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Re: [IP] Re: Testing in the Middle of the Night

In a message dated 10/2/2002 11:29:13 PM Mountain Daylight Time, 
email @ redacted writes:

> I guess what I was wondering is:  when your child was diagnosed, were  
> you told specifically to test them every night?  Or was that something  
> you decided on your own was a good idea?  If you were told  specifically
> to test at night, was it presented as something your child  would have 
> to do for the rest of his/her life?  Or just while they were  young, or 
> while their bg's were being stabilized?  I would guess  (possibly?) that
> hypos might be more dangerous for a young child than  for an adult, and 
> that children might not be as skilled at recognizing them  or waking up 
> on their own at night knowing they're having a low bg.  Is  that why 
> nighttime checks seem to be more recommended for children  than for 
> adults? 

At diagnosis (Katie was 9, almost 100, we were told that it was a good check 
during the night maybe once or twice a week (they worry a lot about parent 
burn out).  That was on MDI (NPH and H) and I started finding so much 
variability (highs & lows) that I started checking at least once a night, 
every night.  When Katie started pumping (7 mos. after dx), once her basals 
got fine tuned (which happened fairly quickly, I pretty much did night checks 
only on those nights of high physical activity (about 2-3x a week) because 
her pump kept her numbers SO level through the night on "regular" days --  
but that relative vacation was short lived because she really started in on 
the hormone roller coaster (which means insulin resistent highs that hit in 
the middle of the night that ocur unpredictaby).  I'm determined to get her 
through puberty with the best possible A1cs I can manage (along with the best 
quality of life possible) -- without nightly checks to watch for these 
"hormone highs" and treat them when needed there is no way she would have had 
A1cs in the sixes consistently for the last 17 months that she's been 
pumping.  I also know that without the pump trying to manage these highs 
without risking her crashing during the night would have been FAR more 
stressful and MUCH LESS succesful . . .

As for your other questions, studies do show that severe hypos can be more 
dangerous for very young children in terms of a long term impact on cognitive 
processing, but I think that the reason most parents that do nightly checks 
continue to do so long after diagnosis is the simple fact that when you're 
dealing with growing children with constantly changing schedules, activity 
levels, eating patterns, hormones, etc. etc. you really can't count on 
anything staying stable for long -- so, as a parent you do what you need to 
do to keep your child safe.  

I know that for me, too, I also do night time checks because my daughter asks 
me to -- one of the drawbacks of her first diabetes camp experience was one 
of the campers sharing about a brother of a friend of theirs (a teen) who 
died in his sleep presumably due to a hypo (sometimes called "dead in bed").  
Even though she's only every experienced mild lows (in terms of symptoms), 
and though she has even fewer of those since she's been pumping, the way the 
experience of a low unsettles her combined with this information gave her 
something to worry about that she'd never previously considered . . .

Pumpmama to Katie
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