Diabetes Night Testing- What’s bestElissa Renouf
Q. My six-year-old was diagnosed with Type 1 last year. I test his BGL around 8pm before he goes to sleep. Should I retest before I go to bed – around 11pm – or even later?
A. When our first child, Charlie, was diagnosed, from day one, we always tested his BGL before we went to bed at around 9:30pm, then at 1am. The reason for this is that we wanted to keep his levels well controlled but also avoid any serious night-time hypos.
A few months later, our specialist and diabetes educator told us the 1am test was no longer necessary. But, I felt the reason they suggested this was to prevent the kids father and me from becoming so overloaded that we’d go to the other end of the scale and do very few tests per day. And, having heard stories of children and adults slipping into a diabetic coma during the night, we decided to continue what we’d started. This way, we could give our children the best possible chance, not only of avoiding comas but also of keeping their BGLs well enough managed to reduce their risk of health complications in later life. As well as for detecting hypos, night-testing is valuable for identifying high levels. This is critical when you consider how long a child sleeps – it amounts to around one-third of their life. If their levels are outside the normal range for eight hours or so, this can have a huge impact on their HbA1c (haemoglobin A1c) levels.
The high BGLs are easily treated now that our children are on insulin pumps, but before this, we used to give them an extra injection, when necessary, to normalise their levels and make sure they didn’t wake up in the morning with ketones. Taking this action meant we could head off any chance of diabetic ketoacidosis – a life-threatening condition, which results from abnormally high BGLs.
With four out of our five children now diagnosed, night-testing has become a tall order. The way the kids father and I get around the enormity of this constant routine is to take it in turns, so you are either on or off duty for a whole week, normally from Friday night to Friday night. Whichever one of us is on duty carries out both the 9:30pm and 1am tests, allowing the other to have a full week’s break. We’ve been sticking to this little routine for nine years now. Some weeks are harder than others but, as parents, we will do anything to keep our children as healthy as possible.
The night watch is never dull. You can be sure that at least once or twice a week one of them will either have a hypo or a high level that needs treating. But we are totally committed to caring for our kids in this way for as long as they need us. Our payback is in knowing that the lower we can keep their HbA1cs, the healthier they will grow and the fewer long-term complications they risk.