Our 11 year old daugther was diagnosed with Type 1 almost a month ago. I feel we have pretty good control of it, she is almost always within her target numbers already. The past few days she has had a few lows, I think it is because she has been super active, bike riding, at the pool for five straight hours, etc. I haven't exactly figured out how exercise and activity affect her sugar, but we are trying to keep a log and see if there is a pattern. That being said, today she was at 47 in the afternoon after only 2 unitis of insulin all day...she is on a hunger strike, trying to get by with only little snacks so she doesn't have to have insulin. I know if I smile and agree, she will get through this "I don't need insulin and I can eat whatever as long as it is under 15 carbs " phase in a few days vs. fighting her and trying to change her mind. She did seem to be almost back to normal eating today. But, her bedtime sugars have been around 80. I don't know if that is too low, so I make her eat a snack, including some protein and carbs. Because of her lows today, I am getting up to check her midnight, but don't want to go back to that. She has been fine when she wakes up in the morning, around 100. So how low can I let her go to bed at?
Personally I would not go to bed at 80, I always go to bed between 100-130. I always got up at night to check, I think it made me feel better!
You guys are doing an amazing job!
80 is considered low for my 11 year old daughter. She has had type 1 for 2 years. She had a target of 130 when she was still in her honeymoon like your daughter. 180 is considered high. She should be at or above her target in my opinion and you will need to check her in the middle of the night once or twice too. Some parents skip middle of the night checks but everyone I know winds up doing them eventually after trying to avoid them.
What are the last few checks before the bedtime reading? Is it falling? rising? Steady?
My two-year old is supposed to be at least 125 before going to bed, per our Endo's suggestion, and generally >170 seems to be better for her, because she drops under 100 in the morning otherwise, with our target range being 100-200... so I guess it depends on your daughter's blood sugar trends. How did her numbers end up looking these last couple days?
Like others have said, 80 is too low for bedtime, especially after a busy day.
When we do an unusual amount of activity our bodies need more glucose, so it often uses glucose stored in our muscles (called glycogen). Later the body has to replace those glycogen stores and will take the glucose from the blood, causing a delayed blood sugar drop hours after the activity.
Most people need less base insulin in the evening and just after midnight, so blood sugar will drop then if a person is taking shots, which provide a flat base dose (an insulin pump can be programmed with the exact base dose needed throughout the day). So if a diabetic is taking shots and is 80 low at 9pm, chances are his/her blood sugar will drop even more as the night goes on.
Because her numbers are so good it's likely that your daughter is still producing some insulin. Some doctors advocate a low carb diet for those in the honeymoon period with the thinking that it will help protect the insulin producing cells that are still working. So your daughter eating her 15g snacks might not be a bad thing, as long as she's getting enough calories and nutrition. The best known author who advocates this is Dr. Richard Bernstein, author of "The Diabetes Solution." He's a physician who's had type 1 for almost 60 years and is complication free. The book is pretty academic, but it's worth borrowing from the library.
I'd really recommend you buy "The Diabetic Athlete" by Sheri Colberg. She's a type 1 exercise physiologist who does a great job outlining how to adjust food and insulin for different activities.
Take care.
-Jenna