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Re: [IP] A Poll -- 3am check on kids

> I guess what bothers me about this thread is what are your kids going to do 
> when they leave the house?  I would think it would be more beneficial to 
> teach them to make adjustment to their basel rates according to their 
> activity level that day, etc..  For me teaching them this would help them 
> when they are on their own.  I would think with the pump that you should be 
> able to alleviate the nightly testing, but from what I am reading this is 
> incorrect, why is that?

When Lily goes on overnights or camping in the summer (2 weeks away), she 
takes an alarm clock that is loud. If she does not wake up, her camp 
mates know to wake her or help her if required. 

As a child reaches maturity, the wild bg swings due to puberty and growth 
diminish as do the changes in basal requirements. Most adults have fairly 
stable basal requirements. This problem is hidden by the MDI regimen for 
kids that lets them run high most of the time anyway. It is not really 
practical to address the basal need of a growing child with MDI. The step 
function in insulin needs when they fall asleep is really tough. If they 
have dawn phenomena as well that means a large increase at bed time, 
followed by a decline followed by and increase prior to waking. Kinda 
hard to get out of an NPH insulin activity curve. The compromise is to 
give as much insulin as possible without a crash in the middle of the 
night. This is probably a good explanation for why so many kids have such 
a hard time getting stable results on MDI.

The reason for the continued 2-3am checks is an attempt to make bg's as 
normal as possible. Since you can't do this anyway on MDI, the check was 
a waste of time.

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