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Testing overnight - dr recommendation?

Discussion in 'Parents of Children with Type 1' started by kvnc, May 17, 2014.

  1. kvnc

    kvnc Approved members

    Mar 18, 2014
    I was wondering what your child's dr recommended regarding checking overnight. When my daughter was diagnosed the hospital discharge instructions were to test at breakfast, lunch, dinner, bedtime, and 2:00am. We had an appt one week after diagnosis and were told we did not have to check anymore. I was surprised when we were told this since just about everything I was reading online said to check. But I figured the dr knew what she was talking about. One week after that my daughter woke up with a low of 49. We ordered a CGM on Dexcom's website that day.

    So, I was wondering if you check overnight and if your dr recommends it. Wouldn't drs be concerned about liability if something happened overnight?
  2. MomofSweetOne

    MomofSweetOne Approved members

    Aug 28, 2011
    Be thankful your daughter woke. Mine doesn't, and if I could go back, we would have ordered a CGM right away. We were told to check for the first 6 weeks. After that we were given 5 criteria that if none of those were happened, we didn't need to set an alarm. By then, even the rare night that didn't hit nay of the criteria, I was so used to waking, I checked anyway and saw 60s when I wasn't expecting them. At pump start, the expectation was to check every single night again, but with the Dexcom, they've said if I'm comfortable with how it's reading, I can rely on it.
  3. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

    Sep 23, 2007
    This topic comes up rather frequently





    Personally, I think most endos either don't want to frighten parents, or they want to "normalize" living with Type 1 as much as possible, or because they don't live with it, for all their professional knowledge they don't really appreciate what a variable best it is. Then again, those of us who spend time here are like the cream of the crop in terms of aggressive treatment and use of every available tool.
  4. wilf

    wilf Approved members

    Aug 27, 2007
    For many families with a new diagnosis, after the initial crisis passes and blood sugars come back into range with the administering of insulin, there is then a so-called honeymoon period. If your child is honeymooning there may be little need to measure overnight. In the best cases you just make sure they're in the ballpark of your range at bedtime and that they have no insulin going and you're good. :)
  5. sszyszkiewicz

    sszyszkiewicz Approved members

    Dec 24, 2013
    Just 6 months into this, but enough nights now under my belt to have an opinion.

    D is semi-random. You have rules of thumb with lots of exceptions to those rules of thumb. There is nothing for it. that is just the way it is. the only way to know the number is to know the number; Once you have accepted that mindset, you act accordingly.

    I still check him at least once after he falls asleep, typically 3 hours after his nightly Lantus, to make sure the dex is close.
  6. mamattorney

    mamattorney Approved members

    Apr 9, 2013
    Our doctor said we didn't have to check at night unless something had changed (dosages) or it was a particularly odd day. Basically, that we would just have a feeling about when to check and when to let it go.

    When my daughter was about 3 months post diagnosis, summer hit and she asked me to check every night through the summer because of swimming, camp, etc. And I did, but I wish I could have had those nights back to get a full night's sleep. Every night was a number I was fine with. It didn't last long, but the doctor was right that I "would just know" when to start overnight testing. I wasn't surprised when I saw numbers that needed to be dealt with a month or two into the school year. Either her honeymoon started to taper off or the puberty hormones overpowered the honeymoon and things started to go bonkers at night. We got a cgm in November and now I just respond to the alarms, which are often, but she's on a more aggressive insulin dose than she would be without one, so I'm OK with it. So, I don't think there is a right answer.
  7. shannong

    shannong Approved members

    Sep 15, 2012
    Our endo never told us to test at night. I see this as a huge omission. My son's blood sugars have always varied greatly at night. Perhaps some kids have more stable blood sugars at night, I don't know, but testing at night certainly showed me just how much his blood sugars swing. I have often thought, why would I go 10 hours at night without testing when I would never do this during the day. Also, it scares me to think that he could have a low that could go on for hours without being caught and what kind of consequences there could be. I have caught many, many, lows at night. Would he be fine if I didn't bother to test? Maybe, there must be lots of type 1's that do not test, but I'm not going to roll that dice.
  8. missmakaliasmomma

    missmakaliasmomma Approved members

    May 31, 2013
    We were told we could stop too a few years ago. I actually did because for a long time there, lantus was doing great, we knew where she had to go to bed at, etc. after she woke one time screaming because she was in the 40s, I've tested her at night since, sometimes it being like 4 times depending on the night.
  9. Snowflake

    Snowflake Approved members

    Dec 1, 2013
    Like you, we were told only to test overnight for the first week post-discharge. I would have taken this advice at face value. However, my daughter happened to get dx-ed when her newborn baby brother was under 3 weeks old, so we were up with him quite a bit. Because we weren't sleeping anyway, we started doing random checks overnight and discovered that she was typically in the mid-300s overnight for the first several weeks after diagnosis.

    I shared this surprise with a T1 parent on another online forum, who told me to push for a Dexcom, and like you we started the CGM pronto (against our endo's advice). We have since moved to another city and are in a new endo practice; the second endo has also told us that we really don't need to check overnight. But DD's bgs are still variable and unpredictable -- for reasons that sometimes escape us, she will run super high one night, and low the next, following days with nearly identical activity and diet. We both wake up automatically a couple of times a night to check the Dex (no alarms needed), and most nights we do a finger poke around 3 as well.
  10. kt_mom

    kt_mom Approved members

    Oct 17, 2013
    We were told to test around midnight and 3 am. We took turns getting up and we did that until we got the cgm. Now I just let the alarms wake me, but it ends up being all me because it only really wakes me up. A couple of times she has wanted to take a few days off from wearing the sensor and we'll go back to setting the alarm. I also set the alarm if I think the cgm isn't as accurate as I would like.
  11. Christopher

    Christopher Approved members

    Nov 20, 2007
    I think checking at night is a key management tool when dealing with Type 1 diabetes.

    As for the Dr. being liable if something bad were to happen overnight, it doesn't seen very realisitc to expect a Dr. to be liable for that. Dr's tell people all sorts of things but the patient has to have some responsibility to do their own research and make their own decisions as to if they want to follow the Dr's advice or not. But that is just my opinion.

    I do, however, believe that Dr's do their patients a disservice by not explaining why it is important to check at night.
    Last edited: May 19, 2014
  12. momof1CWDinohio

    momof1CWDinohio Approved members

    Jun 6, 2010
    Our endo never told us to check overnight either, and so we didn't for awhile. Then my "mentor" assigned by our endo's office (an experienced T1 parent) told me she always checks once or twice. Since then, we've done so and have never regretted it. He's either high or low almost every night! Now that we have the Dexcom, we rely on the alarms unless something has seemed off with the calibration at bedtime.

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