Night time highs [emoji19]

[Skye's_mummy]

Hi all need a bit of advice my daughter seems to be going really high during the night. Her sugars are usually great when I put her to bed but when I check her at 10pm she's shot right up??!!! Should I increase her basal? I'm not too sure what to do we're only 8 weeks new to all this. I've phoned her nurse a few times but she just tells me to keep checking her every two hours!! We're both desperate for a nights sleep!!

 

[GrantGam]

Hi all need a bit of advice my daughter seems to be going really high during the night. Her sugars are usually great when I put her to bed but when I check her at 10pm she's shot right up??!!! Should I increase her basal? I'm not too sure what to do we're only 8 weeks new to all this. I've phoned her nurse a few times but she just tells me to keep checking her every two hours!! We're both desperate for a nights sleep!!

Hello

Can you please tell us a bit more?

Age, insulins used, what time her last meal is, what her diet consists of, history of hypos, I:C ratio, injection times for basal insulin and quantity, is the basal a split dose, etc.

Sounds like I'm asking for a complete medical history, but there are many factors that can result in high overnight BG's. Knowing as much as possible will help the excellent forum members here give you re answers you need

 

[Skye's_mummy]

Hello

Can you please tell us a bit more?

Age, insulins used, what time her last meal is, what her diet consists of, history of hypos, I:C ratio, injection times for basal insulin and quantity, is the basal a split dose, etc.

Sounds like I'm asking for a complete medical history, but there are many factors that can result in high overnight BG's. Knowing as much as possible will help the excellent forum members here give you re answers you need

She's two, she's on novorapid and detemir.
She eats at 5pm in bed for 7pm.
She eats a lot of mash and pasta so I'm wondering if it's that that's making her go up later on?she has 3 units of dememir at 6.30pm and that's her.
I think that covered it all!!
Ohhhh hypo's she's not too bad at the mo but we did go through a patch with at least 2 a day.
Thanks.

 

[azure]

Mash and potatoes would tend to spike fairly soon after a meal not delayed. Pasta can have a delayed spike. Does she always spike or just after some meals?

Have you tried testing her at say 8.30pm to see when the rise is starting?

 

[Skye's_mummy]

What basal does she use and what time does she have it? What does she typically eat for tea? How high is she going?

Hey,
She uses detemir at 6.30pm.
She mostly eats mash, fish fingers, pasta, chicken nuggets, sausages, chips in various forms. It varies anywhere from 17 down to 9.
But I've got her up this morning after her being 15.1 now she's 4.7?!

 

[Skye's_mummy]

Mash and potatoes would tend to spike fairly soon after a meal not delayed. Pasta can have a delayed spike. Does she always spike or just after some meals?

Have you tried testing her at say 8.30pm to see when the rise is starting?

She always spikes, I've really noticed it with pasta would love to cut it out but she loves it! Good thinking, I'm just a bit lost don't really know why it's happening?

 

[azure]

She always spikes, I've really noticed it with pasta would love to cut it out but she loves it! Good thinking, I'm just a bit lost don't really know why it's happening?

Are you able to bolus in advance of her meals? I know that may not be possible with a young child or you may have been told not to, but advance bolusing can stop immediate spikes. For things like pasta, I usually use an extended bolus on my pump - ie I have part of the bolus as normal but have the other part delivered over the next couple of hours. That works well. Obviously you're more limited on injections and your daughter may be on too tiny a bolus to split, but I thought I'd mention it.

Sorry if I've already asked this, but is a pump something you would consider? Apart from the fact it would let you spread the bolus, you may also find the ability to tune the basal precisely very, very useful. As an example, my hourly basal rate varies enormously through the night in order to match my body's needs. I could never even approach that control on injections.

 

[Skye's_mummy]

Are you able to bolus in advance of her meals? I know that may not be possible with a young child or you may have been told not to, but advance bolusing can stop immediate spikes. For things like pasta, I usually use an extended bolus on my pump - ie I have part of the bolus as normal but have the other part delivered over the next couple of hours. That works well. Obviously you're more limited on injections and your daughter may be on too tiny a bolus to split, but I thought I'd mention it.

Sorry if I've already asked this, but is a pump something you would consider? Apart from the fact it would let you spread the bolus, you may also find the ability to tune the basal precisely very, very useful. As an example, my hourly basal rate varies enormously through the night in order to match my body's needs. I could never even approach that control on injections.

I've never split doses as it two injections, but it's something that I would consider if it meant her not spiking.
As far as a pump I'm giving it serious consideration but I'm just worried about her hating having it on all the time, she hates having clothes on!! I'm having that discussion later this month with her nurse. I want to see which pump they would offer and how big it is first.