# Testing through the night?



## Kei (Jan 25, 2010)

I often see parents on here mentioning testing during the night.  Is this just parents of children with pumps, or others too?  

We've never been told to test in the night unless F is ill.  I DO test sometimes when I go up to bed if she wasn't very high at supper time, but otherwise I leave her to sleep.  Should I be testing her?


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## Becca (Jan 25, 2010)

Hiya, when Rose was on injections, we didn't test at the beginning because we were never told.  It was only on reading things on the web and on CWD UK that we began too.  Some consultants think that children will ALWAYS wake up if hypo or if they are hypo will come back up.  These consultants, IMO, should frankly be shot! 

There are scary stories out there and i know of a couple of people who sadly went hypo in their sleep and never woke up.  I'm sorry if that is too much info  but it's the reason why we get up and test.  From midnight (Rose's last test) it could be 7 hours before she's awake and that's a lot of time where we don't know what is going on for a child.

Also, by doing the 3am test the body is at it's lowest blood level (or something like that) and so possible hypos can occur there.  

It is down to personal opinion and how your life is, but this is what we do for Rose.  Consultants and DSNs might raise their eyebrows at it but for us it's to keep her safe.

HTH


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## ruthelliot (Jan 25, 2010)

Hi, we were also told we didn't need to check Ben through the night (ie after 8pm) then having had a few odd readings over a few days (though nothing drastic) my gut instict told me to check him and he was 2.1 at 11.30pm. One of the doctors we saw shortly after said there was absolutely no guarantee he would ever have woken up - despite this our consultant whom we saw a few weeks ago still says we shouldn't test though also says his occ night time hypos are worrying. This is the same consultant who says the best way to deal with mid morning highs of 18+ over 2hrs after his novorapide is just not to test at this time and ignore the constant trips to the loo! I will never not test through the night now - at the end of the day I dont know how low the risk is but there def is at risk and thats too much for me.


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## Patricia (Jan 25, 2010)

Hi there

we rarely tested in the night on mdi because we were told E would wake- and because control for us was not good enough for a low in the night to be a possibility. 

Now that control is better, and with fine adjustment possible on pump, we test at might more often than not and have unfortunately found him v low- to no short terM
 detriment thank goodness- several times. We only leave him for the night when a) absolutely shattered and number is high enough to drop badly and still be ok, or b) when he's had some stable nights. 

This is a bit if a sore point with me today: after over a month of chasing v unpredictable night numbers, two nights ago things seemed pretty good. One night of not getting up went well, but last night out ofthe blue it went pear-shaped- after going to bed on 6.8 at 12am, he woke at 6.30 am on 2.1...


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## Patricia (Jan 25, 2010)

Sorry, phone being difficult. Despite all this tho I want to say that only you know your child and your lives.... We simply can't do night upon night, both of us work long busy hours often... But we do test a great deal anyway, for the reasons above. And will tonight too, ditto!


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## Adrienne (Jan 25, 2010)

Hiya

Yep I test overnight.   One of our old consultants actually specialised in night time hypos and all the studies and tests she was involved in, the majority of children do NOT wake up when hypo so whatever these consultants say about they will, is rubbish, there are papers out there written on this.

When we were on twice daily mixes (in my opinion should be banned as I believe they do more damage than good, sorry to those that are on them) I didn't always test at night, I'm a single mum and just too knackered doing it all on my own.   We then got our hands on a CGMS and boy what a wake up call.     There I was thinking that that 9 or 10 was a lovely number to go to sleep on at about 11.30 pm and waking on 7 ish and all inbetween hours would be fine.... wrong.    THe CGMS caught hypos.   Some were long hypos as well which were very dodgy.    She never woke once but did come up from them.   That doesn't happen now, she just keeps going down and down.

Like Becca, unfortunately I too know a couple who didn't wake up and I won't and can't take that risk.    Like Becca, sorry if that frightens anyone, but it is reality that happens with diabetes, however rare it is, it does happen.  One of these girls was our friend and Becca and I will never forget that.

So yes I test nightly.    We have full time sensors now for our pump so I have the added bonus of an alarm if the sensor says she is hypo but it is behind the finger test so she goes hypo before it alarms so although I do get up every night, sometimes I can look at the sensor reading and not do a finger test.


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## delta (Jan 28, 2010)

do not listen to the dsn they are just going by the book my son generally
gets checked before bed then twice through the night it takes only a minute to do and if you have to get up you'll soon get back to sleep how else can you know what is going on through the night without checking
i remember having to call for a ambulance one night never again never been so scared


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## gewatts (Feb 11, 2010)

Katie has been diagnosed for nearly 4 years and we only test in the night if she is ill. Though reading everyone's posts I wonder if we should be! Am seeing our DSN next week so will discuss.


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## Janet (Feb 18, 2010)

*Testing at night*

Hi everyone.

I havn't been on the forum for while now but do read the posts regularly.  I do test my son a couple of times through the night, at times he's v.low without waking, even though being quite high at bedtime.  Our specialist always tells me to test in the night if my son has exercised alot during the day because that can have an effect overnight or if he has hypo'd also during the day.  Adrienne what is a CGMS?


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## bev (Feb 18, 2010)

Janet said:


> Hi everyone.
> 
> I havn't been on the forum for while now but do read the posts regularly.  I do test my son a couple of times through the night, at times he's v.low without waking, even though being quite high at bedtime.  Our specialist always tells me to test in the night if my son has exercised alot during the day because that can have an effect overnight or if he has hypo'd also during the day.  Adrienne what is a CGMS?



Hi,
A CGMS stands for 'continuous glucose monitoring system' - its a device you wear that tests your blood every 3 or 5 minutes and sends the information to either your pump or the hospital download the data and use it to make changes. If your hospital have one - it might be worth asking for the use of it - its great for overnight readings!Bev


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## Janet (Feb 27, 2010)

*testing at night*

Hi Bev.. 

My son (Diag -June 2009) is on twice daily.

Is this device only for use with a 'pump'?  If not, where can I get one? how does it work?  where do you attach it? and does it have an alarm?

Dont mean to sound a bith thick but I have never heard of this monitor


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## rh040 (Feb 28, 2010)

*waking for night time testing?*

Like others here, my DSN advised us at diagnosis last month not to bother with night testing. 

My husband, also Type 1 visually checks when he comes to bed around midnight for sweating and wakes my son (aged 8) for a glass of milk if worried. 

Those of you who test at night - do you have to wake your child?

Rho.


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## Kei (Feb 28, 2010)

I have to check J at least once a night still as he tends to go hypo very fast, even if he was high at the beginning of the night.  I'm checking F when I do.  They don't usually wake, and J has even started just poking a finger out in his sleep for the test!


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## grahams mum (Feb 28, 2010)

I Do At Least One For Graham If He Goes To Bed Below 10 I Always Test Around 12 1 O Clock


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## ZoZo (Feb 28, 2010)

I have never tested O at night., and never been advised to by the DSN. 

His control is pretty good though, so I see no reason to do that. However if there are problems and things chnage which can always happen, then I'll discuss the need for it with his nurse.


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## bev (Feb 28, 2010)

I didnt test when he was on injections - but since he has been on a pump we have found lots of hypos at 3am in the morning and have altered basals accordingly. We now do random checks because the alarm on is sensor alerts us if he is going low - but not always!

Sorry to sound morbid - but i know a 12 year little girl who died in her sleep. She went to bed on a good level and didnt wake in the morning. There have been a few others last year too - so i personally think it is too risky not to test - even if its just random testing.

The idea that people ALWAYS wake when hypo is not true. There have been studies done on this and it is fairly clear to me that the diabetes teams should be telling people to test - even if its only once a week or something.Bev


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## bev (Feb 28, 2010)

Janet said:


> Hi Bev..
> 
> My son (Diag -June 2009) is on twice daily.
> 
> ...



Hi Janet,
Your team should have one of these that they lend out for a week and they interpret the data for you and tell you where to make changes etc. They dont have to be used with a pump - they are fine to use with injections only. I hope this helps.

They have a canula that fits onto the tummy or bottom and its a little square box - it takes a blood reading every few minutes. The hospital ones dont have an alarm and you cant read the data. The ones attached to pumps do have alarms and we see a graph of levels taken every three minutes so it helps to spot trends etc..

You can buy a 'navigator' device and these are very good - but not cheap.Bev


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## Adrienne (Feb 28, 2010)

bev said:


> I didnt test when he was on injections - but since he has been on a pump we have found lots of hypos at 3am in the morning and have altered basals accordingly. We now do random checks because the alarm on is sensor alerts us if he is going low - but not always!
> 
> Sorry to sound morbid - but i know a 12 year little girl who died in her sleep. She went to bed on a good level and didnt wake in the morning. There have been a few others last year too - so i personally think it is too risky not to test - even if its just random testing.
> 
> The idea that people ALWAYS wake when hypo is not true. There have been studies done on this and it is fairly clear to me that the diabetes teams should be telling people to test - even if its only once a week or something.Bev



Hi

I agree with Bev wholeheartedly.   Regardless of what your DSN tells you (talking any 'you' here, no-one personally ) every parent should consider overnight testing.   It appears majority of adults (on this forum anyway) do wake up but studies show that majority of children do not.  On mixes, random hypos happen without your knowledge.   This was a major problem for me.  We had the use of the CGMS and it showed hypos happening inbetween testing overnight and they were very low.   We changed to Lantus/NR as soon as Lantus become available, it wasn't in the UK at the time I'm talking about.  Levemir followed shortly after by another company.

The young girl Bev is talking about is the daughter of a friend of mine.  She was one day short of her 13th birthday and was on MDI (which is neither here nor there).  This was three years ago in May.   We have a tree planted in her memory, her mum will never be the same again.

This isn't to frighten you but to point out that DSN's do not always know everything.    When a DSN has ever said to me not to do night testing, my one question to her/him is 'can you guarantee that my daughter will not hypo in the night'.   Of course they can't and until they can, I test overnight.   Always have and always will.


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