From Rockford, Illinois, USA:
My 12 year old son has had type 1 for three and a half years and been pumping for six months. We use Humalog and change his site every two days. Our experience with the pump is positive. He doesn't have much trouble during the day. Nighttime is a different story, he is very inconsistent as far as what directions his blood sugar will go. It is very hard for us to come up with a correct basal rate and a safe number with which to put him to bed. Some nights he remains steady, then will drop around 4 a.m. Other nights he will rise around 4 a.m. Some nights, he climbs all night and is resistant to a correction bolus. Other nights, he will drop all night. This has been our observation on nights that he has had similar activity levels and I have not made changes to his basal. There is no pattern, so I get up about every two hours to check him. On the nights that he has sport activities, I have had pretty good luck adjusting his basal. Is this common? I've spoken with his doctor and he can only help me adjust for recurrent problems. Will I ever get to sleep all night?
You should go back to your diabetes team and review this information in some detail. Usually, there is some activity or food explanation. Perhaps high fat foods last a significantly longer period of time than you are estimating and you might want a temporary basal increase after such foods (i.e. pizza). Similarly, after activity that is significantly aerobic, the aerobic effect may last for many hours afterwards, so, that afternoon or evening activity would produce such lower blood glucoses in the middle of the night. Also, if he has already started puberty, pubertal hormones and growth hormone specifically may be produced overnight and this may also have an effect since these are intermittent bursts of hormones.
Original posting 29 May 2004
Posted to Daily Care
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Last Updated: Tuesday April 06, 2010 15:09:58
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