Night Checks?

Type 1 and LADA
#1

I didn't want to start this in the other tread about the NYT video. I have a feeling this would have brought it off topic.

How many people here actually set an alarm to get up and check?

My mom used to get up at around 2am and check me, but that was only for the first few years. It wasn't even a nightly thing, and it DEFINITELY wasn't 3 times a night. It was usually after a change in dosages or if I was sick.

My opinion on this: if I have my lantus set right, I should be able to go 7-8 hours without checking at night. If I go to bed at 120, I'm 99% sure I'll wake up between 80-150. Its a very rare occurrence that I'll wake up extremely high or low. It would seem that after a few years you should be able to build up a little confidence. The person in the video is on the pump AND has a diabetic alert dog. It would seem like they should have the confidence to get a good night's sleep.

This isn't the only family I've seen do this. I know quite a few people who get up multiple times a night, every night, for years, to check. I just don't see the point.

What is every one else's opinion on this?

#2

My mom used to get up at night too to check at 2am. Now i rarely check at night, because i am so exhausted the next day if i dont sleep through the night. but if i have been making adjustments to my basal lately, been waking up high a few mornings in a row, have patterns i cannot explain, or have been out drinking, i might set a clock and test. i can test in the dark basically while half asleep, so its no big thing.
and i hope once i get my CGM i dont have to do that anymore at all. :)

#3

I currently set my Lantus, exclusively, according to how it performs overnight, even if that means some higher readings during the day. I'm lucky to have pretty flat line data, during the night time period, and as a backup, I think I produce a lot of adrenaline when I go low. So much so, that if I hit 60, my body will generally push back to 100 on its own and I always wake up. I'm lucky in that way. Of course, I think the nature of my personal physiology, presents other challenges, like going high, when I exercise. I know some people have a lot of flux over night and that makes it challenging. It is hard to know without seeing their data.

#4

I have never regularly gotten up in the middle of the night to test. Now that I have a Dexcom, I check when I get up for the bathroom (I have OBS; Old Bladder Syndrome).
However, I can state for a fact that female hormones can cause crazy blood sugar swings. I went through a phase recently of about a week, where suddenly I needed much less insulin. One day, I took about 2/3 of my normal TDD, and I ate the following without bolusing: a granola bar, a small bowl of ice cream, about 30-40 grams of jelly beans, and three slices of pizza. (I later bolused one unit to correct a 154 from the pizza.) I could probably have taken one-half my TDD. I'm now closer to my old TDD.
This girl is an adolescent, and hormones at that age can swing all around. I was 21 when I was diagnosed, so I didn't have the adolescence types of swings she is probably experiencing. They may need this level of checking at this time. Of course, I recommend a Dexcom, but they aren't open to that right now. I wish them the best of luck.

#5

I never wake up for the sole reason of checking my blood sugar... I work a job where I'm away from home for weeks at a time and sleep on the job site though and often have to get up at all hours of the night, I take advantage of those times to check my BG in the middle of the night--- I haven't seen much if any erratic trends in the middle of the night to justify intentionally interrupting my sleep just to check

#6

Let's see, I was diagnosed back in 1988, and I routinely get up at least twice overnight to check my BG. I also wear a CGM, and am considered exceptionally well controlled. A flat-liner!

There have been many, many, many times I've been unexpectedly awakened and be in the 40's or lower for no discernible reason. Whether it was the CGM, wife, dog, alarm, or a bladder signal waking me up or simply the low itself.

#7

I only set an alarm if there is a reason for me to check my BG at that time (constantly waking up low/high, basal testing, emergency bedtime site change, etc). If for some reason I wake up during the night and don't fall back asleep right away, I typically do a quick BG check just to make sure that I am not low or high (both cause sleep issues for me).

#8

I'm up for much of the night most of the time anyway so I do test at night and my bg lately has been spiking at 4-5am, since I also drop sometimes it isn't possible to program my pump too much to help, I have a small basal boost then but I would be worried to do a larger one in case I drop alot instead. My trainer said the pump is going to let me sleep but so far it doesn't look like that is going to be the case. I'm still up doing corrections when needed unfortunately. I have always been somewhat nocturnal but since D much more so. On mdi I had to take my second basal shot from 2-5 am depending on what my bg was doing.

Also I'm not going to comment or judge what someone else should be able to do with their D because I know very well, as many tools as you have and as crazy as bg can be it is still difficult. I just try to do the best I can, and for me it isn't easy at all because my bg is very unpredictable and not nearly as bad as other people's I'm sure. I do hope I can get more sleep though eventually at an earlier hour because this is exhausting. Even with all of these tools it is still difficult and the dexcom isn't always accurate and doesn't always wake me either.
#9

I have no answer but I do know this. Some Type 1s are much more unstable than others. One of the parents said that the child has unstable diabetes (she used another word). Mine has always been unstable. In those cases, tight and careful management does not always prevent the wild BG swings. Each person has a unique metabolism and a unique case of diabetes. Each is his/her own textbook case. Just my opinion. And we can't know if this set of parents is overdoing it without knowing all the details, which we will never know.

#10

I rely on my Dexcom through the night. That being said, I rarely make it through a night without multiple alerts for either highs or lows. If I get up to go to the bathroom, I test with my meter.

After a very flaky Dex sensor, I ripped it off before going to bed last night. For the first time in a year or two, I went to bed without a sensor with the plan of inserting a new one in the morning. I had plans for a totally uninterrupted night of sleep. At about 5:45AM my pump buzzed and turned off because I had not pressed any buttons in 12 hours. Restarted the pump and then got a loss of prime 15 minutes later.

I was diagnosed T1 as a young adult in 1976 so never had parent involvement in my diabetes. I know that If I were a parent, I would be neurotic with keeping my child safe. At the same time, I hope that I would be encouraging my child to spread her wings rather than being afraid she would die every night.

#11

I get up virtually every night between 2 - 4 am and test. I never set an alarm. Like Michelle, I wake for other reasons and as long as I am up, I test.

Recently, because the Dexcom has gotten more accurate, if I wake up for other reasons and see a GCM flat line that is in range and below about 120, I will go back to bed without testing.

Of course, I almost always wake up around midnight, and I frequently wake up around 6. If I think things are awry, I test. Therefore, I could arguably say that I test pretty regularly @ Midnight, 3 and 6.

I can see the point ... for me. You can't see the point ... for you. Therefore, you shouldn't do it.

#12

Overnight, I depend on my Dex CGM and my dog, neither of which are 100%. I'm usually pretty flat at night but I do run through patches of more volatile BGs. If I've developed a stubborn trend of overnight highs or lows I'll occasionally set an alarm to check and make corrections if needed. I'm generally blessed with being able to sleep through the night.

I'm sympathetic with anyone that sets alarms regularly to test their or their child's BGs. They obviously get some value from that activity. Would anyone do this if they didn't feel they had to? I see no harm in trying to keep diabetes on a short leash. It's the times I've assumed that I'm OK, turned my back on diabetes, and then got bit hard that proved my assumption wrong.

There have been periods in my D-life when I should have been more vigilant and pro-active about overnight BGs. I used to wake up in the middle of the night all too often seeing spots in the dark with a funny sensation on my lips and knew I was wildly low and was sentenced to 8-12 hours of a rebound 250-300 high that day. Second guessing another's vigilance is foolish and unkind.

#13

I drink a couple of glasses a water with my pills before going to bed and that guarantees that I wake up at least once to test. When I’m worried about how my blood sugar is going to behave overnight I drink an extra glass and will wake up at least twice.

#14

I am up at night all the time but I never really check. I'm neutral on this because everybody is different and different people need different treatments.

#15

i dont get up regularly to check. if i get up to use the toilet and i have to pinball my way to the bathroom instead of just walking, ill check. if ive been out drinking and happen to wake up in the middle of the night ill also check. any kind of waking up in the middle of the night for no reason makes me check bg, just to be on the safe side, though i do it only when i happen to wake up.

#16

My 12.5 year-old daughter has T1D. Most of what Laddie said applies to my daughter and I. My daughter uses a Dexcom G4. I have the alerts set for 70 and 160 these days. I keep the receiver in bed with me, wake up every time it vibrates, and correct my daughter’s BG. We run a tight ship around here BG-wise during the night (when I’m “driving”) and her great A1Cs reflect this.

In our “BD (Before Dexcom) Era” I used to tuck my daughter in with a BG in the low 100s and check her BG once to three times during the night. She’d almost always awaken in the morning with a nice (75 to 120-ish) BG. I felt like I kept her safe overnight. Then we got the Dex and I saw how very much her BG could vary in between finger sticks. Just because you go to bed with a reasonable BG and wake up with a reasonable BG doesn’t mean it stays that way overnight!

#17

I don’t check during the night, but I have the Dexcom. I’m newly diagnosed type 1, and I’ve noticed that since I’ve had my CGM, my blood sugar does pretty much the same thing every night. It goes down starting shortly after I go to bed, hits its lowest point around 2 am, and then very slightly increases beginning around 4 am (Morning numbers generally 100-120). The only time I check with my meter during the night is if Dexcom is alarming (I set the low alert to around 85 at night) and I want to know if I’m actually that low or if I was just sleeping on the sensor.

#18

Oh, come on Terry, I've never posted anything on here that wasn't second guessed. Its helpful sometimes, although annoying at others. Its worth it for any new perspective that can be offered, dont you think?

#19

Without checking every one of your posts, my basic reaction is that you frequently post in a manner that invites second guesses.

Of course, that is part of the value of communities like Tu. We get to see what others do and then get to see if their strategies and solutions would have value in our individual world.

TimmyMac is asking a multi-part question. The first part, I have no problem with (Do you set an alarm?). It's the next part where I have an issue. My opinion is the community is better served by questions like the first part; ill-served by the second part.

#20

Yes I would check my BG in the middle of the night… when I used Lantus.
I lost several years of sleep at night using Lantus, it was probably the most unreliable insulin I have ever used and it had around a 30% to 40% variability or impact on my BG. I had many low’s with high rebounds. I spent years on the Lantus roller-coaster.
Some individuals cannot achieve stable BG using basal insulin’s (Levemir was the best for me but it was still unpredictable)

I spent decades worrying about my BG at night…The only way I was able to overcome this was to start pumping insulin…I rarely ever worry about my BG at night but now I have a pump/CGM…it gives me much better more predictable BG at night.