Whether you should or should not do night-time glucose checks is a topic that has divided the diabetes community for years. When new parents raise this question, it will divide the diabetes community and raise blood pressure faster than the mention of Halle Berry. It can create strife among friends and can cause a serious strain on marital relationships.
Parents who believe in night-time glucose checks worry that blood glucose levels could drop during the night. They often argue that they would never allow their child to go for eight hours during the day without a check, so why would they do so at night?
Parents who don’t check feel that the danger is minimal. They argue that disturbing their own rest and the rest of their child is not worth it.
In both cases, parents feel that their very love for their child with diabetes is put on trial. It, therefore, isn’t surprising that the issue creates such a hotbed of emotions.
What is Dead in Bed?
Dead in Bed, or Dead in Bed Syndrome as it is called in the medical literature, denotes the sudden, unexplained nighttime deaths of people under 40 (or in some definition those under 50) who have type 1 diabetes. “The patient is found dead in an often undisturbed bed after having gone to sleep without undue medical concerns.”
Is Dead in Bed a real threat?
Dead in bed is a very real fear. A 2012 journal article suggests that “up to 7.6% of deaths in patients 50 years or younger that could be ascribed to the dead in bed syndrome.”
If you have been a part of the diabetes community for any length of time, you have most likely heard of at least one person who has died of Dead in Bed. That is one person too many personally.
My take on night-time glucose checks.
I am a night tester. I have been since my son was diagnosed. It is something that I will continue to do it for as long as my son lives under my roof.
My son sleeps soundly at night. He has looked the most peaceful when his blood glucose levels have been out of whack. That terrifies me.
With age, he has begun to wake up to the occasional low–much to his dismay and his mother’s delight. One day, he will hopefully choose to use a continuous glucose monitor and that will help him to better manage his blood sugars while he sleeps.
Diabetes doesn’t warn you that you will low tonight.
Diabetes does not show itself in anything but bad attitudes, fatigue and occasionally nausea or thirst. You see it when a glucometer is pulled out, when a syringe is injected or an insulin pump peaks out from a belt around someone’s waist.
Diabetes does not tell you before you go to bed, “Please know that while you are sleeping peacefully, and despite that basal adjustment you made for the yesterday’s activity last night, tonight your child’s insulin needs will still be low. Since you didn’t realize that and did not give him an extra snack or reduced basal rate, I will make sure that his blood glucose drops really low tonight. You won’t notice. He will be peaceful and you will sleep pretty soundly after all of these nights of broken rest. Don’t worry, I will take care of things. I will deplete his liver of glycogen and this time? Well, this time I will cause a seizure in his body, shaking his bed and waking the house. You will get to him in time, take him to the hospital but none of you will take diabetes for granted again….until the next time.”
Night-time glucose checks also provide valuable knowledge
Fear of dead in bed is not the only reason that I check blood glucose readings at night. I check out of respect for the unpredictable nature of diabetes and a desire for knowledge.
Knowledge is power. If I do not check my son during the night, I have no idea about the highs and lows he may have experienced. He may go to bed and wake up in range but during those 10+ hours, he may also have been low, high and a few readings in between. I am only human. It is impossible to catch all of the blood glucose swings but I will catch a few. I will get an idea and it will allow me to make small adjustments to keep him healthy.
Should you check your child’s blood glucose levels at night?
Whether or not to do night-time glucose checks is a family choice. In our family, we choose to do it. I am not obsessed with doing it. I naturally wake multiple times during the night (and did this before diabetes moved in).
When I wake up, I am okay with stumbling into my son’s room and checking his blood glucose levels. It’s selfish–I feel better doing it.
Again, whether or not you choose to do night-time glucose checks is completely up to you. Find a system that works best for your family but as with all things diabetes-related, make sure your choice is an informed one.
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