Overnight management of sons T1.

[Kai's dad.]

Hi all. I am new here and one of the reasons for joining is because I am interested in how other parents manage overnight.

My son is now 9 and has been T1 now for nearly 6 years. He is on a Medtronic pump. Every night our pattern is roughly the same. We check him about 10pm and adjust if necessary. Then at 12:30am one of us will get up and check him and again if necessary adjust and then again at about 2:30 repeat the process.

Frankly, we are exhausted but he is our little boy so we do it, but I am wondering is there a better way, one that gives us more sleep?

One thing that does regularly crop up is how little difference his blood sugars are between the 12:30 and 2:30 checks and any insulin administered at 12:30 doesn't really make any difference, but because we re-check at 2:30 we rarely get the early morning rise that you often hear T1 people get.

The local Diabetes NHS team suggest minor changes but to be honest, nothing really changes.

So, how do other parents do it?

Steve

 

[EllieM]

So, how do other parents do it?

Not a parent but have you considered getting a continuous glucose monitor with alarms? Then you could just wake if the alarms go off? Ideally, if his levels are stable, you should be able to set things up so that his pump doesn't need adjusting through the night. (I appreciate I may be being very naive here. When I was diagnosed 50 years ago at 8 glucometers didn't exist, let alone insulin pumps, so all my parents had to do was ensure I injected and didn't go hypo during the day. I was very soon able to carb count and manage my own injections.)

 

[Jaylee]

Hi all. I am new here and one of the reasons for joining is because I am interested in how other parents manage overnight.

My son is now 9 and has been T1 now for nearly 6 years. He is on a Medtronic pump. Every night our pattern is roughly the same. We check him about 10pm and adjust if necessary. Then at 12:30am one of us will get up and check him and again if necessary adjust and then again at about 2:30 repeat the process.

Frankly, we are exhausted but he is our little boy so we do it, but I am wondering is there a better way, one that gives us more sleep?

One thing that does regularly crop up is how little difference his blood sugars are between the 12:30 and 2:30 checks and any insulin administered at 12:30 doesn't really make any difference, but because we re-check at 2:30 we rarely get the early morning rise that you often hear T1 people get.

The local Diabetes NHS team suggest minor changes but to be honest, nothing really changes.

So, how do other parents do it?

Steve

Hi,

I am neither a pumper or a child.. Though I have been & am a T1 son.

Are you saying your son has a pattern of going high twix 12.30 & 2.30am? What numbers are you seeing?
Do the numbers drop to reasonable levels by the morning?

 

[Seacrow]

I think it really depends on how often you have to make adjustments and how big an adjustment. If he's very close to being stable throughout the night then maybe you should look into a cgm with alarms, or possibly the libre2. You might be able to drop one or possibly both middle of the night checks. Are you still stabbing fingers to check bg? If so, your boy might be a lot happier to scan and check for himself if he wakes in the night.

 

[rsagoo]

Hi there,
My son, who is nearly 8 and has been T1 for 5 years, is currenlty using the Omnipod and the Dexcom G6 CGM. Even with the CGM we get up about once or twice a night due to alerts , but we monitor on our phones if we wake up during the night and we have had some occasions of a full nights sleep.

Earlier this year we were doing too many corrections in the night so I reset nearly all his pre-bed and night basals and worked from there slowly, which helped. And now I make small basal adjustements, wait a few days or week to see how they go.

If the corrections do not affect him enough I look at the ISF settings. He is steady most of the night, dipping down about 5am and needing some juice - which we're trying to eliminate.

Not sure how other parents do it, but we've accepted that disrupted sleep is going our normal for a while. The CGM really helps, so if you can I'd definitely recommend getting one.

I upload his pump info weekly, but his NHS team have not made any suggestions for a while now as they are happy with how we are handling his levels.

Not sure it anything helped, but I think lack of sleep must be common with most parents.
Best

 

[Kai's dad.]

Hi,

I am neither a pumper or a child.. Though I have been & am a T1 son.

Are you saying your son has a pattern of going high twix 12.30 & 2.30am? What numbers are you seeing?
Do the numbers drop to reasonable levels by the morning?

Hi. No, not necessarily high, example: a lot of the time if we blood test him at say 12:30 and his blood sugars are (picks random number) 12.1 (or 10.1 or 8.2 etc) and then of course we correct through the pump, but then we would re-check him at 2:30 and quite often his blood sugars would not have dropped that much so we correct again and then we would notice a drop to a much better level.

Kai normally wakes around 6. If he wakes before that we find his blood sugars to be at quite a reasonable level, but the longer he sleeps the higher he gets.

 

[Kai's dad.]

Hi there,
My son, who is nearly 8 and has been T1 for 5 years, is currenlty using the Omnipod and the Dexcom G6 CGM. Even with the CGM we get up about once or twice a night due to alerts , but we monitor on our phones if we wake up during the night and we have had some occasions of a full nights sleep.

Earlier this year we were doing too many corrections in the night so I reset nearly all his pre-bed and night basals and worked from there slowly, which helped. And now I make small basal adjustements, wait a few days or week to see how they go.

If the corrections do not affect him enough I look at the ISF settings. He is steady most of the night, dipping down about 5am and needing some juice - which we're trying to eliminate.

Not sure how other parents do it, but we've accepted that disrupted sleep is going our normal for a while. The CGM really helps, so if you can I'd definitely recommend getting one.

I upload his pump info weekly, but his NHS team have not made any suggestions for a while now as they are happy with how we are handling his levels.

Not sure it anything helped, but I think lack of sleep must be common with most parents.
Best

Hi. ISF settings - what are these please? Also out of idle curiosity what do you give your son for hypo?

 

[rsagoo]

Hi. ISF settings - what are these please? Also out of idle curiosity what do you give your son for hypo?

Hi, Sorry I'm a bit late.
ISF is the insulin sensitivity factor/correction factor - basically it is how much the blood sugar levels will drop with 1 unit of insulin. A lower ISF will give more insulin, and a higher ISF will give less insulin.

This would have been set up on the pump when your son first got it. It's one of those settings that I forget about but worth looking into.

If he is high at 12.30am - depending what time he sleeps, pre-bed snack, his basal may need increasing from about 10pm.

Best talk to the team to see about any adjustments you want to make and see what they say.

Regarding hypo treatments - during the day we give him gluco tabs or if he is trending down but not low, we'll give a quick snack like hald an orange and see if he still needs a tablet. At night we give him apple juice as he finds it quicker to drink than chew a tab at night.

Have a happy new year