Nighttime Lows

Hello everyone. I was wondering if any of you check your children’s bs at night to see if they experience any lows while they sleep. My sons Endo suggests at every appointment that we check him for a few nights around 3am. Well it usually ends up he’s fine. I was told by some type 1 friends that if his bed is soaked from him sweating it’s because he went low during the night and his body reacted to raise his bs level . He has woken up like that but not a lot. This week he ended up being low 1 night. I checked him at 3am the first night and he was in range but he woke up higher than when I checked him at 3am which has me thinking he may have went low after I checked him and his liver produced some sugar. The following night I checked him at 4am as I figured 3am was to early too catch the low. Well he was 3.3, so an oj juicebox was given and I checked him again just before 5am and he was good. I will probaly check him every night now as I won’t be able to sleep due to worrying if he’s dropping in his sleep. Losing sleep is a sacrifice I can make. And yes he gets a bedtime snack before he goes to bed. So much for being well rested to got to work LOL!. Oh well, work sucks but that is another topic I will talk about later.
If anyone else experiences the same thing with their kids and have found ways to avoid the nighttime lows let me know.

Hi David. My daughter Olivia is two years old (dx 6/12/07). She has her bedtime snack at 8:00pm. It usually consists of 15g of starch snack and 1/2 cup of milk. I am then up at midnight to check her. If she is below 100 at midnight we usually give her 1/2 cup of warm milk (she drinks it without even opening her eyes). I then am up (or my husband is up) at 3 o’clock to test her again. What’s sleep? LOL We check her at midnight and 3am almost every night. We don’t check her at 3am if her midnight number is over 180.

Ok, for starters, what measurement is 100? The way you measure in the US is different from Canada, I’m not sure what that would equal at our measurements. We measure in mmol/L and Don’t ask me what that stands for. LOL! We have tried to give him milk before bed but he doesn’t want it anymore and he even turns down his peanut butter which he loves. Yes, I also know about the no sleep thing, but that is a sacrifice I am more than willing to make. We share the same snack times and and quantity of snack (15grams). I check him at 3am not at midnight but that depends on his levels and how much he ate before bed. Depending on his level at 3am I’ll check him again 1-2 hrs later at 5am or 6am. Thanks for the insight and I never thought of trying to give him milk instead of oj if he is too low at 3am, he probaly wont notice since he’s half asleep lol.

Careful with the milk for lows. It has fat and protein in it and will not bring them up very quickly. If they are just mildly low and you just want to safeguard against going lower then that’s probably fine. If they are below 70 (4) then you should probably use juice or regular soda, or glucose tabs to bring them up. I think the conversion is to divide the US number by about 18 to get teh Canadian equivalent. So a 270 BG reading is about a 15, 126 = 7, 180 =10. Just as a check a “HI” reading on one of our readings is like 500 - 600, would a HI to you be about a 30? and really low to me would be 40, which would be close to a 2. Does that seem in the ball park?

Back to your original question. We have a pump and we still check every night, roughly around midnight or 1 am. Depending on her numbers we’ll either do a correction bolus, or give her some juice. And if the numbers are really high or low we’ll check again in a couple of hours to make sure they are going in the right direction. I think that’s a big reason why our A1C’s are halfway decent. Like around 7, because she doesn’t stay high all night long. We’ve always given her a snack that has some fat and protein in it before bed, since the days of shots. Usually ice cream or yogurt, or something like a cookie with milk.

I think Children with diabetes has a recipe for some kind of snack that is supposed to be long lasting without a big peak. It had peanut butter and corn starch which lasts a long time, and maybe something like corn flakes.

Hi David,

I bookmarked a site to convert mmol’s to mg’s. Here’s the link:

http://www.childrenwithdiabetes.com/converter.htm

I got really alarmed the first time I read about someone’s child being 400!!! Now I just convert, so I know what everyone is talking about :slight_smile:

Hi David,

I know the feeling!!! Before my son was on the pump, we didn’t have to check to often at night. We only had to when we did some kind of a change to his carb/insulin ratio or if he was sick or something out of the ordinary. He has been on the pump for 6 months now and out of that 6 months, he slept in our bed for 3 months because we had such a hard time finding the right dosage (he’s 4). So we had to check him at midnight and then at 2:30 or 3 am. My husband and I start work at 4am so to try and get as much sleep as we could, we just brought him to bed with us so that I could just turn around and check him right there.

He’s now back in his bed :)… finally and we check him before we go to bed ourselves and then when we get up in the morning at 3:30. So far, everything is working out well… we just had to find the correct dosage :)… and make sure that he wasn’t sick on top of everything. Good luck with the lack of sleep.

Hi, even on the same basal (recently tested fasting basal) she can vary. I check at midnight and 2:00 or 3:00 a.m. and then one of us checks either at 5am or 6am when we go to work. I think if you do a basal test one good night after a low fat dinner, you will have a general idea. Example: Feed at 6pm, test BS 10pm, 12pm, 2am, 4am, and 6am for one night. Thereafter, you can check at midnight and either 2am or 3am as many nights as you can manage. There are nights when her last check is 1:30am because we work early and just can’t stay up. Disagree with testing at 4am as a general rule since most kids drop between 2am and 4am. 4am may be too late to catch it. Some kids are relatively stable at night, once the basals are tested. So you may luck out. There are nights you won’t wake up for the alarm, you are so tired. Just do the best you can.

Is your son still in the honeymoon stage? I remember having to check my son at 2:00 a.m. several times a week during that time–it’s normal for your Endo to want that while the child is honeymooning. We were diagnosed almost 3 years ago and I still check him periodically during the night. Somehow I just know when I need to check–mother’s intuition I suppose. My decision to check during the night is based a lot on what his B.S. was at bedtime. If he was below 100 and had his snack, I will check him at my bedtime. If I’m not happy with what his B.S. is at that time, I’ll set the clock for 2:00 a.m. Same goes if he was really high like 300 or more–check him at my bedtime and again at 2 a.m. if I feel it’s necessary. Frequent night time checks are also warranted (for me) if he had an extremely active day–such as swimming. We have a pool and so if he swam all day the chances of him being low late in the evening are high. I’ve kinda learned how different activities affect his blood sugar and act accordingly. Because my son has been living it with diabetes for a while now and has become so intuned to his body there have been several occassions where he has awakened on his own because he was feeling shaky, checked his sugar and treated himself. Then he’d come wake me up and say “Mom, I was low and had juice and a snack.” The first time he did that I was so thankful that he was able to get himself up like that–because I sure didn’t set my clock to get up that night. And, thinking about that scared me. But, I have faith that God is watching over him at night and I know that He is the reason Brandon wakes himself up or I have this sense that he needs to be checked. How old is your son? Brandon will be 10 in August.
I don’t know if this helps you or not. The only thing I guess I could suggest is making sure you check B.S. and have a descent bedtime snack about 15 minutes before going to bed. My son likes to try and get away with having snacks that won’t stay with him through the night so I have to watch close for that.

Hi there,

I’m not a mother with a diabetic child, but I am diabetic. Does your bed time snack include protein? I find that protein helps keep the sugars stable for longer - so it’s better to have carbs with some protein before bed.
Also, what my parents did when I was a child was to keep a baby monitor next to my bed. I usually would scream or breathe more deeply when my sugar was low, and my parents were able to hear that and came right away. (I always had honey by my bedside - and was often given some protein to go along with the correction). However, it all depends on how your child reacts when he is low - if he is vocal or not - and how lightly/deeply you sleep. You should tell your Endo about the lows that you catch so that he/she can ensure that that is fixed. It may require that less Lantus and/or long acting is given - or if you are on a pump - that the basals be fixed. Your child should not be having lows during the night. It happens, of course, when your schedule may be changed (more exercise is done, for example) - and in that case a bigger snack before bed (with protein!) may be needed. But your endo should help figure out the correct dosage.
Best of luck.
Highs in the morning could be due to the ‘dawn phenomenom’ which many type 1s experience. High blood sugars in the mornings do not necessarily indicate a low overnight.

we have to check our little girl several times every night.

My son was diagnosed at the age of 6 and is not almost 13…coming up on his 7th year with diabetes. Since he was diagnosed we have been checking him at bedtime (9:00 p.m. now) and then my husband or I check him when we go to bed (around 11). If his number is in target and he hasn’t had a lot of exercise late in the day or insulin given close to bedtime, we only check again around 2 0r 3 a.m. If things are off at 11:00, then we get up as often as needed until we are sure he will be o.k. It is tough, but well worth the effort. Some times we get up more than others depending upon stress, excericse, food choices, and hormone changes. I found that if I drink a lot of water before going to bed I am guaranteed to get up at 2 or so and then I don’t have to worry about sleeping through an alarm!! Sounds silly, but it works for me.

Good luck!

Priscilla
www.mylifeasapancreas.com

I check every night before I go to bed and at least once more - usually 1am. If there’s an issue, then again at 3am. Issues will arise based upon what he ate - like tonight he had ice cream cake - can’t remember the last time he had ice cream so I’m dealing with corrections since I don’t know the proper extended bolus for it.

But pizza, pasta and chinese tend to also be nights with more checks.

Sorry, hate to say but we’re going on almost 3 years of no sleep:( Hopefully soon we’ll have the CGMS and that will help.

We check Gabriel every night about 23.00-00.00 something to see what the night may take us when it comes to his bloodsugar. If he lies a little too low or if we want to sleep in , we give him a little applemarmelade/applesaauce in his sleep or a piece of sglucose to raise his bloodsugar. Even if we always had “perfect” Hba1c´s ( lots and lots of work to get there, i asure!) i would never dare to go to sleep witout checking him first since he´s extremly sensitive to both insulin and carbs…

My daughter is 7 and was diagnosed 2 years ago, and up until March of this year, we could check her before bed and if she was over 120, we could sleep, and only a couple times a week we’d get up in the middle of the night to check her. Well, she had a seizure in March, and her blood sugars have just gone nuts since then. We check her at bedtime, then at midnight then at 3am. I think someone else said it - “What’s sleep?” She gets a pump for the first time tomorrow, and I expect to have a lot of sleepless nights ahead of me til we get her settled into good doses, etc. But I agree that losing sleep is a sacrifice, but that’s OK - that’s just the way it is, so I have to do it. When it gets old, and I get burnt out, etc, I try to remind myself that my daughter is the one that really has it bad. I’m sure she’d trade her diabetes for not sleeping. It’s hard and its so scary. They should have chat rooms on here for people that are up in the middle of the night so we can all chat while we’re hanging out waiting to recheck, etc.!

My daughter, 2, was just diagnosed a couple weeks ago–one week on injections, and just finishing our first week on OmniPod. While we are just getting familiar with her BGs and trends, she definitely goes high from about 10pm to 2am, then goes low from about 2am until 7am. Even though I dialed her basal all the way down from 2am to 7am (.05/hr), she still drops 150 pts. We check pretty often, since she sleeps right through the night time pokes, and have had to put a bottle of juice in her mouth several times around 4am to get her through the morning without plunging. The alternative is to try to get her to 2am at around 240, but I don’t like the idea of doing that.

But after reading the posts here and a couple of other places, I made her a high protein/fat smoothie for her bedtime “snack” (19g at 8:30pm) and she made it through the night! Does that sound right to all of you–can a snack like that really “last” for 6-8 hours? I’ll try it again tonight, but want to say “thank you” to all of you who post–we’ve been devouring information for the last two weeks since the diagnosis and the blogs have been the single best source of information and inspiration.

-Aaron

I have a 7yr old who is on MDI – Lantus in the am and Novalog – Her beditime is around 8:30 and if she is lower than 100 we give a snack of about 15 carbs –

We check again before we go to bed between 10:00-12:00 then again during the night between 2:00 & 4:00 –

I get extremely paranoid if we don’t wake up to check her BG – also we have been having a big problem with bed wetting — Is anyone else having this issue ??? It almost a regressive behavior (???) Cailin is 7…so she’s been potty trained for quite some time now –

It seems to happen more when she runs high during the night … Just wondered if anyone else had experienced this …

Hey Lisa… I know what you mean about not sleeping… What caused your daughter to have the seizure ??? DB related ??? That is so scary …

Any clue on how to get insurance to pay for CGMS ??? Sometimes (like when I haven’t slept for a few days) I get really down about the costs associated with CGM – We just truly cannot afford the expense of it along with all the other medical expenses too — Do you know of anyone who has been able to get their insurance to pay even partial ???

I feel like I am the only one who gets irritated with this !!! Like you, we haven’t slep in about 3 yrs…the technology is there… just having a hard time getting it !!!

Alexa’s seizure was caused from going too low too fast. She was 53, and we were giving her all sorts of stuff, but she was dropping at a rate that was faster than I could get the sugar in her - she started seizuring at 38 - which was minutes after the 53, and even after 25 carbs. It was absolutely horrible.