, and eats.
I think so many Endos tell us this so we can rest because they know the stress many of us have raising and caring for our CWD. Sleep is very important for all of us so I think maybe that is why they promote to checking a couple times a week at night.
I hope that in IDK 10 years or so I can go to checking every couple nights LOL I joke about this to family when they ask "how long till you can sleep a full night?"
I can also say even tho I have only been doing this for about 6 months I feel like I am use to this new sleep pattern, if it can even be called that I think all of here differences aside, are here to be the best parents we can be to our children with or with out diabetes.
The other night when I checked my daughter at 2am, I gave her a small correction for her 215... She woke up at 48. Oops, would have been better off not checking her that night.
My Endo has had an almost apologetic tone when saying "I want you to check tonight around 2am because...". I find it so strange. I've wondered if they meet resistance about it and don't want new dx parents to tune them out altogether.
I am grateful for this site as well! I have learned alot from our endo team, and one thing I learn from reading here about other experiences, is how great our endo team is, and how good we really have it when it comes to care and info. But I do feel that this site has been so valuable in teaching me fine tuning skills (like getting out that magnifying glass to get that .25 dose) and teaching me about such things as 504s and my CWD's rights in school and in public.
I just don't get that. I really don't.
This is just all so confusing, and frightening. We have never, ever been told to check at night (until recently). To be honest, before I started to read CWD, I'd never even thought of it. I've had nights where I didn't feel comfortable and tested,but it was just b/c of activity or how her numbers ran that day. Since diagnosis we've had at least a dozen times where she was low upon waking up, so I started getting up earlier and testing, but still rarely middle of night. Then she went to camp, and they did the 2am tests. When I asked why they did juice fairying at 2am, they said it was due to increased activity at camp, but she's swimming hard core all summer and very actively training, so I thought maybe I should do that at home. The endo team laughed at the idea.
Since school started it seems like her am lows have increased. We've cut back on lantus, but then her afternoons and eves run higher than we want. For the last few weeks I've been staying up and testing at midnight and trying to get up at 4am to test. At our recent endo appointment I pressed her on the issue of overnight lows and how dd sleeps through them. She finally said maybe I do need to check at 2am. I am having a really hard time waking up, but it's just me. I can't expect dd or my ds to get up, and there is no one else. Now I'm tired all the time, and feel like a terrible parent when I sleep through. This morning is a perfect example.
We went on a Choir field trip in the mountains yesterday (7:30am to 9:00 pm and >10,000 feet). She ran low enough that she had an uncovered lunch, two uncovered snacks, and drastically higher carb ratio at dinner. She still needed a bedtime snack more than hour early, so I was worried about the night. We were both so tired from the trip I knew I'd never wake up at 1am, so I stayed up and checked at 12:30. 132 - too high to do anything then, but low enough I felt I needed to check at 4:00. I set the alarm with 5m snooze to go off 10 times. I still slept through it all, and at 5 am she was 62. Treat w/ 4oz juice and check 10 minutes later, she's 59. Treat w/ 8z of juice and check 20 minutes later, she's back at 62. One more juice, wait 15 minutes, we bumped up to 83. I felt like such a horrible mom for sleeping through the alarm.
I don't know how you all do it, but I'm hitting a breaking point. I'm exhausted all the time, it shows when I interview for jobs. It shows in how hyper-reactive I am at home. I feels like I have to check in the middle of the night, and yet I'm losing my ability to do other essential things as well as I should (normal parenting, working, house cleaning, etc.) because I can't function on just four hours sleep.
This has been an incredibly interesting thread to read, but now I feel more confused and conflicted than ever...
You are in the early days....it is very tough but things will make more sense the longer you are at this. You need to do what makes sense for you and your child.
Lack of sleep is very tough, but for me, it is well worth the peace of mind I have when I correct a high or treat a low in the middle of the night.
No, only if I feel there is a reason. I test after the dinner fastacting is gone, more if I feel there is a reason.
Since I'm so new to this I wouldn't feel comfortable giving advice on treating D, but *have* been a mother long enough to know that when a woman goes on a 13 1/2 hour field trip with her daughter and then gets 4 1/2 hrs of sleep because she's trying to check BG's chances are she isn't a horrible mother
As an aside, that must have been a gorgeous field trip. I'd LOVE to live out there somewhere. Anywhere!
I think there is a balance that needs to be struck.
Testing my daughter at night is for me a part of basic diabetes management. That having been said, I do her no favours if I'm so sleepy during the day from the night testing that I start making bad decisions regarding the D management (giving her the wrong insulin, or bolusing incorrectly).
Some nights when she's a bit high, if I'm really beat I will not correct and will take the opportunity to also not test sleep right through the night. But most nights we test..
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