Friday, April 27, 2012

To check or not to check?

I know there are so many different viewpoints on many things when it comes to raising your t1 child;
  • real sugar vs. sugar free
  • pumps vs. MDI
  • Giving your child the choice when it comes to pumps, CGMs, etc.
  • weighing/measuring vs. SWAG-ing
No two parents do things the same, and I think that's great.  Diabetes, after all, is not a one-size-fits-all disease.

One of the biggies that can sometimes cause a lot of tension between us D-Parents is overnight checks.  Fred and I were never taught to check Elise overnight by the CDEs, except when we made any changes to her bedtime insulin.  About two months in, I read about Dead in Bed Syndrome and discovered that a lot of parents do check overnight.  Every night.

And so have we.  Every night since she was about 14 months old.  That's a lot of lost sleep, my friends.  But those nights when you catch a 40 with two hours to go before the NPH peaks, or a 95 with .20 IOB (which would drop Elise by 50), makes all that lost sleep so worthwhile.

For the longest time we were mostly worried about catching lows.  When Elise was on MDI, we seldom corrected at night because even if she was 300 at midnight, she would almost always come down by morning.  Once we started pumping, we would just correct a high and move on. Consequent checks that night were usually done to make sure we weren't over-correcting.  Again, she would almost always come down.

Until this past Wednesday night.  I had checked Elise at 11:00 pm before I went to bed.  She was 123, which I felt comfortable with because I knew she had been running a little high during the overnight.  I set my alarm for 2:00am.

My alarm went off and I stumbled into Elise's room.  As I grabbed one of her feet to poke her toe, she rolled over and I saw the pod that we had just put on 12 hours earlier was hanging by a thread.  I took a closer look, hoping the cannula was still inserted so I could MacGuyver it up until morning.  No such luck.

At this point I might have muttered something that sounded a little like "seal" in French. 

A quick check showed her at 298.  I woke her up and with the help of my Mom (mostly to keep her calm), Elise had to endure a shot and pod change.  Sucktastic.

Afterwards, all I could think about was, "what if we didn't do overnight checks?  How high would she have been by morning?"  Thursday was a school day for Elise, and her class was participating in "Suessical the Musical" along with the rest of her school.  Most likely she would have had to stay home so I could get her safely back into range.  And she would have been so disapointed and mad at diabetes.

So to check or not to check?  I believe it is YOUR question. My viewpoint is, "your kid, your choice."  But for this family, night checks will always be a part of the diabetic life we lead.

This photo has nothing to do with the post... just a fun shot celebrating Fred's and my Mom's birthday.  The 104 is for the total number of years we were celebrating.  They didn't think it was so funny.


  1. Great post and we check every night too. Or I should say we try for every night but sometime that alarm does not seem to wake this tired mom up. UGH!

    and hahaha seal in french...I remember when we figured that out in grade school. So funny!! Crazy Canadian kids...

  2. I had a similar conversation with a non-D mom the other day. She asked me if I still had to get up and test Bean and I told her that I did get up and check her in the middle of the night. She kinda seemed surprised (what does she know, she doesn't live this life) so I told her about Dead In Bed Syndrome and told her that I'll get up for the rest of my life if it means there's the chance of catching a low that Bean might not have woken up from on her own, or at all.

    It's a personal choice and there are nights that the alarm doesn't wake me up, but it's rare that I don't wake up an hour or so later and check on her.

    Everyone has to make the choice for themselves! No matter what D issue it is, it's up to each person/family to do what works for them.

    ...and done... ;)

  3. I think its GREAT for those that dont feel the need (or see the need) to check numbers overnight....but for us its a MUST! If we have a good streak and have everything just right for several weeks I may push a 5-6 hour stretch overnight without checking...but ya know......that never lasts long!

  4. Hi, night checking is down to the family circumstance but we also were never taught (or thought) to check at night, we started about last September after reading about it online...and found many unknown lows...

    K never woke for them (until about two weeks ago when after weeks of steady readings we decided to go for a full nights sleep, guess what, she woke about 2:30am with a low...effing D gave us a hell of a guilt trip that day). BTW seal in french - i had to google that one :)

  5. Yeppers...night checkers here as well.

  6. Us too. I'm going to share this very well put viewpoint with a parent who has recently asked about this. Thanks.

  7. I remember when I first asked at the Endo office about Dead in Bed Syndrome and nighttime checks and the CDE I was talking to told me that it would never happen to Our Sugar Babie...I have never forgotten that could you. We check too for you can never say never to anything with this disease. I so love the pic and I think that was very creative of you to combine the years of total celebration. xoxo

  8. It's definitely a personal choice, but I can't sleep unless we check at least twice a night. Every time we think about cutting back to once a night, we catch a low which tells me to keep on checking!

  9. I'm MUCH more concerned about DKA overnight than I am with lows. Is that crazy?

    Overnight checks -- check.

  10. after an early am seizure shortly after diagnosis we check, EVERY single night. Granted that night we had checked and the problem wasn't from not checking i just don't know if I could handle it if I didn't have a full picture of where things went wrong, knowing helps me rest. My mother-in-law asked if I could just set his insulin lower so he'd be higher over night and then I wouldn't have to check, but honestly overnight is one of the easier times to keep BG in a tighter range and if I can get 12 hours of great numbers helping his body maintain health better for those 12 hours I'm all for it. My lack of sleep for these few years seems to pale in comparison with the fact that he'll be doing it all himself for the rest of his life.
    so, yep, for us we check. every night. sometimes multiple times, you know depending.

  11. we check at night too...wouldn't have it any other way honestly. I LOVE the pic too...looks like Mattias is pointing out which cupcake he wants LOL

  12. i second everything sarah said about using those 12 hours as a way to help her average out over time. (of course she said it way better than i just stumbled through).

    so yeah, we're checkers here, though i get plenty of strange looks from (non-D) peeps when i mention it. sigh.


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