Am i "TOO" obsessive?

Type 1 and LADA Parents of Children with Type 1 Diabetes
1

I have been reading this site for a while now. And i find it very useful and comforting at times (other times a little nervous about some of the things i read that we have fortunately not encountered yet). My son Mark was dx when he turned 9 years old, he is now 10. When he was first dx the pediatrician sent us to a hospital that still believed the best treatment was Humalog and NPH 2x a day and a very rigid diet of a certain amount of carbs at certain times of the day!! My wife and I didn't know any better and assumed that since it was one of the "top" children's hospital in New York we were getting the best treatment. After 5 months of pure HELL we switched to Columbia (excellent docs and nutritionists!!!) and walked out of the consult appointment with a insulin pen and a reasonable treatment plan. One month after that we were on the pump!!! (mini med). That's our story. My question is: I am still checking his BG at around 3 a.m. every night, in addition to checking at around midnight. there have been a few highs and a few lows at those times and I am just nervous. I know we are all nervous about our kids, but i was wondering if I am TOO nervous/obsessive.

Any thoughts or comments would be appreciated.

Thank you

2

Hi…I am a parent of an 11 year old…our daughter was diagnosed just 9 months ago…we pushed to get the pump as soon as we could and started using the Animas Ping in February…we are so happy with it, we find that each day can be different and the days when her sugars are low we generally turn down her basal rates before bed time and we have had lots of luck with that. Have you had an endo or diabetes educator help you with fine tuning the insulin to carb ratios and basal rates for different times of the day? I feel that we are all going to have those days when we know things are wonky and we will have to set our alarms to check sugars in the night but if you are thinking your son is having lows in the night I don’t blame you for feeling nervous. Does your pump have the option for Continuous Glucose Monitoring? if so maybe try it for even one week, that might help with getting the insulin ratios worked out. We all just have to do our best…diabetes is unpredictable…that’s the most frustrating part.
All the best

3

Hey “dad” - I don’t think you’re too obsessive. My son is 4.5 and was dx’d a little over a year ago at 3.5. We pump on an Animas Ping. I have his nighttime basal established well enough that I know if he’s +/- 120-180 then he’ll remain at that level until I feed him breakfast as long as breakfast is before 9am.

So what I’m doing these days is I’ll always check his BG 3-4 hours after his last dose of the night which is usually dinner but sometimes a snack later or a high BG correction later. That usually works out to 10pm-1am.

IF and only IF his BG is in the “happy zone” at that first night check - I’ll sleep comfortably knowing that he’s ok. If he gets up in the night to go to the bathroom - I’ll check him again right then in case his site has failed (on occasion it has, which is what makes him pee!).

If it’s not in the “happy zone” at that time, I’ll dose and re-check in 1.5-2 hours (if under 300-350)… and then again in another 1.5-2 hours (for a total of 3.5-4 hours from the last dose) before I’m comfortable with letting him sleep. If he’s over 300-350 at the “happy zone” check and particularly if I have no reason to think of why he might be high - I’ll physically check the site, then I’ll dose and check again in 30 minutes to see if something not obvious is bad about the site or the insulin. We’ve had more than one 1am set change… it sucks but it’s worth it.

“happy zone” sleeps happen about 2-4 nights/week now which is much better than it was only a couple months ago.

I don’t think I’m obsessive, and I don’t think you are either. I think you’re a responsible parent.

Kids are TOUGH with Type 1… growth spurts, exercise, hiding food from you, eating out, bad sites that they’re unaware of, hypoglycemic unawareness, and very low relative body weight (Tyler is only 40lbs) when compared to an adult… it all adds up to a lot of out of control variables.

More than a few times I’ve been glad I did a night check for a “high” due to something he ate or an unknown factor or due to a bad site. More than once I’ve been glad I did a night check because we caught a “low” before it went too low.

Keep being a GREAT DAD… and take it easy on the self-criticism.

We get our endocrinology visits from The Barbara Davis Center for Juvenile Diabetes Research (they have a clinical division) here in Denver - they are amazing and generally at the cutting edge of therapy ideas and uses… yet they are always accurately conservative with how they tell us to handle his needs. The moto is “test test test… and test if you’re not sure… and test if you are”.

4

Hi there Dad of Mark,

Caleb is 7, dx’d at the age of 3 and was on the same treatment as your son was initially. The theory behind that was to limit the number of injections. There was a while Caleb needed only one shot per day bc his pancreas had been helping out quite a bit. The difference for us is that Caleb was pumping within a few months of diagnosis and that was the intent from the very beginning.

As far as still checking overnight, well I do after three years and Caleb also uses a CGM.

My vote would be, “no”, you are not too obsessive.

:slight_smile:

PS - We may be neighbors (kind of). We are in CT, very close to NY.

5

Dad of Mark,

David was diagnosed at age 10 and is now 17. I set a nightly alarm for 3 a.m. to do an overnight check, every night.

The only time or times that I do a 12 a.m. check is if he is heading to bed already leaning toward the low side and is not sure whether or nor he might go lower, or if he does a site change before going to bed, keeiping in mind that he is usually heading to bed around 10 p.m. We have found that the 3 a.m. check catches readings that are too low for comfort, less than 3.5 (63 in the U.S.). His pump is set to increase his basal at 3 a.m as he typically has a rising BG between 3 and 7 in the morning, so we just don’t want to chance him going too low by mistake. We have also found that if we correct any reading over 8 (144 in the U.S.), he has a much better start to his day as he wakes up feeling fine, instead of woozy.

This method helped us to get his A1c under 7 which I think is difficult with growing kids/ teens if you don’t have some sort of overnight check in place. So I don’t think you are too nervous or obsessive. You are just doing the best that you can for your son.

Cheryl

6

Hi Dad, we too are living in the pure HELL as you described it. Our son is 7, he was diagnosed 7 months ago and we are not yet pumping, his doctors don’t even mention it, we’ve only seen the endo twice as it’s a 7 hour flight from home…We check every night at midnight and if he is below 7.0, we feed and check again at 3 am. If he is above 7 at midnight, then we don’t check. I find checking him helps me sleep easier, so no you are not TOO obsessive!

7

I can only speak as a former kid. I was 8 when I was diagnosed. So far as I remember, my parents never woke me up to test my blood sugars. (Or maybe they did a few times, and I don’t remember. But it definitely was not that common.) I was the one who was responsible for making sure things worked, since diabetes is something I will have to live with my whole life, and I’d be leaving my parents in 10 years or so.

I have to disagree with some fo the others. I think you’re obsessive. Yes, there are sometimes going to be highs or lows; it is impossible for a type 1 diabetic (especially a child) to have perfect blood sugars all the time. It’s just not going to happen. You can do the exact same thing from day to day and still be high one night and low the next. I’m assuming he’s not going down too low. If he’s just 60 or even 50, it’s not going to kill him. And you’ve been doing this for a while now, months? How often and how severely is he going low? Have you noticed a pattern?

Anyway, I think this is the most important lesson for parents to learn. (Well, if your child is 3 or so, ignore this, but, once they hit 10, pay attention.) This is their disease. No matter what you do, you’re not going to get rid of it. It’s never going to be perfect. They’re going to have to take charge of their disease. If you do everything for them for the first 5 years or so, there’re going to be problems when they’re older. Either when they hit their mid-teens and rebel against you or you decide they need more responsibility. Or when they go off to college/work, and you’re not there any more. I know you get nervous and you don’t want anything to happen to your kid, but they’re a human being, and they’re capable of taking care of themselves (well, once they hit 10 or so).

8

I think there is a balance between trying to control your child and their disease, and helping as much as possible without getting in the way. I don’t know if you have a child with diabetes as well, but as a parent, I’m willing to get up in the middle of the night because it’s my child. That’s a choice I’m okay to make and it doesn’t make my child more dependent on me, since he doesn’t wake up to do anything about his blood sugar at that time anyway. He can be 50 and he can be 400 in the middle of the night - and you can bet that I’m going to do what I can at this stage to hopefully extend his life and make the day after a high or a low more enjoyable for him.

I’m also teaching him (he’s 9) all I can to help him manage his own disease and I hand any responsibility over to him that he is willing to take. He is an excellent carb counter, checks his own bg, can do most of a pod change, knows how to treat a low and a high - also including how to adjust his treatment for the activity and time of day. But sometimes he wants me to do something he normally does himself, and I’m willing to give him a break. He has to live with this for the rest of his life and I’m willing, as his mother to sacrifice some of my own time and energy to help him live an enjoyable life as a kid.

Now if he were feeling smothered, or I was resentful, things would have to change, and obviously as he enters puberty our dynamic will have to significantly change, but for now I think there’s nothing wrong with checking. Parents have to go through a different process to come to terms with their child’s disease and if this helps me cope and doesn’t do anything negative for him, then I figure its a win win.

9

Well said Natasha. I agree with every single point. Caleb doesn’t even wake up in the middle of the night when I check him. I don’t expect him to and I don’t see that at all as taking any responsibility from him at the age of 7 or even 17, although I do expect things will be different then. There are many opportunities in the waking hours of the day to gain a balance between Caleb’s independence and my care-giving. Goodness knows out of range numbers happen, but a check or two each night to help things along is well worth it to me.

10

My son is 14 and was diagnosed 7 months ago. We don’t check him in the middle of the night but did for the first month or so. My husband would set the alarm and check him while he was sleeping at first. He actually wakes up on occasion and checks his own blood glucose. He’s just coming out of the honeymoon phase and going on the omnipod next month. We haven’t had any super lows yet and when he’s high, we just correct as we were instructed. Hoping the omnipod will be as wonderful as everyone seems to think it is! I think each parent needs to check as often as they feel is necessary for their peace of mind. I used to constantly check on my kids when they were babies but I know some parents who were able to sleep through the night without a worry! Good luck!

11

I don’t think you are too obsessive. It takes years to figure out this disease, and then when puberty hits it will all change again. Regarding overnight testing, you might consider whether your son wakes up if he is low. If not, then by all means test. (I have type 1 and so does my son; I wake up if I’m low, but my son doesn’t. It depends on the person and age I think). If he’s fine at midnight and didn’t have a large evening bolus, then maybe you could skip the 3 am test. That is, if his basals seem to be OK and he’s not going low in the morning, or didn’t exercise a lot the previous day… it all depends on so many things! My son is on a continuous glucose monitor, which is unbelievably useful at night. If it’s not working for some reason, then we always test sometime at night (he’s only 5 though).

12

No, if you are obsessive then so are we. Our son type 1 since feb 09 pump since april 10. We automatically wake up every night to check around 2:00 am. Like one post said if he is low which rarely happens we can treat, if he is high we can adjust and he wakes up with a good number. Plus we sleep so much better from then on because we aren’t tossing and turning thinking could he be low? He never even knows we have been there.

13

It looks as if I’ve been overruled by parents. I do want to say, though, that, even if your kid’s not awake, he’s going to know you’re testing his sugars. And that anxiety is going to get passed on to him. So, in 8 or 10 years or so, he’s going to think, “I should obsessively test my blood sugars at 3 in the morning, because that’s what I’m supposed to do.” (Or he might not do it, but then he’ll feel he’s not doing all he should for his diabetes.) And that’s all he knows.

But he’s going to read your anxiety, and it’s going to cause anxiety in him. I know this is fairly new to you, but try to act like it’s not that big of a deal. Sure, worry - you need to do, but don’t let your kid know. Because then he’s going to become anxious about the diabetes, and that’s really not something a person needs. (Yes, a person will be anxious about their diabetes, but you want to do as little as possible to increase the anxiety.)

14

I’d be interested to know what percentage of parents do test their kids in the middle of the night and at what age they stop? Seems like this conversation seems is pretty one sided. My concern is that all this sleep deprivation may cause additional stress or anxiety among parents. I know that when I don’t sleep well, I have a hard time functioning the next day and then it’s harder to deal with kids issues, etc… What do most doctors recommend? Our endo said we didn’t need to check him in the middle of the night after the first month or so and we haven’t had any issues. Every once in awhile we might check him if he is running low or high for some reason but if the numbers have been good, it’s not an issue. I have always been on the over-protective side when it comes to parenting, but for some reason, this doesn’t cause me as much anxiety as my teenage daughter driving… My husband is a little more obsessive about the numbers though… he’s an only child and I’m one of eight so maybe that factors into our parenting styles…

15

I think checking midnight and 2am or 3am is necessary, at least in our case. Rarely has my niece been stable at night, though her blood sugars do not fluctuate as much during the day. Evenings, up until 2am, we are correcting a lot of highs or lows on tested basals. Since every night is essentially a basal test night, I know it is not her basals. If I am tired, I just do a 2am or 2:30am check. Usually able to catch the high or low by then and it makes a difference getting more sleep. There are still many nights I do a 3 or 3:30am check, though.

16

I tend to agree. I’d never actually heard of parents checking their kids in the middle of the night till I saw this thread. But I survived. I mean, you can test at 12:00 and 3:00, but what about at 6? There’s always going to be some iffiness, and (unless you have a CGM) you’re never going to know exactly what the sugars are.

So long as everything usually runs fine, your kid’s not going to go low enough to pass out. And a nighttime of slightly high sugars is not going to kill them.

17

I don’t think all parents have to test - but I don’t think it’s a bad thing for those of us who don’t mind doing it - that’s all I’m saying. I’m not anxious about it, and my son definitely doesn’t worry about it - he was diagnosed with an anxiety disorder two years before being diagnosed with diabetes, but all the psychological evaluations he’s done concerning diabetes have been off the charts non-anxiety producing. (I don’t know the proper words for that)

Just because something doesn’t kill someone doesn’t mean that there isn’t a healthier choice though. White bread won’t kill me, but I choose whole grain because it might make a difference in my health in the long term. Obviously you can go to an extreme using that logic (wearing bubble wrap all the time would also cause fewer injuries) but checking my son in the middle of the night doesn’t change anything for him like wearing bubble wrap would. It might make his life slightly better or longer though, and I don’t mind doing it. I’m willing to make those choices for him, but I don’t expect him to do the same, and if he ever feels like I’m doing too much I’ll back down but right now it’s working for us and I don’t think it’s bad.

18

thank you for your reply. Yes for the most part i think we have his basals and carb ratio right. There is just a huge amount of variables every day, now that the weather is nice, extra activity, warm weather possibly effecting the insulin, allergies etc… we were looking into the CGM but that would mean an extra site, Mark is pretty skinny and it could be difficult to find 1 good site let alone 2 :frowning: thx again and good luck to you.

19

thx for your response

20

thank you “neighbor” i just wanted to make sure i wasn’t the only one.