Please forgive my lack of knowledge - if my question seems dumb, I apologize but I'm still trying to figure this out after only three months of dealing with my son's T1.
In reading an article about a night time monitor that works with pumps to alert parents to overnight lows, there were some scary info and stats cited, specifically:
"... most parents of little type 1s get up several times a night (or at least once at 3am!) to check their children’s blood sugar. Every night. Night after night. Week after week. Month after month. Year after year. For years. Why? Because nocturnal hypoglycemia is a real, persistent, common, and dangerous threat to type 1 kids. Which means the worst time for the parent of a little type 1 is when the sun sets and all the mythical fears of the night become very real.
In a study published in The Journal of Pediatrics, Dr. Màrta Beregszàszi and her colleagues estimated the prevalence of nocturnal hypoglycemia in type 1 children and adolescents is a whopping 47%; and nearly half the incidents were asymptomatic—meaning the children felt no symptoms of the low. Another study by Dr. Alexandra Ahmet places the prevalence as high as 68% and notes that 75% of all severe hypos in kids occur at night. And if that doesn’t chill your blood, consider Dr. Francine Kaufman’s 167-night CGM study of young boys that found in a full 27% of the nights, the boys dropped below 40 mg/dL in their sleep, and that the length of time they spent low was longer than previously believed."
OK, I will say that when my 13 year old son goes to bed and his readings are less than, say, 4.9, I do test him at about 1:30 or 2 a.m. But most nights, when his numbers are in the 5's or 6's, I leave him be and we've not had any trouble so far (that I know of, I guess...his morning numbers are always in the 5's for the most part). How worried should I be? He is (and always has been) an extremely deep sleeper, and I would be willing to wager that he'd not wake up from a low if it happened.
Anyone else out there with a child of similar age...do you check every night, regardless of bedtime test results? Does age have any relevance here? How confident should I be when I go to sleep at night that my son is going to be okay?
Well...one of the things you have on your side is your son’s age. At this age during the night, hormones and testosterone peak. This is why a lot of kids this age have what is called the dawn phenomenan. Which is basically they wake up high because of all the activity that their bodies go through during the night. Now does this mean your son couldn’t go low during the night? Absolutely not. My son is 13 and we do not check in the middle of the night unless his bedtime BG was questionable, if he is sick, if we have had a recent change in his carb ratio, if he was extremely active that day etc. Does your son wear a pump?
My son was diagnosed when he was 12. He will be 14 next week. He has been diabetic for 1 1/2 years. My son loves and I mean loves the pump. A pump gives so much tighter control, eliminates so many shots and really gave him back normalcy that he lost. Unfortuantely with diabetes, you can do everything right and still be scared 24 hours a day. I worry every day. But I know we are doing everything we can to manage and control his diabetes and for now thats all we can do.
My son was diagnosed at age 8, and did not want a pump at all. We waited a year, and by that time - the thought of pushing buttons every time he ate something became much more appealing than 5-6 shots a day. I wouldn't even push it during the honeymoon phase. Your control is easier, and the pump might not have the benefits it does afterwards. Once he is making almost zero insulin - and every snack, and every second helping requires another shot - he might be more interested. My son also refused the tubes of a pump but has been really happy with the Omnipod. It becomes a very personal decision if you do decide to try. The other thing is that if you decide to try a pump most companies will let you trial the pump first so you can decide if it is worth it or not.
My son definitely feels the cannula being inserted (at pod change) but then he doesn't feel it after that except in a few cases. We notice with a big bolus he feels the insulin and sometimes we get close to a nerve so he will notice the cannula slightly throughout the time that pod is on. Mostly we 'stick it and forget it.'
I have 2 T1s, both on Omnipods. We generally check both kids at midnight or 1. My son (8) does go low in the night sometimes. He is asymptomatic to lows even during the day (dx'd 7 years ago) so that is a worry we have. My daughter (10) has been having what we call stubborn lows. She goes low and it takes several hours to get her back into range. This has happened almost every night for the last month. She does sometimes wake up when she feels low, but not always. We have a Dexcom CGM for both kids. They don't wear them all the time because they don't like having something else stuck to them and they don't keep up with Dex very well. Whenever we start having problems highs or low, we put on Dex so we can get a handle on their trends. The Drawback to Dex is that it is not a loud alarm, so it rarely wakes me up from the other room.
So we just hope and pray and do the best we can. Night times can be hard (harder than days I think). We are getting a Diabetic alert Dog to help us especially with nighttimes.
Oh, and both kids love the OmniPod. It sometimes hurts, but less often than getting a shot 6 times a day.
We all need each other. Glad we are able to offer support.
First of all, especially since you are new to this, there are no dumb questions. Besides that it's a good question.
I would say that it does depend on age, and on length of diagnosis.
Age: according to my doctor, young kids' bodies do not wake up from low blood sugar until they are maybe 8 or so (probably depends on the person). My son is 7 and has never woken up while low. I have type 1 also and I always wake up when low. So age makes a difference. A 13 year old would be more likely to wake up. That said, if he's a deep sleeper, it might be harder to wake up. Let him know that if he *ever* wakes up at night, especially after having a bad dream or if he feels hot/sweaty, he should check his blood sugar. (based on my personal experience, those things happen to me; he may have other symptoms that he will figure out).
Honeymoon: if he is only taking a couple units of fast acting insulin and still honeymooning, then you don't have much to worry about. Save your worry for later when he takes a lot of insulin before bed! :) Not that he would never go low now, but it's a lot less likely during a honeymoon, with a lower insulin dose.
You can ask your doctor about this. He could also try a continuous glucose monitor for a few days/nights to see if there is a problem. If it's flat, then your current plans are probably fine. Worst case, get up and check more often.
First, welcome. Second, do not panic. Type 1 diabetes is manageable, some days more so than others and you and your son/family can do this. You also deserve a good night's sleep!
My daughter is 10-1/2, wears an Animas Ping, loves it. Went first year in honeymoon and on shots first 18 months. I SELDOM check her in the night, only if she had a funky bedtime number or is sick, or as another parent said, if I have changed any of her pump settings.
My daughter is a heavy sleeper but has always awoken when low. I keep tabs and sugar packets next to her bed. My advice is to try to not get too wrapped up in other Type 1 horror stories. It's good to be vigilant, but everyone has different experiences. We allow our daughter to go on sleepovers, stay home with babysitter, whatever. But we have met other parents who are terrified to do those things. Listen to your instincts, teach your son to be in good communication with you about his blood sugars, and don't read too much! :)
I really think it's up to the individual family to figure out what works for them. My son is almost 13 and is coming up on 3 years with diabetes. I check him every night. He has never woken up from a low and I have discovered him sleeping peacefully everywhere from 34 to over 500 with ketones. I do not let horror stories or fear run my life, however, I do keep a very close watch on my child's numbers when he cannot. He stays home alone after school, babysits his younger brother, rides bikes around town and has occasional sleepovers at friend's houses (where he tests and texts me very late at night and very early in the morning). I definitely encourage you not to panic, but make your own informed choices depending on what you're comfortable with.
I say better safe than sorry. My son has been D for 3 years and we still check around 2 to 3 am. All it takes to convince me is to read the posts about death in bed. I always sleep better after checking or else I will lay there and wonder. He is rarely seriously low in the night but sometimes somewhat low and doesn't notice he is 10 years old and wears an Animas ping pump.
Me too, MsShelly!! I can be overboard though checking multiple times a lot of nights. I just can't stand the thought of her being low and usually when I check her multiple times it's because she was high and then I lay there thinking "is the correction working?" so I might as well get up and check. I think a cgm would really help but she's only 6 and I need what little "chunk" she has for her pump sites. Holding out for the "non"invasive cgm........
My little one has a cgms; we've put it in his arm (back of upper arm) or upper thigh. His pump is in his butt. We've done this from age 2 till 7. He's skinny, but it works. It is *so* helpful at night. Without the cgms/when it's not working, I get up at night. Otherwise, I sleep.