My son was recently diagnosed - dx 4/26/11. We are working out all the kinks and have somewhat figured out his carb ratios & insulin amounts. However, he is still waking up low. It ranges from 99 to 49 (49 was the lowest ever.)
His dinner insulin - Novalog - is given around 6 pm. He gets no bedtime insulin. He does eat a snack @ 8pm. His BGs are within range when he goes to sleep,.
He is only 2 and is in bed by 9pm the latest.
Any thoughts? Experiences?? We meet with our endo tomorrow…but Im curious.
Thanks!
Hi Stacy. 
Caleb was on shots for a few months and I remember that he had to be around 160-170ish at 11pm ish in order not to wake up low the next morning. It seemed that any pancreatic function that may have been left in him was really kicking in in those wee hours of the morning. He was on NPH and Novolog at the time and was getting very little insulin (less than 2 units and only in the morning - nothing even with his dinner). We just made sure his snack at night was enough to raise him to be able to tolerate the wee hours drop.
Lo
Normally, a low reading in the morning would indicate a need to reduce my son’s Lantus. Also,a high reading in the morning would tell me that it was time to raise my son’s Lantus. Is your son on Lantus? I agree with Lorraine - we also needed to make sure my son was high enough with his bedtime snack to hold him through the night. I would see what your doctor tells you. Good luck! Let us know how it turns out.
When my son wakes up low, and I am sure he has had a bedtime snack, it is a sure sign that he is having a growth spurt. When we were on shots, I would just give a slightly more substantial bedtime snack, making sure it had protein and fat with the carbs. Ice cream worked well for him, kept his BG nice and flat during the night and he enjoyed the treat.
Thanks all! Yes, he is on Lantus. He gets 1 1/2 unit in the morning.
I will try a more hearty snack at night and see if that works. Last night I was certain he would wake up within range, but he did not.
He may be in his “honeymoon” period and now that his body has some help with insulin production (shots) it may be making some of its own insulin and his Lantus may need to be reduced. When my son was first diagnosed we had to keep reducing his Lantus until we found the right amount. Once the “honeymoon” period started to end, then we had to increase his Lantus. Of course, I would tell you to follow your doctor’s orders.
I wondered about Honeymoon too. But he was just diagnosed, so I thought maybe it is too soon…
Even though you are meeting with your Endo. tomorrow, call the nurse today. Lily was dx 3/31 and she also had trouble waking up low.
Before: She was getting her Lantus (long acting insulin) at bedtime. The Lantus reaches it’s peak effectiveness around 6 hrs. after being taken, hence her morning lows. Doesn’t exactly make for easy sleeping huh Mom?
At our clinic/teaching/follow-up appt. at about 4 weeks, this is what they changed.
Now: Lily gets her Lantus at breakfast instead of dinner. Her most vunerable time for hitting dangerously low is still about 6 hrs. later but since that’s during her nap-time (she’s 4), I am able to watch her easier. Also, when she was hitting low several days in a row, the nurses realized that she had hit her honeymoon, which she is still in.
Our target range is between 100-200. At bedtime, we make sure she is OVER 150 to give her enough space to fall during sleep. Also, it makes a difference WHAT KIND of carbs you give, especially at bedtime. MAke sure your little guy gets enough carbs to bring him UP to where he needs to be, but also, enough PROTIEN to sustain through the night.
Ex. Whole Wheat toast w/ cheese, cottage cheese w/ fruit cocktail, or our new favorite for when she isn’t hungry but she’s not high enough - Gatorade G3 ! Look for it on sale because it’s normally $2+ but Smiths just had it on for 10/$10 and we stocked up. It has 7g carbs and 7g protien per 8oz. and the berry flavors are yummy.
SO NOT fun!! Ooooooo, it makes me want to give your little guy a hug! Night-time lows are so scary. If there’s anything else, let me know!!!
Nicole
My son’s doctor explained it like this: Most type I diabetics have about 20% of their beta cells remaining when they are diagnosed. The beta cells have been struggling to make enough insulin so they stopped. Now that the person is getting insulin through shots the remaining beta cells say hey we have help let’s start producing insulin again hence the “honeymoon” period. My son’s doctor did tell us that of course those remaining beta cells will be killed off as well which will then end the honeymoon period. I would assume that his cells may be kicking in and helping with some insulin production but your endo will know better. We were told the honeymoon period is different in everyone some only have it for a month others for a year. My son was in his honeymoon period for a little over a year. Good luck with your appointment!
Or some may never have any perceptible Honeymoon, like my son.
I know someone else who barely had any honeymoon at all. I wonder what makes such a difference. I believe that we caught my son’s diabetes so early and maybe he had more then 20% remaining. Of course, I am only guessing here. I had heard a friend’s story of her child’s symptoms, so the first night my son was up going to the bathroom I thought diabetes right away. My husband thought I was crazy! Daneenm, how old is your son?
He was 20 months at dx (he is 10 now). We took him in after about a week of soaking his diaper through at night and I too ‘just knew’ what the doctor would tell me. I was so sure, i had my sister come with me for moral support.
His BG was over 500 and his A1C was in the high 8s, as I recall. However, no ICU or such was needed. So, hard to tell how early we caught it. I have heard much worse stories about children’s conditions when they were dx.
I can relate Daneenm. I finally diagnosed my son (thanks to google) after 2 weeks of crazy soaking diapers. I knew in my heart the doctor’s would confirm my fear, but my brain told me I was being neurotic. When the doc tested his bg, he was in the 400s. His A1C was 11.5.
Thankfully, he needed no icu or iv’s either. Looking back a few months prior to dx, I did see some signs, but none stuck out enough to make me think something was wrong.
Breaks my heart to think my baby was sick. I think that is worse than the actual diagnosis.
My son is 13 and he was diagnosed at 10. I guess my thinking we caught it early and maybe that’s why his honeymoon lasted so long doesn’t hold water since it sounds like you caught your son’s early as well.
My son was not admitted to the hospital either. We left the emergency room Saturday night with insulin and syringes and told to be at Hershey Med Ctr. by 8:30 AM Monday morning. My first experience with a needle was to stick it into my baby’s arm (10 yrs old). In my head, I was thinking shouldn’t I have practiced with an orange or something. LOL
Even though you are meeting with your Endo. tomorrow, call the nurse today. Lily was dx 3/31 and she also had trouble waking up low.
Before: She was getting her Lantus (long acting insulin) at bedtime. The Lantus reaches it’s peak effectiveness around 6 hrs. after being taken, hence her morning lows. Doesn’t exactly make for easy sleeping huh Mom?
At our clinic/teaching/follow-up appt. at about 4 weeks, this is what they changed.
Now: Lily gets her Lantus at breakfast instead of dinner. Her most vunerable time for hitting dangerously low is still about 6 hrs. later but since that’s during her nap-time (she’s 4), I am able to watch her easier. Also, when she was hitting low several days in a row, the nurses realized that she had hit her honeymoon, which she is still in.
Our target range is between 100-200. At bedtime, we make sure she is OVER 150 to give her enough space to fall during sleep. Also, it makes a difference WHAT KIND of carbs you give, especially at bedtime. MAke sure your little guy gets enough carbs to bring him UP to where he needs to be, but also, enough PROTIEN to sustain through the night.
Ex. Whole Wheat toast w/ cheese, cottage cheese w/ fruit cocktail, or our new favorite for when she isn’t hungry but she’s not high enough - Gatorade G3 ! Look for it on sale because it’s normally $2+ but Smiths just had it on for 10/$10 and we stocked up. It has 7g carbs and 7g protien per 8oz. and the berry flavors are yummy.
SO NOT fun!! Ooooooo, it makes me want to give your little guy a hug! Night-time lows are so scary. If there’s anything else, let me know!!!
Nicole
When our daughter was in her honeymoon - we had lots of lows at night (I thought we would never get to sleep through the night) . We thought they should call it a divorce since her numbers were so crazy (low one night - make a change - low the next night - then highs thrown in for good measure) . Our daughter is now four (also diagnosed at 2) and her highs and lows are becoming more reasonable (I think it has to do with them getting bigger - so .5 insulin will not have as large an effect - her parents gaining more experience helps too). Though we still have issues (activity seems to throw us for more of a loop than food) - we are seeing a difference. Hang in there.
We found that chocolate milk with cornstarch before bed helps keep the numbers up overnight.
Celeste
Much thanks to all for your input!
To update since our appointment with our endo, my son is indeed in his honeymoon phase. She advised on giving him a higher carb count food before bed also. So instead of a 15 carb snack, maybe closer to 20 like a whole yogurt.
@Mstangs - He is on Lantus but he takes it in the morning due to the lows at night and the long period without food while sleeping.
@Nicole - I will look for that G3!
My five year old daughter was just diagnosed on 5/15/11 and we are having the same problem that you are with morning lows. We have decreased her Lantus from 5 to 4 to 3 and now 2 to see if it helps. I have found that a snack of bread and peanut butter before bed keeps her numbers better during the night and now her morning numbers, which have been in the 30s and 40s most mornings, are up to the 70s. We still have a long way to go to get to our target, so I feel your pain. Good luck finding the right balance for your son!