There was a recent post on Diabetes Mine by Will. You can read it and all the great comments in response to it HERE (Link removed because I am suspicious the post was written only to generate page views and put money in Will’s pocket. Basically Will called our kids ‘spoiled brats’ because we do our best to keep them alive including checking blood sugars at night. If I’m wrong Will is welcome to leave his thoughts as a comment on this post.)
So last night I tucked my kids in with kisses and hugs and went off to read in my bed while I waited for my hubby to get home from Denver. He was due home within the hour. I hadn’t brought glucose meters upstairs with me since I’d planned to get up and visit with my hubby. Instead I fell asleep reading. (Not the books fault – I had been up till 2am the night before so I was exhausted.)
I woke up around 2am to find my dear husband asleep beside me. I realized my mistake and got up to get glucose meters. Both kids were slightly high at bedtime and I had corrected them before sending them off to bed. I had that panicky feeling that maybe the correction was too much. Checked kids – Sugarboy was within range. Sweetstuff was still a bit high so I gave another correction.
That panicky feeling usually keeps me awake for sometime and last night was no exception. I went back downstairs and played on pinterest for a half hour (I love the Geek category – those are my people) after being amused regarding all things Dr. Who I fell asleep on the couch.
Around 4am (I think) my dear daughter came down and gently woke me to tell me her pump was out of insulin and she was gonna fill it. I vaguely remember this.
Chad woke me when he came down to leave for work around 7am but I remained on the couch listening to his footsteps and wishing him a good day.
This is what I found on the table when I got up around 7:30am.
That additional correction I tried to give in the middle of the night – she didn’t get all of it and I didn’t hear the alarm on the pump alerting me. Turns out her pump didn’t have enough insulin to give her the entire correction or basal insulin for the rest of the night. It took 2 hours of alarms to wake my daughter so she could fix the problem.
She not only filled her pump with insulin, she checked her blood sugar and gave a correction. Score one for my beautiful daughter.
This was her at 8am.
Look I know not all parents of CWD check sugars at night. I don’t do it every night. Maybe I would do it every night if I went to bed when my kids do but I’m up till midnight most nights. I check them before I go to bed and the alarms I set to wake me are dependent on what their numbers are when I go to bed.
Below are my numbers and plans but honestly its like Bennet of YDMV says – Your Diabetes May Vary. My guidelines may not (and likely would not) work for all CWD – some kids react faster than others to corrections, some react slower to fast carbs, some go high/low depending on the cartoon print on their pjs. Please don’t use my numbers as your own guide. Now I’m worried I shouldn’t even share them. Shoot. Ok just promise you will not use my guidelines – mine are specific for my kids and how I know they will most often react. Seriously – these are kid specific – I don’t even use the same guidelines for both of my kids.
Between 85-150 with no working insulin (no insulin given 2-3 hours prior) – do nothing, sleep soundly.
Under 85 – treat with fast 15 fast carbs – wait. check. repeat if necessary. If within range with no working insulin – I sleep soundly, if there is insulin still working I wait it out if less than 1 hour worth of insulin or set an alarm if longer.
Between 150-250 – check working insulin, if there is IOB (that’s ‘insulin on board’ – it’s a pump thing) I do the math – 1 unit will generally reduce my daughters BS by 50 points. If the working IOB will bring her into range I sleep soundly. If not I give additional insulin and sleep soundly (even with no IOB the amount of the correction is small enough I still sleep soundly).
Above 250 – check IOB and give correction if needed – I set an alarm. Anytime I give a correction of more than 2 units I get up. Insulin/hormones/the phase of the moon – these can all toy with diabetes and larger corrections make me more nervous at night.
Sugarboy is similar but I’m more cautious/conservative with him. He is more sensitive to insulin and 1 unit can drop him at minimum 100 points. He is also more active than my daughter, always on the go. He spends upwards of 2 hours a day on the trampoline and a good deal of that time is within hours of bed.
Also something to note – I recheck any reading over 300. You may have heard about the Strip Safely campaign. Basically current glucose meters can have a 20% variable. That might not mean much if a PWD number is within range – a 100 could be a 90 or a 110. However once those numbers are upwards of 300 that variable can be scary. 300 could really be 240 to 360 – Considering those 120 points mean 1.2 units of insulin and my boy drops 100 points per 1 unit – well it can get scary once the BS gets really high and I am dosing insulin based on a number that could be WAY off.
Click HERE to find out more about how you can help with the Strip Safely campaign – your support can help us all stay safe.
Ok that last bit about Strip Safely got me a bit off track but its an important message.
My message this morning is don’t let anyone tell you that night-time blood sugar checks are unnecessary or that you are taking on too much or that you are spoiling your child. Night time blood sugar checks are a personal family decision. Of course you should talk to your child’s doctor about night-time checks but also follow your gut. My son’s endo told us we only needed to check at night for the first two weeks after diagnosis. My son was 2. He was using Lantus for his basal insulin. Every night for over 4 months he would be in the 40s by 2am – despite decreasing his Lantus dose multiple times. It was not the fault of the Lantus – he was just very sensitive to insulin and still is. What if I had stopped at the two-week mark?
When our daughter was diagnosed we were told the same thing, she too dropped low every night.
The other side of the coin – don’t let anyone scare you into doing night-time checks if not doing them is working for you. Trust your instincts. I have yet to meet a parent that normally doesn’t do night-time checks that would send their kid off to bed after a huge correction without either staying up or getting up to check. Do what works for your family and trust your kids too. We’ve been lucky that my daughter will normally feel a low and get up. My son has never woken up when he was low to alert us.
I am very proud of my daughter for being so independent last night. It is a great relief (but not a surprise) that she is able and willing to do what she needs to do to take care of herself even in the wee hours of the night/morning. I will tell her this as soon as she gets out of bed – it after 11am and yes she is still in bed – yea teen years and summertime.
Thanks for getting through all the babbling and long stints of text. Here is cute cat picture as a reward.
PS- I really hope the FDA approves the Dexcom G4 CGM for kids soon. My kids both participated in a study with the Dex G4 and it was the best week of sleep I’ve gotten in over 7 years. I’m not saying I didn’t have to get up – but when I did get up it was because the Dex alerted me. I slept soundly otherwise. Our current insurance will not approve anything that the FDA has not approved thus no Dex for us until FDA says its ok for kids. (Although we all know it is as effective with kids as it is with adults and a great deal of kids use the Dex)