17 Responses

  1. June S.
    June S. October 2, 2012 at 5:16 am | | Reply

    Before I got my pump and CGMS (in January 2008) I always tested my BG during the night. When I was on injections, nighttime was my worst time. Sometimes the BG went low, sometimes it went too high. I set the alarm for 3:00 a.m. every night. If the BG was low at that time, I ate something. If it was high, I injected insulin (and then set the alarm to awaken me one hour later!) I don’t know how I endured all those years of interrupted sleep!

  2. Jessica Apple
    Jessica Apple October 2, 2012 at 5:47 am | | Reply

    Nice and important article, Allison. Thank you! My husband sets alarms to check blood glucose levels at night whenever he is worried, but it’s not a nightly event.

  3. Betty
    Betty October 2, 2012 at 6:31 am | | Reply

    Once my husband for a com he didn’t. MOST of the time it catches the lows and he can take care of it. He does have a freak moment where it will alert a low, and he’s normal or a normal and he feels low.

    Before he got a cgm I would check him to see id he had symptoms of lows in his sleep and wake him up if he did.

    I think it’s definitely ideal to have a cgm, but the cost is prohibitive. The only reason we got it was because of a car accident he had due to a low.

  4. Kelly
    Kelly October 2, 2012 at 7:13 am | | Reply

    I dont usually test after bedtime unless I went to bed to high and had a hefty correction. I will check if I wake up to pee or Im crazy thirsty…for my Daughter, we check 2 hours after bed and then 3 hours after that…of course, it all depends on what the number shows and how things have been trending! Sometimes things have been good to go for quite some time, and we actually get a break and just check her at 3am.

  5. David Downs
    David Downs October 2, 2012 at 7:39 am | | Reply

    Dangerous lows at night are the #1 reason I use a Dexcom sensor. I get good night’s sleep when all is well and the alarm (buzz, buzz, buzz) wakes me up only when I need to hit the glucose tabs.

  6. mollyjade
    mollyjade October 2, 2012 at 7:44 am | | Reply

    I test if I wake up in the middle of the night for any reason (I usually sleep straight through), or I’ll set an alarm and test if I’ve had any alcohol.

  7. Allison
    Allison October 2, 2012 at 9:08 am | | Reply

    25 y/o pumper (type 1 for 17 yrs) – I set my alarm most nights to wake me up halfway through (I’m an evening snacker and it always messes me up) so I’m more concerned for hyperglycemia than lows. However, I sleep through the alarm 60-80% of the time :)

  8. Wendy
    Wendy October 2, 2012 at 10:19 am | | Reply

    Thanks for sharing such great information! There are a few factors that affect my decision, as a parent, to test regularly overnight…

    1) Her basal rates are constantly evolving. In a growing child, it seems that we’re constantly tweaking something somewhere. As a very young child, I had to balance the smallest basal increment available (0.05u/hr on Cozmo at the time) with her actual needs…this meant she had regular hourly basal changes, alternating between 0.00u/hr and 0.05u/hr. Even after she didn’t seem to need the fluctuation as much, she still had periods of 1-3 hours set at 0.00u/hr as part of her regular overnight pattern for YEARS.

    2) When you add, say, activity bursts from a PE/Cross Country day vs a Library/Music day at school — it makes a big difference in the bigger “24 hour picture”. Her schedule isn’t always consistent, and I have no control over whether or not the PE teacher decides to have the kids line up and take turns shooting hoops for an hour…or opts to get everyone on the track for a 2 mile run. In fact, most of the time I don’t even know for sure what her daily activity level might have been — it just works better for us to have a routine in place, regardless of the days variables.

    3) When I was struggling to bring her A1c safely into the 7′s, I discovered that correcting for anything over 150 helped. (As opposed to 180, per her previous targets.) But, with an ISF of 250, that also meant corrections needed a follow up test 2-3 hours later — including at night. Even 0.025u can make the difference between stable and unstable in little people with high insulin sensitivity.

    Overnight checks work for us, given the type of insulin and technology we have available to us right now. As technology evolves, we’ll evolve.

    As a parent, I’ll never know the internal cues/feelings/symptoms that alert her to a problem. I’m doing the best I can to manage from the outside, sitting on the sidelines.

  9. Ed
    Ed October 2, 2012 at 10:40 am | | Reply

    I also do not worry too much at night, I guess I got more comfortable after the diagnosis. I also set an alarm if I have drank anything though. Better safe than sorry.

  10. Mark
    Mark October 2, 2012 at 11:40 am | | Reply

    Hi Allison thank you for a great info rich post. I find the research interesting that states we don’t go high after night time lows. About a week ago I was waking up with crazy highs and adjusted my night time basal to two units more, which now keeps me stable through the night. I don’t test at night, unless I’m having trouble with my morning readings, and I’ll then test for 1 or 2 nights.

    T1D, 16 yrs, 31 yo

  11. Jennifer
    Jennifer October 2, 2012 at 2:25 pm | | Reply

    I check my 8 year old daughter every 2-3 hours every night. She never wakes up at night if she is low. Her blood sugar at night varies on what she ate or did the day before. She sometimes has highs that stay high, or highs that drop fast or lows that stay low, or lows that turn into highs. Some nights her blood sugar only varies a few points. Most times I wake up before my alarm goes off. No way could I sleep all night without checking. She does not wake up when I check her, but I do worry about how much I am disturbing her sleep.

  12. Pat
    Pat October 2, 2012 at 4:56 pm | | Reply

    After losing my sister to a coma following a severe insulin reaction, I do test often at night. She would go low around 4am. But more important than testing at night, is to have someone check on us every morning and then have a plan if we don’t respond.

  13. Susan f
    Susan f October 2, 2012 at 9:09 pm | | Reply

    I hardly ever test at night, and do rely on my cgms heavily. I have a lot of problems with insomnia; I have to balance my need for good sleep with being overly cautious.

    One default for me is a 12 hr temp basal the night after boot camp or extreme hiking. I have a gut intuition of how hard I worked out, and roll with anything from 85% to 95% on those days.

    To the mom of a highly insulin sensitive kid, I send you a virtual hug. Have you ever considered diluting her insulin with sterile saline?

  14. DiabetesMine – Overnight Glucose Testing: Who Does It and Why? « DiabetesNews

    [...] up. Surprising, huh? Most of us probably think that if we don’t wake up, we didn’t go low. Read more var dd_offset_from_content = 45; var dd_top_offset_from_content = 0; Category : Featured, [...]

  15. Amy E.
    Amy E. October 3, 2012 at 2:05 pm | | Reply

    While trying to get pregnant and pregnant my high-risk ob/gyn wanted me to check my blood sugar overnight once every couple weeks. That was a 5 year span! I am burnt out!. I got the Dexcom CGM this year and even though it might not be the most accurate, I wake up for the alarms of being too high or low.

  16. Martin
    Martin February 28, 2013 at 2:13 am | | Reply

    We have a daughter aged 7, diagnosed when 3.
    Always test at night at least once. Then if blood sugar required correction, I will check again 2 hours later.
    We find if she starts the day in a good place(5 to 6 mmol) the rest of the day follows.
    But more important than that, before diagnosis she was a happy loving child, smiling, laughing, clever. After a while of being diagnosed, she became irritable, crying, shouting, smacking, angry, I could go on.
    I realised that it was her bood sugar out of control, I can’t imagine how she must have felt.
    Now with better control, she has returned to that little girl we had.
    So will always test at night, and to anyone reading this, yes it is hard.
    One more thing, for about 2 years now, I would argue with anyone about a rebound from low. What causes the high after the low is; getting the bolus for the food eaten wrong, 90% of boluses we give are combo.

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