Night time highs.

[Tom1982]

We’ve now got a Libre 3 which has been pretty good. Starting to see some patterns develop which we could use some help in solving.
Daughter is 4 and on Levemir (6 units at nights) and Novorapid for meals (Ratio about 1/10) all seems fine, but after about midnight her levels start to climb every night and then drop again by wake up time. For example, she was ticking along nicely at about 7 yesterday then at 12:30 a.m started to climb all the way to 16.1 then back to 8 by wake up time. Any ideas?

 

[Inka]

What time does she take her Levemir? That seems an unusual pattern (to me, at least) as insulin needs usually decline in the early hours of the night.

What is she having as a bedtime snack and when? Just trying to think of things that might be affecting her.

 

[helli]

Please bear in mind that CGMs are calibrated to be most accurate between about 4 and 9. A reading of 16 is very likely to be inaccurate.

As @,Inka mentioned, you are seeing an unusual patern. It may be worthwhile checking what her finger prick reading is one early morning if the pattern is repeatable.

Given the inaccuracies of CGMs in double figures, I would be very reluctant to draw any conclusions or make any changes until I had confirmed the pattern.

That said, if it is confirmed that your daughter is going high over night, is this a recent thing? Could it be related to the heatwave causing disrupted sleep? Again, don't change until you have had some "normal" days.

Remember, many of us have lived unscathed through decades of only knowing what our readings are when we go to bed and when we wake up. We would be happy with an 8 in the morning and blissfully ignorant of the high.

Today's technology is amazing but it can cause us to obsess over perfection. Recently, my sensor died when I was away. The first day was difficult but, the second and third days were a wonderful break.

 

[Tom1982]

What time does she take her Levemir? That seems an unusual pattern (to me, at least) as insulin needs usually decline in the early hours of the night.

What is she having as a bedtime snack and when? Just trying to think of things that might be affecting her.

They told us off for giving her a bedtime snack a couple of months back so we’ve blown that out. May of been like that from day one but no idea as when we check at night it’s all good, then again in morning it’s all good.

 

[Inka]

As @helli suggests, if it’s a shortlived high, I wouldn’t panic. I’d try to confirm the actual figure by fingerprick, then leave it for now as she’s waking up at an ok number.

 

[Tom1982]

As @helli suggests, if it’s a shortlived high, I wouldn’t panic. I’d try to confirm the actual figure by fingerprick, then leave it for now as she’s waking up at an ok number.

I think they are looking at changing from Levemir to Treblisa (or something?) does the back ground work with the Novorapid at meal times? We are quite high spikes after dinner too.

 

[Tom1982]

Please bear in mind that CGMs are calibrated to be most accurate between about 4 and 9. A reading of 16 is very likely to be inaccurate.

As @,Inka mentioned, you are seeing an unusual patern. It may be worthwhile checking what her finger prick reading is one early morning if the pattern is repeatable.

Given the inaccuracies of CGMs in double figures, I would be very reluctant to draw any conclusions or make any changes until I had confirmed the pattern.

That said, if it is confirmed that your daughter is going high over night, is this a recent thing? Could it be related to the heatwave causing disrupted sleep? Again, don't change until you have had some "normal" days.

Remember, many of us have lived unscathed through decades of only knowing what our readings are when we go to bed and when we wake up. We would be happy with an 8 in the morning and blissfully ignorant of the high.

Today's technology is amazing but it can cause us to obsess over perfection. Recently, my sensor died when I was away. The first day was difficult but, the second and third days were a wonderful break.

Cheers for the reassurance, it’s proper stressing me out now to be honest. Do kids/levels pick up on stress to you reckon?

 

[Inka]

I think they are looking at changing from Levemir to Treblisa (or something?) does the back ground work with the Novorapid at meal times? We are quite high spikes after dinner too.

No, in theory the Levemir should keep her levels in range and fairly steady in the absence of food. The Novorapid is to deal with her food.

Your daughter is very young and I think some spikes are unavoidable - and much better than hypos. Bolusing slightly earlier might work but it’s a risk with a young child in case they don’t eat or there’s some delay. Keeping active after a meal can reduce spikes too eg a walk, a game in the garden, etc.

 

[Tom1982]

That levemir is doing nothing at the moment. She’s either on the up or on the way down. It’s draining!

 

[Inka]

This hot weather won’t be helping @Tom1982 Hopefully cooler temperatures will help a little. I was thinking about her nighttime high. Could there be anything partly waking her at that time? I find waking in the night can cause a blood sugar rise.

 

[helli]

That levemir is doing nothing at the moment. She’s either on the up or on the way down. It’s draining!

Basal insulin keeps levels stable in the absence of food, bolus etc.
As you mentioned earlier, her levels do fall over night (after a rise) when the only insulin she has onboard in Levemir so it must do something,

 

[PhoebeC]

8 is not bad for waking, so if you can confirm she is really going that high, too 16 (blood test) then if I was me I would increase my background by 1 unit and see if that helps/.

Cheers for the reassurance, it’s proper stressing me out now to be honest. Do kids/levels pick up on stress to you reckon?

Stress increases most peoples levels. Also hormones' do. She could be having a growth spurt.

Hope you get it sorted.