Correcting at night

[Moddey]

How high would you let your child's bg go at night before you'd correct it?

I'm really uncomfortable correcting the night highs, I'm paranoid it'll cause hypos. Unfortunately E's regular night pattern is rarely regular, meaning that 5 carbs or 5 minutes of extra (unknown) exercise can result in hypos or hypers that bug him all night.

I need encouragement, a bit worried that his HbA1C will be sky high due to the night highs.
E is on Novorapid and Levemir and we just brought his evening Levemir down to cut the hypos.

 

[shiv]

Have you spoken to the parents on the Children With Diabetes emailing list? They are fab at giving advice about children and type 1!

http://www.childrenwithdiabetesuk.org/

 

[MeanMom]

Hi - I am like you and worry about night time lows so we let K run a little higher when she goes to bed than the rest of the day - I aim for under 10 but above 6.5 (ish!) .

We have not corrected for a high at bed time since just after dx (when we had some over 20's) - K had a 19 once at bedtime and I phoned the dsn ( at 10.30 at night )- dsn said not to correct as it was a one off and there were no Ketones . K had a period of 10 days in February when her bedtime BS were in double figures 8 times - 4 of which were over 15. She had no Ketones (never does) so we did not correct. Her HbA1c was 7.2 a fortnight ago - not brilliant but good enough for her age I'm told - it has been around that figure since just after her Dx.

Others will no doubt say we should correct with those numbers - but so far it is working(ish) for us (and K rarely gets night time hypos and her before breakfast numbers are Ok too)

You have to do what works for you🙂

 

[Mumlé]

well that's a tricky one really. we've only been on a pump for 5 weeks or so, or is it 8 now I think about it???! well whatever. Before pumping when we were on MDI (novorapid and Levemir) Lo would often be 13 before bed and we'd give her a bowl of porridge!!!! Guess she would have been running in the teens most nights really - we thought that was perfectly normal and acceptible. We hardly ever woke her at night to check, and often didn't even check BG after she had gone to bed (late, before we went to bed), so she would sleep right through from 7pm.

That's not the case now. We check 10.30 ish then 2.30 ish. I'm hoping we'll get to stop the regular 2.30 slot soon because I hate being sleep deprived and everyone else knows it! But I guess we will be facing the same dilemma then. I guess probably aiming to run between 7 and 10, at a wild guess. So I would only correct if really high. But I may well change my mind on that one... Sorry not really that helpful. Probably the best thing to do is make an action plan which suits you and your levels of worry about hypos - eg - if this then that, then just stick to the rules.

 

[Adrienne]

Its very different on MDI than pumping. We pump and I correct anything over about 9.0 or 10.0 overnight.

On MDI different story but my daughter was extremely sensitive to insulin when on MDI.

Is E pumping or MDI?

 

[Ruth Goode]

I understand how you feel but lately I have corrected Carly in the nights, twice last week - she couldn't sleep well because her level was high at 18.9, I corrected it with 2 units of narvorapid then she slept better and woke up at 4.3 and again in another night she was 13.9 I wasn't sure whether to give her narvorapid but because she couldn't sleep so I did give her 1 and half narvorapid then she slept better but I didn't :-( she woke up at 4.1 so I'm glad I did give her them. I was told by DSN to keep her level between 7 -10 in the nights.
You did the right thing to reduced levemir if they have hypos in the mornings, I have done it before. If its go up then you can increase it again. It is all like a yoyo!