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When/Why do you Check BG at night?

Discussion in 'Parents of Children with Type 1' started by Reese'sMom, Feb 16, 2009.

  1. Reese'sMom

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    When we came home from the hospital after dx, the endo instructed us to do 2 am bg checks for 2 or 3 more days. So that is all we did, I haven't checked in the middle of the night since then. But I've seen that many of you do this somewhat regularly.

    So, my question is, if you do this, why and under what circumstances?

    Reese goes to bed between 120 and 140 and he wakes up between 70 and 95. Only once did he wake up below 70 and that was after being sick. I am assuming these numbers wouldn't prompt a middle of the night check, but I am wondering what numbers would. Thanks!
     
  2. miss_behave

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    You will find that many parents here check every night for several reasons

    - diabetes doesn't go away at night, you wouldn't not check for 8-10 hours during the day, so why is it ok at night?
    - most children do not wake up by themselves if they are low
    - levels can and will fluctuate at night, growth hormones, delayed exercise lows etc

    During the night I have been extremely low for no apparent reason. Luckily I tested and treated. IMO theres too much risk for dangerous undetected lows at night.
     
  3. jcanolson

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    We don't check every night, but we probably do most. Especially if we have had an extra busy day or certain foods that tend to cause spikes or lows later.

    Think back to graphing in 6th grade. Just because you plot one point a 140 and plot the next 8 hours later at 70 doesn't mean that there is a straight line between those 2 points. BGs could be varying greatly through the course of the night.

    I've noticed that if I can get her overnight numbers in a good range and steady that our A1C is typically much better.
     
  4. AlisonKS

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    we've had a few lows at 2 am where it made no sense, well as much sense as there is w/diabetes-not a busy day, no illness, etc. and Tony doesn't wake when he's low.
     
  5. MichS

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    Thank you for asking this. I've often wondered if I am an awful D parent. But I do know that Noah's honeymoon is making our life relatively easy right now. We checked his bg for the first week when we were home, and we will check it periodically if we change his night time nph, but otherwise we've found that if he goes to bed around 6-8 (115-150) he wakes up at 4-6 (70-115) and fine in the middle. Our nighttime checks have always been fine. So far..... I know it will change. All of your posts are preparing me for this,....
     
  6. Heather(CA)

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    I ALWAYS test Seth at 3 hours after dinner, if that number is where I want it, and he hasn't had an excessive amout of exercise. I don't test again.

    While D doesn't stop at night. The fastacting and some other varibles do...That's why some people test and some don't;)
     
  7. Logansmom

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    We ALWAYS test at 230a. We have a toddler and have had many unexplained night lows. And highs. Even with the CGM now, we still test. Most of the time when he's getting sick, we find out due to unexplained night highs. We won't remove that 230a test for years to come, it's peace of mind!
     
  8. Judy&Alli

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    I test Alli every night at midnight. At this time there is no active bolus/fast acting insulin in her system. I use this reading as a bouncing off point. If she has a good reading then I don't test anymore until morning. If she was having issues then I will set the alarm and test again. The few times that I say I am not going to test, I can't sleep. I toss and turn and end up checking her anyway. So until I get that midnight check I am not comfortable. There have been quite a few times that she was low for no known reason.
     
  9. Zanesmommy

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    I do the same. Though some nights he goes to bed too early for me to check 3 hours post dinner. Below are reasons we started to check at night. (we were advised that we did not need to check at night, and still do not check on all nights)

    Reasons we check his BG while sleeping:

    1) gave insulin to correct before be
    2) gave food to correct before bed
    3) he wakes up while sleeping
    4) overly active day
    5) he seems restless on the monitor (we have a video monitor)
    6) if we increase his Lantus

    We probably end up checking 4 nights out of every 7 on average.
     
  10. shekov

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    I test in the night if she has IOB at bedtime and her # isn't where I would like it to be, she's has had a busy day, ate anything high fat (pizza), is sick, in a growth spurt, if we've changed basal/bolus doses or if I happen to be up anyway (bathroom trip:eek:).

    That means I test almost EVERY night. I am used to it now but at first it was SO hard for me.

    You'll find what works best for you. Educate yourself as mcuh as possible. Then trust your instincts.:)
     
  11. Diana

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    We test at night. Well, now we have CGM so we just wake up for the alarms and they go off alot. Before that, I would stay up late (12 or 1) and then make a judgment about whether to test again before morning. I would rather have tested more regularly throughout the night - I do think that is better - but I just couldn't do it and remain a functioning, semi-pleasant parent.

    We didn't always test at night, but then we tried it a few times. And we found all sorts of crazy things going on. My son NEVER wakes up for lows, and it scared me.

    CGM has been awesome for me. I still get up almost every night, but only when I need to, and some nights I get extra lucky and sleep all the way through. And I sleep better now that I'm not worrying all the time about whether I really should be getting up to test.
     
  12. Bsbllmom

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    I do the same as Heather. I will test 3 hours after insulin is administered. So if I do a 4 hour combo bolus with dinner (pizza) and we usually eat by 6 I will test at 1 a.m.

    If I have to give a correction at night then I will test him again in 3 hours.
    I will also test if there are unexplained lows, usually more than one, during the day or if he is really active during the day because he will drop at night.
     
  13. sammysmom

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    D does not stop at night but most of the variables do so that is one reason not to test all through the night. It is an individual thing. It does not make you a bad parent if you do not test through the night. You know what is best for your child.

    We check Sam's bg when we go to bed. Lately, thats been about it. Sometimes for certain reasons we end up checking at night but lately we have not. He is still alive so I think we are doing an OK job!
     
  14. wvchinacat

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    During her honeymoon was when I needed to check lots bc she would drop for no apparent reason about 3 am and by 9:00am she would spike really high. Since we have come out of honeymoon (mostly!:rolleyes:) I do nto always check at night. But I know that will change in about 2 days as we start on the pump and I will for sure be checking her lots until we get into a better routine or until I feel comfortable . . .I do not fault any parent who does not check in the middle of the night - some need more peace of mind than others and some kids as with all D just are more unpredictable with their numbers than other. I really think middle of the night checks is a YDMV thing!;)
     
  15. liasmommy2000

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    That's kind of our theory. Lia also a) wakes for lows b) is a light sleeper which is why I think a) happens and c) started having a lot of sleep/anxiety problems when we started checking multiple times a night. Because she is a light sleeper checking too often messes up her health in other ways. So as long as she wakes for lows, this works for us.
     
  16. 2ladybugs

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    I check every night between 1:30 and 2a. I have done this since dx. Isabella does not wake for her lows since she does not feel them until it's almost too late. She is also young, she is growing. Sometimes it seems as if she is always growing! Anyway, I have checked her at 10:30p and had a GREAT number only to check again at the 1:30a time and found her through the roof!! :eek::confused: Most times it has nothing to do with food or activity level. It's just plain growth hormones. For these reasons alone ~ not being able to determine when the hormones are going to kick in, and not feeling her lows ~ is why I test every night! We have a CGM and most nights I just look at the CGM number and go back to bed. If it looks like I need to do some sort of correction, then I may test by meter to determine how bad it is and then treat.

    The funny thing is I have been out of town for business and the dh stayed with the children. I thought I would have a few nights of good sleep. I was completely wrong! I still woke up when I would have been testing! :eek:
     
  17. WendyTT

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    I never tested at night when we did MDI but once we started pumping and we had to do the 3am night checks for awhile, I would catch lows and now I just can't not check. It does make me wonder if all those months when I didn't check, did she go low and we just didn't catch it? So we now check every single night and I'd say once every two weeks she will be low when we check for no obvious reason. Every child is different, of course, but Lindsay almost always has that low hours and hours after heavy exercise so anytime where she went for a long, long hike that day or swam for several hours we will catch her low during the night. Just a tip if you don't feel like you need to check every single night--keep in mind their activity level that day. Good luck and don't feel like a bad parent for not checking!
     
  18. Christopher

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    I check at night, every night, for the same reason I check during the day, to try and catch lows/highs before they get bad. A lot can happen in the 10 hours they are sleeping. I would not go 5 or 8 or 10 hours without checking during the day. Yes the daytime variables (exercise, food, etc) are not there at night but that doesn't mean things are not going on inside the body.

    Unless you use a CGM, you can't really be sure what is hapening unless you check. Also, numbers can deceive you. A child could go to bed at 150 and wake up at 100 and you might think, great they slowly came down. But in fact it is possible that they started at 150 gradually went up to 200, then a few hours later went up to 280, then started coming back down to 100 by morning. That is somewhat of an extreme example but things like that do happen. So that is why I check. Obviously, that is just my preference and you need to do what YOU think is right for your child and yourself. Me, I will sleep when I am dead ;) And again, don't feel like a bad parent for not checking, each child is different and some may be pretty stable at night.

    Good luck :cwds:
     
    Last edited: Feb 16, 2009
  19. seeingspots

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    We're new to this whole thing ourselves, as our son was just dx over the New Year, but we were confused too about the whole checking at night thing. We were told to just do the 12am and 2am checks for the first week at home, then if things looked good with his pump/numbers we could stop. Because of his young age (10 months at dx), he started straight off on the pump from the beginning, which they told us was more stable for overnights so that is why the checks weren't as necessary. However, I'll admit that for my own peace of mind I did continue checks longer than they said we needed to, and I still usually do an 11pm or midnight one most nights. Plus, if he is lower than 110 at bedtime (and thus the extra 15g), I will get up again at 2am to check. Or, like others said, if there's any adjustments being made to his pump's settings and such.

    One problem we've run in to with doing extra checks is running out of test strips. We've already had our endo bump up the rx, but the insurance company gave us a hard time and had to have the dr's sign other forms and such. Seems insane to me that an insurance co. can limit how many strips you can get per month. Obviously our child comes first, but without the insurance each strip is over a $1 a piece... which adds up in today's economy. (Especially with all the other expenses of D and the pump supplies and such.)
     
  20. Jboudo01

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    ditto for me! We test for these same reasons. I'd say we check at night about 4 or 7 nights. Right now we are really learning alot about the combo bolus and that keeps me up depending on when she eats dinner. If your D is waking up at 70, then depending on the time he wakes up, there is a good chance he went lower than that during the night and morning hormone levels (dawn phenomenon) took him back up slightly.
     

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