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Nighttime confusion - I can't get it right - Please help!

Discussion in 'Parents of Children with Type 1' started by Lorraine, Jul 23, 2008.

  1. Lorraine

    Lorraine Approved members

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    I've asked about similar issues before, so I'm sorry if I'm being redundant, but it's a little different this time and I'm desperate for some help.

    It's been about 4 weeks of me being up with Caleb throughout the night to deal with erratic BGs. As occasionally happens (or more than occasionally), his basal needs have increased significantly (from .20 to .50) for a couple of hours bt 8 and midnight. I've also made increases after midnight (from .05 to .10). It's taken a while to figure out the exact dosing mostly because I'm more conservative about making changes while he sleeps and this is usually when he needs the most aggressive changes and well this is the most erratic issue he has. I believe it's growth hormone related - it's not food. We've been eating pretty much chicken and vegetables or the like for the past few weeks to let me figure this out.

    Ok - so I've dealt with this madness and for the last couple of nights finally started to see numbers that are more within range. Then last night...

    His BG rose at 10:30 - I corrected - came down a little by 12:30 but not within range, another correction. By 3:30 he had risen 60 points, I corrected again. At 5:30 there was no change to his BG, corrected again. At 7:30, he came down about 40 points, but still not in range.

    Upon first inspection, I would say his correction factor is wrong. But this correction factor has been working well after midnight, and I've changed it significantly to what I think is reasonable before midnight.

    I don't know what to do because during these 4 weeks I've tweeked the basal too much and experienced lows, then not enough and highs. I'm afraid to increase his basal after just this one night since the last two were pretty good. This is the first time we are having so much trouble that is not food related after midnight. I'm assuming this is finally the very end of the honeymoon since it is such a dramatic difference to what we have experienced over the last year and a half.

    So here is my question - Does any one else experience this? And if you do, what do you do and do you sleep? In general I have the impression that people see what we see during the daytime - changes in BG's over a few days that warrant a dosing change, but not these dramatic swings. At this point, I see the only way to treat him is by constantly getting up at night to manage the erratic numbers - to ensure he's not low and to correct (or simply attempt to correct) the highs.

    And I've heard that puberty is bad - but could it be worse than this??????

    Thank you in advance - you guys are always so helpful and I appreciate you sharing your experiences with me.

    Lorraine
     
  2. StillMamamia

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    I suspect a strong growth spurt here or, like you said, the end of honeymoon. Check with your endo on this.

    I vote for the growth spurt though. You may need to adjust basal settings to the up side from 10pm to morning.
     
  3. momtojess

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    Jess just went through this.. it was more of an every other night thing where she would run high and no matter how much i corrected she wouldnt budge till morning.

    We chalked it up to growth sprut. Then we went to the endo (scheduled regular appt) and learned she grew 1/2" and gained 3 lbs.

    It stopped about as sudden as it started, and now we have resumed nights back to normal.
     
  4. lynn

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    Since you are having similar dinners and you have gotten things pretty good until last night I would wonder about his site. How are his numbers this morning? Are things going as they should? There are times when we have a site that works....sort of. Corrections barely budge his number and oftentimes it takes more than one to make a dent even. Sometimes, for unknown reasons, Nathan's site will just slow down.
     
  5. mph

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    Could you post his post dinner/overnight #s and correction factor?:D
     
  6. mollysmom

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    Well, I don't really have any advice as I just posted something similar;) I just want to say I'm right there with you! And it's really frustrating:rolleyes:

    I am going to try and start having dinner earlier so that I can make sure her bolus is out of her system sooner. I'm also going to try and give only fast acting carbs at bedtime (if needed) so that I don't continue to see a rise in bg for a super long time. I use to try and give things with peanut butter etc..., but I think it causes me to overcorrect because her numbers took to long to come up. I also would then see a big spike later.



    I hope that you figure it out:)
     
  7. andeefig

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    Sometimes we get into a little funk that I think is similar to what you're talking about. Some nights, he's in range... and then for a couple nights, he'll have stubborn highs that barely budge. Here is what we have tried to get us over the hump...when he is having a high night, I correct but then also do a temp basal increase of, say, 30% for 2 hrs. For some reason, I find that this can work. Now, if I find myself doing this for 4 nights in a row, that I would most likely change basal rate.

    As far as getting up to check, we automatically do it via internal "alarm clock". If he's having wonkey readings, I'll set the alarm to be on he safe side.

    Good luck:rolleyes:
     
  8. Lorraine

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    Hello again and thanks. I appreciate all the ideas.

    Site - not the issue. He was fine all day yesterday - days are always pretty good. (knock wood)

    Last night ended up ok. He only got as high as 145 and I had set a lower temp basal bc he had been 109 at 10PM and I was worried that some basal changes might make him go low. So I think I may have it down - but I think that every night!!!!!!

    I also yanked out one of his teeth that was hanging by a string. There's another one that I want him to work on too. Maybe getting them out of the way will help.

    I also got some words of advice that seem to make sense for these nights for me - sometimes during a growth spurt, if the liver does not sense enough insulin on board to match the growth, it assumes there is not enough glucose - in response, the liver continues to add more and more glucose thinking the body needs more because it is still not sensing enough insulin to match the needs of the growth hormone.

    This makes some sense for what I see for Caleb because when I have the highs that don't correct I will increase his basal over that whole period of time. But then sometimes I will see lows with those adjustments, which always confuses me. But perhaps I need only change the basal more aggressively toward the beginning period and the later period will work itself out. That's about what I did last night with his basal - only made adjustments early on, and he ended up ok. We shall see - tonight's a new ball game :)

    Thank you again. I would be lost without you all!

    Lorraine
     
  9. StillMamamia

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    This is great! Thanks for posting this...I didn't know how exactly it worked.

    Glad things are looking up (well, you know what I mean;)) for you.
     
  10. Lee

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    Me to! I was about to offer some advice - but - now it isn't needed - and ain't that the best advice of all :D
     

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