High morning numbers

Hi Everyone,
I need some advice. My 9 year old daughter had been dx with type 1 for a little over 3 years and has been on an insulin pump for 2 years. Recently her night time numbers have been impossible to control. She can go all night with great numbers one night and then be high the next or drop to dangerous lows. Example, last night she was 132 at 4am them she woke up at 8:30am and she was 301, (usually she does not go that high). This makes it very hard for us to predict what will happen and we can’t get up every 2 hours to check. How do other parents handle this?

She could be going through a growth spurt. Lots of growth hormone released at night. I've noticed this with my adolescent son who is growing like a weed. Also, there is the dawn phenomenon to consider. I have always worried about what my son's BG is doing at night - he was diagnosed 6 years ago. I have to say our Dexcom G4 CGM is wonderful and has made life a bit less stressful and allowed for a more peaceful night's sleep. The CGM's transmission range is strong enough that I can keep the receiver on my nightstand while he is sleeping in his bedroom. The alarm wakes me up (unfortunately, it doesn't wake my son up even when it's right next to his bed -- he's a very heavy sleeper) if his BG goes out of range -- we then can do a correction or treat a low BG before things get too out of control. Might be something to consider if your health insurance covers it.

There are so many variables - Placement of pump, stress, growth etc... My daughter is the same age and has been diabetic for 3 years - the only thing we find that helps us is consistency - routine - and we still have swings in BG - but 85% pretty predictable. We do the same basic snack every night - Goat Milk and graham cracker and it seems to satisfy her and we have found it to be predictable for her morning BG. We are considering the CGM to really dial in her BG - last Endo appt A1c climbed to 6.8. its a daily challenge - I have found great knowledge and advice in "Think Like A Pancreas" and both of Dr. Bernstein's books - just cant remember the names of his. Good luck and God bless.

Definitely could not cope at night without the CGM. Just when we think we have it figured out something changes. His schedule, activity level, growing, fighting a cold . . .I can sleep with the CGM on my nightstand for the immediate purpose of catching highs and lows but more importantly we can use it to analyze the trends (sometimes you can actually see when the real problem is) Sometimes highs in the morning can even be caused by lows in the middle of the night and the body's ability to rebound from them.

Thanks everyone for the replies and support. We received the news today that she had hypothyroidism. That can explain the recent 8.2 A1C. I am glad this is treatable but it still sucks and yet another pill for life.