Night time Highs, betwetting and sweats please help!!!!

[Scarletteve]

my little girl was diagnosed in January but had a long remission period with no Insulin. she turned 5 in March and managed without insulin till May. She is now on small doses of Levimir and Novarapid. she has 2.5u of Levamir at 8am and 1-2u of Novarapid with every meal. her daytime readings are good as long as she doesnt snack between meals and we now have a good routine going. She can do her B/G test herself and is very close to injecting herself.

I am struggling at night tho. Both my children have snacks at bed time and this was sending Scarletts readings through the roof in the night. The Highest being 22.4. when I checked on her she would be drenched in sweat and would then later in the night wet the bed. She also suffered more nightmares than Normal and she started sleep walking again. Introdused a 4th dose of Novarapid to hopefully sort the problem but it hasnt helped. now her levels stay normal but go up again after the insulin has worn off?? is this normal?? Can anyone help?
would changing type of insulin help eg 2 Lantus? or can I swap and give levimir at night? I go on holiday to Spain next week and any help would be much apreciated before we go and have to deal with real heat.

 

[margie]

Sorry to hear that Scarlett is having so much trouble at night.

I think you should contact her DSN. High morning sugars can be due to insufficient basal, a night time hypo or dawn phenomenon. The night sweats may be indicative of a hypo in the night. Can you test her sugars at the time she has them ?

The DSN should be able to ask the questions that will enable him/her to see if there is any type of pattern.

Be careful with extra Novorapid that it is just covering her snack - have the DSNs taught you how to calculate how much insulin is required ?

Hope you get some answers - I will move this to the General board where hopefully more people will see it.

 

[Hanmillmum]

Hi there, sounds like your daughter would benefit from a review of her insulin for overnights, may need the longer acting one in an evening dose to get her through to the morning. I would speak with her DSN first thing Monday and hopefully you can get sorted before your hols. Good luck 🙂

 

[sasha1]

Hiya,

I can only offer what has already been said ... contact the little ones DSN and discuss insulin adjustments etc.

Heidi
xx

 

[Ruth Goode]

Im sorry to hear that, Carly just turned 3 now... she is also on novorapid and levemir in the evening - levemir do increased her level over the night but sometimes hypo first thing in the morning! She still wee alot so she wear nappies in the nights. I dread to think about when she is 5 so hope you will be able to resolve this very soon.

 

[Robster65]

If you've tested at 20+ following a snack, it would imply to me that she is hyper, which also follows the pattern of wetting the bed due to increased bladder function (I often suspect I'm high if my bladder is full after a short time!) and I also feel hot at night if I'm hyper.

I would be tempted to try and get a range of BG tests through the night so you can pinpoint when she's climbing and if it levels off at any time. It may that the snack is taking a long time to get through her digestive system and sends her high in the small hours, after the final bolus.

It's something you really do need to speak to the DSN about, especially before going on holiday with the change of routine and heat, which may affect her BG levels.🙂

Hope you manage to crack the problem.

Rob

 

[Scarletteve]

After holiday from hell!!!

Couldnt get hold of my dsn as she was on holiday. her trainee who knows Scarlett advised to keep regime the same as holiday was so close and perhaps lower N.R insulin by half unit if she kept going low due to heat and exercise in pool ect...
All went well till Scarlett got a water infection mid week. she was a nightmare and refused all medicine. temperature and b/g levels shot up and she ended up being sick in the middle of the night after the paracetamol and Ibruprofen wore off. I was constantly finger pricking, jabbing and squirting medicine down her throat. it was a nightmare!!!!
Thank you for all your advice and support. It has made me realise just how vunerable my child is. Good that I am now focused and aware of the pitfalls early but misrable because I now have a more relistic idea of future challenges and how scary it's gona get.
Thank you again for your support. xxxxx

 

[Robster65]

Sorry to hear she suffered on holiday. Not what you hope for.

Have you got ketone test strips ?

If she goes high (above about 15 or so) for any period of time, especially when ill, she can develop ketosis, which can cause vomiting, and requires urgent medical attention. Not saying this was the cause, but is a very real possibility and something we all have to watch for. You should be able to get some from your GP or DSN, who can explain what the safe levels are, etc.

Also important to keep the BGs as low as poss to allow the immune system to function properly. Hence a greater risk of infections and reduced ability to fight off illness when BGs are high. Bit of a nightmare to acheive but very important.🙂

Did you manage to get the original problem sorted ?

I hope so.🙂

Rob

 

[Caroline]

Can't offer any advice with insulin, but if taking things like antibiotics or other medicines is a problem, have a suagr free drink to hand. Some of the medicines don't taste nice and children react to that. Whenever we have to give little feller anyting I keep a drink he likes handy and he has a mouthfull of that after his medicine. I know it is putting more fluids in, but it helps to make the medicine more palatable and will help clear the infection up a bit quicker. I know it is not appropriate here but remember the song with the famous line 'a spoon full of sugar helps the medicine go down in a most delightful way'. A sugar free drink is the same principle.

 

[AJLang]

[QUOTEI now have a more relistic idea of future challenges and how scary it's gona get.
Thank you again for your support. xxxxx[/QUOTE]

Hi I can't speak from the perspective of a parent but I was diagnosed with diabetes when I was only two - forty years ago! Although it may seem scary to you at times I think as children with diabetes we are much more resilient and just get on with it - yes there are bad days - but you tend to accept diabetes as part of your life and on the whole get on with things. Your daughter has a brilliant life ahead of her. I came from a very loving working class family and have managed to achieve so many things without letting diabetes get in the way. This has included gaining a PhD, travelling to countries such as the Lebanon and Israel, meeting my all-time hereos (Benny and Bjorn of Abba - after I gatecrashed one of their parties!) etc. Diabetes is annoying, and sometimes scary, but there is absolutely no reason why you and your family should not move forward and have a wonderful life. I really hope that you find things a lot easier because it must be particularly difficult as it is only a few months after diagnosis and you are still learning so many things about this condition. Please keep on asking us lots and lots of questions xx

 

[Hanmillmum]

Hi

Sorry to hear your holiday was difficult, hope things have settled now you're back home. As time progresses these things will hopefully become less scary to manage as you will have increasing confidence and knowledge about how to manage things best for your daughter, you will have a good idea of what will work and what to do.
Have you managed to get on top of her night time highs she was originally having trouble with ?

 

[Scarletteve]

Thanks for you replies.
Drinks unfortunatly dont work with Scarlett when she refuses medicine it's for maximum attention and to cause drama. bless her she is a bit of a feisty girl and likes to keep me on my toes. lol.
I dont believe Diabetes will stop Scarlett doing anything she wants in life when she grows up. What I ment was that caring for a lil one who is still unable to properly communicate how she feels is a scary responsibility. It freaks me out that my daughter is dependant on drugs to keep her healthy and alive. Whilst greatful that she can get these drugs easily for free and aware that things could be worse. (I always tell myself that Scarlett takes insulin and is not on kemo like some many people worse off.) I still feel apprehessive and dread all the future trials and illnesses we are going to have to muddle through together.
xxxxxxx

 

[Scarletteve]

Hi

Sorry to hear your holiday was difficult, hope things have settled now you're back home. As time progresses these things will hopefully become less scary to manage as you will have increasing confidence and knowledge about how to manage things best for your daughter, you will have a good idea of what will work and what to do.
Have you managed to get on top of her night time highs she was originally having trouble with ?

Not yet. waiting for a good day (when she doesnt have to go to her dads or play scheme) to swap her levimir does to the evening. I have upped her novarapid at meals now we are home, as she has had some day time highs at playscheme. Her normal dsn back 2morro so going to ring and go through her diary with her then. seems to be sudden jum in her insulin equirement since infection and seems to be going up rapidly in the night without food.
I let her go to bed on 4.5 last night and her b/g test after 3 hours was 20.1!!!! with no extra food or bed time snack I was shocked. only reason I can think of is that levimir has compleatly worn off by then as it only lasts a max of about 16hours. thanks so much for your reply. xxx

 

[Robster65]

I wonder if you might have to split the levemir (hope not with her being so young) or you could discuss switching to lantus.

Ultimately, it may be that she would be better off with a pump, but they seem to be like rocking horse droppings, even for children.

Highs of 20 on a regular basis need nipping in the bud, so try to pressure the DSN to give you the support you need.

And don't worry. Us diabetics are robust animals that tend to be healthier in other ways than most other people !

Rob

 

[Pigeon]

A lot of people split Levemir doses. I take 4 U with breakfast and 6U with tea - I seem to need more basal at night and perhaps your daughter does too. I hope you can get it sorted soon!

 

[Hanmillmum]

"I let her go to bed on 4.5 last night and her b/g test after 3 hours was 20.1!!!! with no extra food or bed time snack I was shocked. only reason I can think of is that levimir has compleatly worn off by then as it only lasts a max of about 16hours. thanks so much for your reply. xxx[/QUOTE]

My daughter's night time needs increased as time progressed, I put it down to the honeymoon period wearing off. At one time, in the early months, she was on nothing overnight, when she started on the pump 3 1/2 months in she began on tiny amounts which gradually increased until she has relatively stabilised. I say relatively as we do tweak every so often but she is still in rapid growth being just under 3 yrs. A jump from 4.5 to 20 definitely demonstrates the need for additional background insulin overnight, she could well be out of honeymoon period now. I hope you can get somewhere soon with DSN, it is hard when their needs are changing, you feel like you have had the rug pulled from under you and you just want it right for them, right now! Take care, thinking of you 🙂