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How do you deal with mornings?

Discussion in 'Parents of Children with Type 1' started by BCmom, Nov 24, 2010.

  1. BCmom

    BCmom Approved members

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    Em seems to wake up high so much... anywhere from 9- 12 is usual... and sometimes she wakes up at 15.

    When she wakes up at 15 she feels awful, doesn't want to eat and I can't get her out the door in a calm manner.

    What do you do? She is on injections of humulog and NPH in the morning... so often, she injects and I pack a breakfast that she can eat when she is feeling better...

    How do you handle these crazy mornings?
     
  2. Christopher

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    are you testing and doing corrections at night?
     
  3. TheFormerLantusFiend

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    Check her blood sugar about 2 hours before she gets up (or have her do it- alarm wakes her, she checks, rolls over and injects, goes back to sleep) so that it's in range when she gets up for the day.
    Or up the bedtime NPH dose.
     
  4. hawkeyegirl

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    Before we got a CGM, that's what I did. I checked Jack at 5am every morning so that if he was high, I could do a correction. Otherwise the day was just a disaster.
     
  5. Heather(CA)

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    Is she on NPH or Lantus at night:confused:
     
  6. Amy C.

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    If she is waking up high, I wouldn't accept that as the norm. A good suggestion has already been made: test a couple of hours before she gets up and correct. I would try to figure out which insulin to raise as a consistently high sugar shows there is a problem.
     
  7. Jessica L

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    I test and correct if need be at 4 a.m. so when she gets up at 7 she is good to go and can get another round if she needs it. Some days she corrects easier than others.
     
  8. Becky Stevens mom

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    Does this happen all month or at a particular time? She is probably going through puberty now ,is that right? Therefore she is going to have more dawn phenomenon now. If you can do more testing at night to see when that high # is starting to appear that would be good. You may need to give her a shot of NPH later at night to combat the dawn phenom
     
  9. BCmom

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    Thanks for all your input. I haven't been on much because our computer died. So can only get on when at the library, or when my daughter isn't on hers (with papers and finals looming that isn't often).

    Anyways. At night she is on Levemir. And we just never seem to find the perfect dose. 1/2 unit lower she was high in the morning, 1/2 unit higher she would go low at night.

    But many questions have been answered because her "monthly" has finally started... so yes Becky, that was probably the source of a lot strange numbers.

    And I don't like to give insulin at night to adjust a high... it freaks me out:eek:.
    I don't see my endo for another 3 months, so I don't even know how to dose for a high at night?? If she isn't eating giving her Humulog and putting her to sleep is just scary...
    :(
     
  10. Becky Stevens mom

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    Oh I understand that! I am the same way about giving insulin at night. I am very cautious with corrections at night. Our CDE said to give half corrections at night so I will do that and then test him a couple hours later to see how hes doing. Fast acting insulins usually peak at about an hour so you could test then, then they are nearly finished working at 3 1/2 to 4 hours so you could test again at that time. Sometimes if you can get the liver to stop pumping out glucose at night with a small correction, thats all it will take to have a lower # in the morning.
     
  11. Christopher

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    If you are not correcting her at night, she is going to continue to wake up high. It should not be scary to correct at night, as long as you test her to make sure the correction was the right dose. And you may need to test her several times throughout the night. Are you not testing her at night? For me, I am more freaked out thinking about what being high all night long is doing to her body, than by doing a correction to fix it.

    As for how much to correct, you could start with half of a normal correction (as Becky pointed out) and see if that works. If it doesn't why not give her the same correction you would if she was awake? Then you can bring down the high and have her wake up with a nice number in the morning. Just because you don't see her endo for 3 more months, can you not still call them to get advice? Especially about something as important as this?
     
  12. hawkeyegirl

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    If you are not willing to correct her at night, I'd do it early in the morning like I suggested in my previous post. Check her two hours before she wakes and correct if needed.

    But I agree with Chris that in my opinion, the downside of letting them run high at night is greater than night corrections with the appropriate BG checks afterwards.
     
  13. HanksMom

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  14. hawkeyegirl

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    There was nothing irresponsible or casual about Chris' statement. Your experience may be different, but correcting at night can be done safely and effectively. It is worth noting that you have a baby, and the child in the OP (and Chris' child) is much older.
     
    Last edited: Dec 2, 2010
  15. HanksMom

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    I agree that it can be successfully done, which is why we keep trying it ourselves. I'm not criticizing that he suggested a nighttime correction. What I took offense to, and stand by, is indicating that someone should or should not be scared about something related to their child's treatment, regardless of their age.

    People use this forum as a way to seek advice from others who have been there or have been at it longer than they have. I have found a great deal of support and encouragement in the past month. However, if I were the OP in this thread, and my fear was dismissed, I would not be a happy campter.
     
  16. hawkeyegirl

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    I took it as a gentle nudge to move the OP out of her "comfort zone" into trying something that would likely be quite beneficial for her child. Perhaps the perfect post would have been worded slightly differently, and if the OP wants to take offense, fine, I guess. I hope the thread is not derailed by the parsing of 4 or 5 words of Chris' post, when the point is that nighttime corrections are a valuable tool and it would benefit the OP to learn to do them safely and effectively.
     
  17. Connie(BC)Type 1

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    I have a spare CGMS transmitter and receiver for trending if you want to use it, you'll need to order sensors. Let me know
     
  18. BrendaK

    BrendaK Neonatal Diabetes Registry

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    We have always tested and corrected at night. CGMS has helped a lot, but before that we'd check blood sugar 2 hours after the correction to make sure he was okay. Since he sleeps 11 hours at night, that's a lot of time to be high if you don't correct. Kind of like 1/2 his life.
     
  19. Christopher

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    Sorry if you were offended, but I think you may have misinterpreted my words/intent. I was simply trying to put the OP at ease about correcting at night. I was trying to offer her an alternative solution to the issue she originally posted about. I did not mean to minimize her feelings or to be irresponsibly casual. We each are at different places on this journey and I was speaking to her based on where she is with her daughter at this specific time.

    The management of diabetes varies greatly depending on a large number of factors (age of the child, sensitivity to insulin, other disease states that may be present, what type of insulin's are used, etc). So advice given in one thread should not be extrapolated to apply to other situations/children. Maybe I could have worded it differently, but even so, I did not say that she should not be scared. My intent was that it does not have to be a scary thing to correct at night.

    I am sorry you had some scary situations at night. I am sure that makes you feel very strongly about this issue. And you obviously need to do what you feel is best for your child and family. But if it were me, I would still try and find a way, even with a toddler, to do some type of modified corrections to avoid letting a child stay at a bg of 350 all night long. But that is just me and the way I feel about this issue. It is not a judgment of your diabetes management. Obviously you need to take your endo's advice and decide for yourself how to deal with it. I personally would push back on an endo that told me to run my child at 350 all night long. Again, that is just me.
     
    Last edited: Dec 2, 2010
  20. MamaC

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    Being nudged out of the comfort zone is a great help, in many cases. My son himself had to nudge me in the direction of more corrections as he became more comfortable with the notion. It has made a huge, positive difference for him.
     

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