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Getting a good bedtime BG reading?

Discussion in 'Parents of Children with Type 1' started by Jasonk320, Oct 9, 2012.

  1. Jasonk320

    Jasonk320 Approved members

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    Our doc said that as long as our daughter's pre bedtime reading is 150 or higher then we don't need to take a reading during the night.

    My question is on the timing of getting a good reading at that time of the evening - how important is is it to get a BG 2 hours after she is finished eating and also at least 2 hours after the dinner humalog? I would think less than a couple of hours would be a too unpredictable BS since the humalog is working full force and the time it takes for digestion etc (Sorry, stilll so new to this and trying to get my head wrapped arould how all of this is supposed to work)

    Some nights when we have a late dinner its hard to wait a couple of hours before she wants to go to sleep and it is quite a challenge to get a BG during the night - she really fights us in the night on it, we are only 8 weeks into the diagnosis so hopefully it gets easier to check her at night in the future.

    Anyway it seems like we should be consistent each night as far as the timing after the meals to get a good number
     
  2. selketine

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    The important thing would be that the less insulin that is still acting on her system when she is tested at bedtime - the less likely the number is to go down significantly. Most of the action of the insulin is done in 2 hours but William can continue to drop for 3-4 hours.

    There are also other factors such as a really fatty meal (very cheesy pizza) can keep his BG's high - and maybe even rising. However if he was really active that day he can drop like a rock at bedtime - even needing an uncovered snack.

    The safest course of action is to test at some point in the night - IMHO - until you get a really good sense of how everything (food, insulin, activity) is affecting her BG's overnight.

    It is probably too soon to suggest a Dexcom cgms. I don't know if she would tolerate wearing it but it could be attractive to her to have one stick and wear it for a week (or more) - and it would definitely replace some of these fingersticks you have to do just to see what is going on.
     
  3. AJMom

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    Same here! We do check every night - how many times or frequency is determined by the day's activities! Last night 213 at 9PM bed - no correction. 88 at midnight - 10carbs and another check at 3AM. Soccer game:cwds: 2 nights previous we corrected a 200 at bed time only to have it up to 280 by midnight and corrected again! :confused:
     
  4. kyle and ryans mom

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    We check every night, couple times per night. I have caught lows, so it is worth the lack of sleep.
     
  5. mom24grlz

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    We also check at night. I just feel safer checking her. For example last friday Ashleigh checked her BS before going to bed at 10pm. It was 160. I checked her 3 hours later at 1am and she had dropped to 53! (actually the first reading said LO, but I retested and got a 53). It was a stubborn low too. After a glass of apple juice and 4 star bursts she had only come up to 77. I ended up having to shut off her basal completely for an hour. That finally brought her up to 114.
     
  6. Jasonk320

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    Im surprised that the Dr didnt recommend checking her during the night - do most people or does it vary a lot?
     
  7. 3kidlets

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    Yes, we always check at night. We were told we didn't have to. However, there are way too many variables to let her go 8 hours without checking.
    Fortunately, right now, her basals seems to be right and her overnight numbers are good and far better than her day time, but that doesn't mean I don't still check. Generally, what she goes to bed with is what she wakes up with but it isn't always the case and it could change tonight. Hana checks when she goes to bed. We make any adjustments necessary (food or insulin). I check about 2 hours later when I go to bed. Depending on what that number is, I check again in either an hour or if all is good at that point, I check again in about 3 hours. So, usually 10 pm. (when she goes to bed), midnight (my bedtime), 3 a.m. and and 6:45 a.m. (my wakeup).

    It isn't always lows that can occur. There are plenty of times her number has risen during the night - usually due to dinner which can cause a delayed rise (pizza, pasta, etc). I would hate for her to go 8 hours in the 200s.
     
  8. cdninct

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    If my son was 150 at 2 hours after eating, I can almost guarantee he would be below 100 at the 4 hour mark (and probably lower, depending on what he ate). The insulin has kicked in for him by 2 hours, but it is by no means done doing its job. As others have said, you probably need to take a bit of time and figure out how your daughter's body works--and that means checking more frequently.

    FWIW, I also check at least once every night between 11 and 12, and often again around 3 (and that is with a CGM).
     
  9. Mommy For Life

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    Our Dr said we didn't need to check at night either....but I often wonder if they'd give the same advice if it was their own child. It's been said numerous times on this forum...you wouldn't let your cwd go 8 hours in the day without testing...so testing at night is a must. No cwd will have perfect numbers every night...ever. :cwds:
     
  10. selketine

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    I would guess most parents do not check their child at night - however I bet a good percentage of parents that read this forum DO check overnight. So your question will get a skewed answer.;)

    Even after years of dealing with diabetes I still had some eye opening moments once we put William on a cgms several years ago. He was having lows at night (not terrible lows always but still 60 or so) that I would have NEVER guessed he was having. We were testing him overnight too but his lows would be around midnight and we were testing more around 2-3am. Only with a cgms could I really get a handle on how long his insulin acted - which was longer than I thought - closer to 4 hours.

    I'm not trying to scare you and I certainly value my sleep. Unfortunately what works great one day doesn't work the next with diabetes - same action different result often enough that what eventually has worked for us is a cgms.
     
  11. Dan

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    We still check during the night either Fingerstick or CGM...I am sure we always will.

    As long as I have gotten good readings through the day with my DexCom I only check the readings on the DexCom reviver. Otherwise I am checking the poor little guys finger during the night. One thing I have noticed is that if he is high he is very restless and moves all over the bed.

    The other thing to remember is that if your little one eats a high protein or high fat meal at night she will run high 3-5 hours after she finishes her meal. For this I always do temp basal. When I first started to use this feature on my pump I used to test all night until I got a good feeling about the additional insulin. Again it was so helpful to have a CGM that I could see what was going on with Joshua's BGs.
     
  12. Lenoremm

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    We check every night, often more than once. The doctor doesn't necessarily think it is necessary but we know it is because of what we have found. We may expect him to be high and find he is at 50 and we may expect him to be low and find he has a stubborn high. There is so much that we just don't understand especially with all the hormones that kick in over night. You sort of learn to cope with the sleep deprivation.
     
  13. emc71

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    We are also 8 weeks in-things maybe different here in the UK but we have never been advised to test in the night.He has woken up once with a low but thats it in the while 8 weeks and BS in the morning so far has been ok-towards the low side by 6 am. Ive been thinking its because he is probably in the honeymoon still-he is only on 1u at night and 8 in the morning. Im worried now I should be checking in the night for 'unknown' hypo's.Definitely going to ask the Doc about this. Glad I read this post as otherwise would never have known! :cwds:
     
  14. MomofSweetOne

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    Going to bed numbers and waking numbers can have almost nothing to do with the numbers in-between. When we were pump/CG shopping, I asked our rep if my daughter would begin to wake to her lows as a adult. He hesitated, wanting to give me the answer he knew I wanted, and then told me that when he began CGMing, he learned that even though he was going to bed and waking with approximately the same number, he was spending time in the 40s during the nights.

    My daughter goes to bed above 100 every night, but last night I was up 5 times to CGM low alarms. On Friday we couldn't get her out of the 200s until we upped her basal to the highest amount ever and then had an in-range day Saturday, but the hormones shifted again (puberty is such fun:() and I was continually reducing basal while feeding throughout the night.

    Even if your doctor tells you nighttime testing is unnecessary, I wouldn't trust his advice on this. Living with D is different than seeing it in a clinic.
     

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