If it was me, probably wouldn’t be too concerned. If it was my kid, I probably want a little more buffer, since any misjudgments would be my responsibility.
I am just speaking for myself here, but I would not feel comfortable being at 60 overnight. It’s just too close for comfort for me. I would definitely have a glucose tab or 2 to try and bump it up.
Also, I was told (true/not true?), that spending a lot of time on the low end gets your body used to lows and makes it more difficult to recognize them causing eventual hypo unawareness. Can someone here verify this?
Also, I was told (true/not true?), that spending a lot of time on the low end gets your body used to lows and makes it more difficult to recognize them causing eventual hypo unawareness. Can someone here verify this?
That is true but I wonder if that’s also the case when you’re asleep? From what I understand your adrenaline and cortisol responses are curbed at night so I would imagine you already have an attenuated hypo response. How much it translates to wakeful low awareness I’m not sure. In any case, Samson definitely feels some lows, but not all – and what seems to be noticed the most is the steepness of the drop. So he may feel low at 100 if he’s crashing, and may not feel low at 55 if he’s been steadily drifting down.
Also, I’m not sure in this instance whether he spent a lot of time low. He oscillated between 60 and 80 at various points in the night but he was pretty steady in the 70 to 75 range for most of the time, dipping down as low as 60 for maybe 10 or 15 minutes at a time two or three times. So not ideal (and like I said I would have bumped him up). Bu tI’m just not sure it’s worth stepping in when my husband is doing the management.
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For most of my life I have always woken up during the night if I was low as far as I know, but I don’t REALLY know because there were no CGMs when I was young, so who know what was happening overnight. Because of that I think doctors told us to make sure that our BG was at around 120 before going to bed (to be safe). That is still ingrained in my head, so I usually don’t go to bed if my BG is below 90.
These days with all of our tech we have more leeway, but I am not sure what long term effects low overnight BGs would have. I would still think that they could contribute to hypo unawareness. Based on my experiences as an adult I feel that the more that I let myself stay low, the more hypo unaware I have become.
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I hope one day Samson will wake to his lows. He never has yet, so I’m not sure if it’s just a developmental thing? He’s 4.
I think if when Samson spends a lot of time low he does feel his lows a little lower, but usually we’ve only noticed that if he was spending a lot of time low during the day – now that Dexcom alarms are working properly he is rarely below 80 at night I would say.
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I would say you have a really good chance of him waking to lows when he gets older. There is so much development left to go for him, that any comparisons made to now would be premature.
60, for Liam is low. I want him between 70 and 120 all night. Hardly ever happens but I would treat him if he went below 70.
We had the opposite problem last night… Finally got it under control at around 0530 or so.
That is what many of our nights look like. There are three different hormones related to growth that can be released in one night. The pattern above is a tough one. The worst nights are when it feels like all the hormones got released and 20 units of insulin didn’t bring him down. The notch at 3:30 am, is when the second hormone got released. (at least that is what I think is happening). Yuck. We would normally hit the first with 12 units, and the notch with another 8.
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In a single bolus or extended?
The 12 would usually be delivered via syringe IM in the calf, the second could be a single bolus from the pump or another syringe in the calf depending on level of rage.
Do you find that extended boluses work in these instances?
Yeah. It is like regular bolus is mostly water. No idea why nighttime would be so different than daytime in this regard.
Bolus 1 or 2 units max up front. And the Tandem already has a slow delivery rate. The rest of the bolus I do extended about 1 unit per 10 minutes. Drags it out but it seems much more effective.
We will give it a try. Can’t be any worse.
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