Bedtime and night and morning lows.... HELP

hi... my name is crystal... my son is T1D... he's 15... at bedtime his b.s. can be 188 , 222, or higher... just varies... no matter what his bs is, when he wakes in the morning, his bs is in the 40's or 50's...

i give him a lite snack if its 250 or less... and when i get up to check him at 3, sometimes his bs will be 80-90. if less than 100, i give a lite snack... \

but still, no matter what his bs is or snack or no, in the morning his bs is 40;s-50's....

his nurse has changed his night time dose ample times... either hes getting to much insulin, or not enough insulin... no inbetweens...

when he's low, i give juice, food, etc. , and sometimes his b.s. will jump right up, and other times it'll drop more and takes longer to raise.

i do not understand... p[ease any suggestions or comments please...

this is just 1 of many delimas/questions that i have.... please help....


Have they told you to check in the middle off the night? When my son was waking up with lows I checked in the night like midnight and two to see what the pattern was. Maybe that works help. Keeping blood sugar where it supposed to be is as much work as an extreme sport. At least that is what my son has said.
Good luck!

Is he on multiple dose injections with a long acting and rapid insulin or is he on intermediate like NPH and rapid? If he’s on a pump it should be easier to lower basal rates in the early am. I’m always of the mindset that I’d rather my son run a bit high over night if the alternative is scary lows.
My heart goes out to you. Sleep is not so easy to get when our kids have diabetes.

Keep communicating with the nurse and changing things until something works. Kids are biological systems with so many factors affecting BGs so there’s never easy answers but with work you can reach that sweet spot (so to speak) with his insulin regime.

Hi Crystal. What time do you get up to check his BG in the middle of the night? You may have to do it twice for awhile until you can figure out his pattern. So if you already check at 2am, maybe check again around 4 or 5 depending on what time he usually wakes up. I agree that it’s more peace of mind to have my daughter run a bit high than low. She is on an insulin pump and she actually usually goes up before waking so I just adjust her basal rate to get a bit more insulin every hour in the 2 or 3 hours before she wakes.
I definitely agree with continuing to keep in touch with his Endo but I have to say, no one knows your kid like you do. I have learned a lot from this website and doing research in my own. The best advice I received, from a Dr friend, when my 13.5 year old daughter was diagnosed at age 10, was to be proactive. Learn as much as you can about T1D. You are your child’s best advocate. Prayers going out to you. This group has been a blessing and a fabulous resource for me. I actually wouldn’t mind hearing back from you when you figure out what works. This age is the most unpredictable by far. Best of luck.

hi crys, I also have a 15 year old soon to be 16! so our best fix for night time morning lows is a higher fat or protein snack with carbs I know its not great for his overall eating habits but most nights he has ice cream. of course he boluses for this but the fat/ protein keeps him going, I am thinking your son is really active??? my son is moderately active we have been blessed to not have too many lows at night but every child is different. I guess you've backed off on his lantus somewhat just a thought have you talked to his endo about the timing of his lantus it doesn't have much a peak but perhaps it is peaking a bit?? most teens tend to be high in the morning we are always tweeking his overnight basal for this because of growth ect. I would try bumping up his snack if he has icecream you could bolus about 15 minutes after to account for the fat, Jacob is on a pump so we extend some out anyways I hope things get better, nacho chips and cheese or cracker and cheese and milk are another good snack option. let us know how things go. best wishes, amy

In general, waking up with a low indicates that the basal (Lantus) dose is too high. Check with your doctor. It really helps them to get the dose right if you keep a really accurate food log – not all the time, just maybe 3 days at a time. You can fax that to them or take a photo with your phone and email it to them. It really will make a big difference in getting dosing right, which will give you much more peace of mind (and a better A1c). It’s especially important with teenagers when hormones and wildly fluctuating BGs.

*with teenage hormones and…

I agree with many of the comments below that it does sound like the Lantus does is off and keeping a detailed log for 3-5 days will really help you and your team make better adjustments. You even might want to ask the medical team about giving him the Lantus in the AM instead of the PM or splitting it up & giving a half dose 2x daily 12 hrs apart. I spent a month waking up every 3 hrs so to check my daughter at night until we got the Lantus to the correct dose. I understand how scary & difficult it can be. Hang in there.

It's so much easier to avoid and/or fix this problem if you pump. (You can set several different basal rates for different times of the day and night based on your need at any particular time.) It is difficult to get this kind of precision by adjusting the dose of your long-acting insulin if you are using MDI.

I ended up splitting our Lantus dose to half in the AM and the other half at night. Helped with the night lows. If your son is exercising (especially lifting weights) later in the day, he may be having a delayed low from that. If you split his long acting insulin to twice a day you can adjust his dose and reduce the bedtime amount to account for any physical activity that may be bringing him low. Good luck!