Would love to get feedback please. When can we stop checking our 10 year old overnight? She was diagnosed 2 months ago and nobody has had a full night’s sleep since.
@mogirl well it depends. How well controlled are the overnight sugars? If she’s going low at night or crazy high then maybe you have to continue getting up. She may still be in honeymoon so anything is possible. Once things get predictable then you can stop checking for the sake of checking.
Hi Mo @mogirl, as with just about any other aspect of managing autoimmune onset diabetes, TypeOne diabetes, is that there isn’t any “rule” that applies to everyone; the only treatment that we all have in common is the need for insulin every day through an artificial means - injection, infusion or by inhalation. The only “during the night” fingerstick blood checks I did in my first 57+ years living with diabetes is when my wife would awaken me because my perspiration was soaking the bed - I heavily perspire during hypoglycemic events.
To answer your question I’d first ask what results are you getting when you do blood checks at night - that is, are readings out of a “safe” range? How often do you need to administer remedial correction - such as feeding her for a “low” or dosing a “high”? If you need to offer assistance to her “often”, then you should continue checking during the night. My best answer to your question would be, you could stop checking during the night when YOU are comfortable that her insulin doses are correct and fit her as best as possible. I would always do a BG Check on days that she has had unusual activities - food or exercise and on days she isn’t feeling well or acting abnormally.
Thanks Dennis. I appreciate your response. My girl very rarely needs any adjusting during the night, so far so good. She tends to stay within her range. I always make sure she’s at a good level before bed.
Thanks Joe, yes some nights it feels we’re checking for the sake of checking as you put it! She’s been in a stable range most nights, in fact almost every night, so I might start moving towards every few nights. Would love the sleep for both of us, but want to be careful too. thanks.
Hi, Mo @mogirl
Please take a look at this video - ignore the part about the dog. Listen carefully to what the mother says.
As others have replied, T1D is different for almost every person who has the disorder. My wife and I have our nightly routine; she sets an alarm for 2:00am and gets me up to check my blood glucose. Then she makes sure I am up by at least 7:00am. This routine has saved my life more than once and we both feel more comfortable.
After 60+ years of living with diabetes you would think I could reliably predict “what will happen next.” Nope! For me (and my wife) I have to stay vigilant so I check my blood glucose level between four and eight times a day.
To some, our nightly routine would seem a bit daft. And the way I frequently check my blood glucose level might seem excessive, too. For me, and the way my diabetes “behaves,” it’s what I have to do to stay alive.
Hang in there. You and your daughter can do this!
What does her doctor recommend?
I am in the same boat, my daughter was also diagnosed 2 months ago. She is 3.5.
We were definitely lulled into a false sense of security at first because she was very stable and didn’t need any intervention overnight, there were a few times if she was in range when we went to bed we would feel okay skipping 2am.
And then things changed, and I realized I should never get too comfortable with diabetes. She started waking up lower and lower, under 60 a couple times, honestly this made me want to start adding another check around 5am.
Our doctor recommended a higher threshold for a bedtime snack, so if she is under 150 she gets one now and she’s been waking up around 100.
This was a workable solution that fits into our life, until things change again.
We also just barely got her a continuous glucose monitor, is that something you have considered at all? 2am now means rolling over and checking my phone which is much more pleasant.
Thanks Bill, I appreciate your response. The video really is quite scary. My daughter is quite stable right now…no extremes…maybe in the Honeymoon phase, as they call it. Definitely hoping to get a CGM soon which will put my mind at ease overnight.
Thanks Flora. Yes, I’m hoping we’ll have a CGM soon! and I imagine that will definitely give us a lot of reassurance. My girl tends to stay within her healthy range at night, very rarely needs any adjustment. We’ve also been making sure her BG is up before bedtime and she tends to wake up 100-120. Wow, I thought life was stressful before, but the waking up is so hard. i tend to be a worrrier at night, so often lie awake after checking when I need to be sleeping.
Check out the Dexcom, Continuous Gloucester Monitoring System. It will alert you when your glucose is dropping and in danger of getting too low, it will also alert you when your glucose is rising. May help with a better nights sleep for everyone involved.
My daughter was diagnosed 2.5 years ago and I still wake up at least once most nights. A CGM helps immensely though since most nights I can just roll over and look at my phone and not actually have to get up. Hang in there! It does eventually truly become the new normal.
You make not like my answer, but until/unless you get a legit artificial pancreas, it never really ends. The irony is that with the CGM you end up waking up MORE because you get alerts for highs and lows. Sometimes ignorance is bliss.
I have 2 T1Ds at home, and have been dealing with it for 2.5 years. Anxiously awaiting the Omnipod/Dexcom closed loop system.
The CGM will help a lot. When my daughter was about 16 I spent a year testing her BG at 3 am which helped manage high BG in the morning. But eventually we were able to let this go. The CGM alarms loudly for highs and lows. You can hear it in another room.
I have a type 1 11 yr old diagnosed 3-4 mos ago. Honeymoon made it easier on us, but we to continued the 2 AM checks until we went to a doctor visit and they said that we didn’t need to do it anymore. Shortly after he 1) started requiring more insulin and 2) got a cgm!
The cgm has definitely allowed for more sleep. It will alarm on occasion and sometimes it is not accurate. The other morning it told us he was down to 58 so when I went into check him he was actually at 80 and had been laying on the device. Better safe than sorry.
One particularly bad night it kept alarming and we changed the settings for our alarm parameters to something we felt was safe so that is an option as well. So my advice- ask the Dr and yes, get a cgm.
It’s difficult for I have been there. Is she running high or low during night? Depending on glucose the educators could change dose to keep in healthier range. My son wears a dexacom g6 sensor . This allows him and I to follow glucose on our phones and will alert if high or low. This was a life saver for a piece of mind . Hope this helps
When I was diagnosed as a kid, my mom woke up every night for at least 3 months to test and the same when I transferred to the pump. Every one is different and adjust at a different pace. The endocrynologist should also let you know when it’s okay to stop.
If she’s stable overnight in safe ranges, I would back off, but as a precaution check every 2 to 4 nights (and eventually 1ce a week?) to verify that no insulin adjustments are needed. Obviously, more attention is required for illness or when normal diet or activity is disrupted.
How old is your daughter?
Hi Mo – My daughter is 16, and was diagnosed a little over three months ago. For the first month, I got up at 2 am every night and woke her up for finger-stick testing. About two months ago, she got a CGM (Dexcom G6), which has really helped. I still have an alarm set for 2 am, but many nights I don’t even get out of bed – I just check her glucose on the app on my phone and go back to sleep if her number is over 100.
There are some nights when the Dexcom will lose its connection with her phone (our insurance only pays for the CGM, not the receiver), so I have to get up and restart her Bluetooth or restart her phone to get the connection back.
Even with that level of activity, it’s not as disruptive as actually testing was, so waking up at 2 am has become more manageable. I’m not sure when we will stop – we all have more peace of mind knowing that either my husband or I are looking at the numbers.
Our 4 year old was diagnosed 2 years and 21 months ago and we are still doing the overnight BG checks. His endocrinologist said it is very important to do this even if your child’s BG is well maintained, due to the slang terminology of “Dead in the Bed syndrome”. He said that this can happen to any Type 1 Diabetic, even those who feel they have a tight control over their BG. Personally I would rather have broken sleep than to wake up to my child unresponsive. Have you thought about a CGM?