Late Nights and Low Readings

[MeanMom]

Can anyone tell me if we are doing the 'right' thing with late nights? With X factor being on til quite late on a saturday night I let K stay up to watch. When she does this (or other late nights - rare😉) she has her Levemir at the usual time (9pm) and then test when she goes to bed. This week we had company and it was about 11pm before she finally tested to go to bed. She was 3.9 (she was pretending to herself that she wasnt getting low so I wouldnt make a fuss in front of the 'company'😡) She has one glucose and some toast. Left it for about 30 mins and tested again - 4.8 - not happy with this for bedtime so another glucose and some milk. Left it another half hour - by now past midnight - tested again and was 3.6! Had another Glucose and some more milk - by this time she was really tired and hubby suggested she just get off to bed and that I sleep in her bottom bunk (not for the first time)
So this is what we did. It was about 1am by the time she got to sleep as she was quite frightened but very tired. Basically I stayed awake most of the night watching her. She made me promise to wake her at 3am to test, but I didnt as she was exhausted and I felt she wasnt low as she was sleeping quietly and was cool to the touch.
She has had a couple of instances where she has stayed up 'til 10pm and tested around 4 when she was going to bed so has extra supper. Should she have her Levemir when she goes to bed or at same time every night?
(And I know we didnt treat that hypo properly and we would normally be much better - the presence of 'company' complicated things and it wont happen again 😱)

 

[Monica]

Can anyone tell me if we are doing the 'right' thing with late nights? With X factor being on til quite late on a saturday night I let K stay up to watch. When she does this (or other late nights - rare😉) she has her Levemir at the usual time (9pm) and then test when she goes to bed. This week we had company and it was about 11pm before she finally tested to go to bed. She was 3.9 (she was pretending to herself that she wasnt getting low so I wouldnt make a fuss in front of the 'company'😡) She has one glucose and some toast. Left it for about 30 mins and tested again - 4.8 - not happy with this for bedtime so another glucose and some milk. Left it another half hour - by now past midnight - tested again and was 3.6! Had another Glucose and some more milk - by this time she was really tired and hubby suggested she just get off to bed and that I sleep in her bottom bunk (not for the first time)
So this is what we did. It was about 1am by the time she got to sleep as she was quite frightened but very tired. Basically I stayed awake most of the night watching her. She made me promise to wake her at 3am to test, but I didnt as she was exhausted and I felt she wasnt low as she was sleeping quietly and was cool to the touch.
She has had a couple of instances where she has stayed up 'til 10pm and tested around 4 when she was going to bed so has extra supper. Should she have her Levemir when she goes to bed or at same time every night?
(And I know we didnt treat that hypo properly and we would normally be much better - the presence of 'company' complicated things and it wont happen again 😱)

You have done the right thing by Katie doing her Levemir at 9, eventhough she didn't go to bed till later. It doesn't matter what time she goes to bed, the Levemir has to be taken at the same time every day. For Katie (and Carol as it happens🙂) that means 9pm.

I completely understand Katie not wanting to make a fuss. Carol used to be the same and still is with strangers. Maybe you could tell her to tell you quietly (or have a special signal) and then you both take yourselves to maybe Katie's bedroom to deal with the hypo.

Did the guests not know Katie is diabetic? Our friends who come round know about Carol and Carol now quite easily tests her blood in front of them. She injects in private though. Our friends talk about football (they have a son, a football fanatic) and we talk about diabetes (how sad!!)

I hope Katie is OK now.

 

[novorapidboi26]

Thats strange she went low just by staying up later...........does this happen every time she stays up later........

The only thing I can think is happening is as she is more active for longer, and by that I mean simply awake, the insulin within might be getting used up more efficiently (tha acitvity-resistance link).

I agree with Monica on the dose timing, I dont think it was the background that was responsible in this case and with levemir its just a case of making sure its in the system every 12 hours....

 

[MeanMom]

Thats strange she went low just by staying up later...........does this happen every time she stays up later........

The only thing I can think is happening is as she is more active for longer, and by that I mean simply awake, the insulin within might be getting used up more efficiently (tha acitvity-resistance link).

I agree with Monica on the dose timing, I dont think it was the background that was responsible in this case and with levemir its just a case of making sure its in the system every 12 hours....

Thanks - its a releif to know i got something right! Yes it has happened 3 or 4 times now - although not as extreme (curse you X factor 😡) If it is the extra activity - do I give her something more for supper - she would usually have Milk and a biccy at 8.30 - total carbs 15g (so no extra Novorapid). She had a big carb feast at tea time 🙄

Did the guests not know Katie is diabetic? Our friends who come round know about Carol and Carol now quite easily tests her blood in front of them. She injects in private though. Our friends talk about football (they have a son, a football fanatic) and we talk about diabetes (how sad!!)

It was an old friend of ours but he is very needle phobic and a bit of an old drama Queen - especially after a few glasses! he was horrified when he realised what was going on and got very upset, bless him.

 

[novorapidboi26]

This obviously wouldnt happen to me, but a child is different I suppose......

You could maybe think about dropping her tea time ratio at the weekends, only after a test and retesting of course, just to make sure the lows are connected to the longer hours awake.......

 

[everydayupsanddowns]

Sounds like you handled it brilliantly Carolyn.

If the meal was not quite 'usual' I guess there could have been a miscalculation there. If it was a much larger NR dose than usual it would tend to have a longer profile (bigger doses seem to).

If it develops into a regular pattern, you could just knock a unit off your calculation for the meal bolus on X-factor nights to see if that prevents the mystery dip. Not very scientific, but it's the sort of 'gut instinct' thing that can work pretty well.

Mike

 

[MeanMom]

Sounds like you handled it brilliantly Carolyn.

If the meal was not quite 'usual' I guess there could have been a miscalculation there. If it was a much larger NR dose than usual it would tend to have a longer profile (bigger doses seem to).

If it develops into a regular pattern, you could just knock a unit off your calculation for the meal bolus on X-factor nights to see if that prevents the mystery dip. Not very scientific, but it's the sort of 'gut instinct' thing that can work pretty well.

Mike

Thanks Mike - dont think I miscalculated but I could have - she had 25 units of Novarapid but Haloween weekend she had 26 on the Saturday Evening (similar 'party' food) and was 7.2 when she went to bed (late) Also she injected before 7 pm so would have thought all NR would be used up by 11?. Think there is a bit of a pattern here - which is why I wanted to make sure it wasnt the timing of the Levemir that was wrong (so thanks folks 😱)

 

[Robster65]

I have suspected, although never proved, that when I'm very tired through a few bad nights, etc I have trouble keeping my BG up as if it justs wants to stay low so I collapse into bed and sleep ! 🙄

Ive never found any medical evidence to back it up but it does seem to happen. I wonder if K was having a similar experience ?

Well done for sorting it out in the best way.

Rob

 

[MeanMom]

Well done for sorting it out in the best way.

Rob

Not sure I did -was s'posed to be my Birthday celebration and I had a glass myself - shouldnt have when in charge of diabetic child

 

[AJLang]

Not sure I did -was s'posed to be my Birthday celebration and I had a glass myself - shouldnt have when in charge of diabetic child

Of course you should have a glass when celebrating your birthday. My mum and dad always celebrated birthdays and Christmas with a tipple and it never caused me any harm as a diabetic child. Life with diabetes is about getting a balance which means that things won't be always be perfect or even nearly perfect. The low sugars could also be because of excitement related to the staying up late - when I was a child I could guarantee every Christmas Day morning that I would have a hypo which took mum and dad quite a while to sort out each Christmas Day morning (i.e. I was barely conscious to begin with) but it never did me any long-term harm and was always a good excuse to eat lots of Quality Street plus the added benefit of them always putting my latest Christmas present Abba LP on to try to tempt me into feeling better faster!!!🙄

 

[Robster65]

Not sure I did -was s'posed to be my Birthday celebration and I had a glass myself - shouldnt have when in charge of diabetic child

Absolutely agree with AJLang. You shouldn't put your life on hold. By the sound of it, you did everything perfectly and there were no problems in the night. I had a couple of nasty hypos in the night as a teenager, which warranted an ambulance call out, and I'm still here. Assuming you don't go out drinking all weekend and leave her home alone, you won't go far wrong. And I bet k is far more savvy about her own needs than you imagine. Don't let it be a handicap to any of you. The more normal you can be with it, the better she will be able to cope in the future. You're doing a brilliant job. 🙂

Rob

 

[Estellaa]

i have lantus before i go to bed, i always have 21 units, but my usual bedtime ranges from 1am-4am soo its a bit different.
i always make sure i am 12 or above before i go to bed as that is was the docs recommend.

 

[Northerner]

i have lantus before i go to bed, i always have 21 units, but my usual bedtime ranges from 1am-4am soo its a bit different.
i always make sure i am 12 or above before i go to bed as that is was the docs recommend.

What do you normally wake up to? 12 seems quite high to me for bedtime, but I'm not questioning your doctor's advice as they know you much better than me! I used to go to bed in double figures, but then I learned that it was my lantus dose which was too high and dropping my low overnight. It took a while to get that right, but now I can generally go to bed around 6.x

I'm another one of those people who takes their lantus more in relation to bedtime than at a fixed time, so there can be a couple of hours difference in the actual time injected.