Nightime numbers

Keep in mind I have only been doing this for two weeks.  Question- How can my son have a 120bs before bed and at 3am have 254 bs or in the opposite direction go to bed with 156bs, next at 3am 104bs then at breakfast have 135.  I know he is not getting up and eating in the middle of the night.  I have the book Think like a Pancreas in route to my home but until then can someone explain to me why the off the wall numbers.  It has stumped me.

He is probably still adjusting to his insulins and may be starting his honeymoon (let me know if you don't know what that means).

The numbers could mean several things, like his basal insulin is not the right amount, that his bedtime carb ratio is not the right amount. You need to look for trends. If most nights are like the second example, that is probably OK, there is something called the dawn phenomenon that causes BG to rise in the early morning. But in that case, I'd say his basal insulin looks like it is doing a good job.

For the day that had was 254 at 3 am, it could just be a fluke. I am sure they are having you write all your numbers down. This is so that your dr. can look for trends in the numbers and make adjustments to the insulin. If only one day it happen, then it might be unexplained. Those happen. You may also want to look at what his activity level was the day (esp. afternoon or evening) before. Sometimes exercise can cause a BG rise several hours later. So it is important to keep track of exercise or unusual activities as well as the insulin amounts and BG numbers.

I hope you like Think Like a Pancreas. It is great.

Hi, tylee,

Keep in mind that every hormone produced by the body will increase blood sugar, except insulin which reduces it.  Growth hormones, stress hormones, sex hormones, etc. ALL effect BS, and most kids are pumping out growth hormone in the middle of the night...usually around 2:00 - 3:00 am.  My son can be 110 in the morning, eat no breakfast, and test at 130 at lunchtime.  It is an incredibly complex balancing act between hormones (including insulin) and blood sugar.  Just keep testing regularly and reporting to your endo.  It will take a few weeks at least before you can expect to have his BS numbers in your "target range" at least 80% of the time (which is considered good control).

You're doing great mom!  Keep asking questions ;)



Hi tylee   i totally understand your frustration and share the same one.. we have been at this for ten months and this is what i have learned.  sometimes the numbers just don't make sense.. what works one day may or may not work another. for those of us logical thinkers it can drive you over the edge.  we can not nor will we ever be a pancreas. you do the best you can recognizing that there are many many things that effect sugars that are not food and you have no control over them... this is what is so maddening about this disease.. we can not fix it..... you are doing the best that anyone could do.. we all are.... i can tell you that after two weeks i stopped checking in the middle of the night and adjusted my lantus/ levemir based on the morning sugar then seriously prayed.. after ten months i no longer live in fear that he will be in coma in the morning and we all have decided that a number will not make us happy or sad or mad anymore.... we are taking our life back, using our knowledge to do the best we can and enjoying the life that we have been given.. doing our best not to try to figure out why or how etc......   you have begun your journey..   i pray we all can walk in peace and happiness inspite of it.....

[quote user="kerri"]

 sometimes the numbers just don't make sense.. what works one day may or may not work another.


I totally agree with kerri.  Just last night William's BS spiked big-time after dinner.  Same carb/insulin ratio as always, but three hours after dinner he was 430.  Could have been excitement from playing in the snow.  Could have been something else.  I was completely clueless.  All I could do was adjust and move on.


I agree with everything that everyone has has already stated.  There are times when the numbers just don't make sense.  Keep in ming that high fat foods take longer to process.  It takes a good 4-5 hours beofre we see the result of my son eating ice cream or a high fat food.  You are doing a great job!!  the first few weeks are the hardest.


You are not alone as I am sure you can already see.  While they give you all those formulas and ratios it  is not an exact science.  And as much as I depend on the glucometer giving an exact reading it is also not the case.  When I get a real low or a real high or a number that does not make sense I always check the bs a second time - there is usually a difference even from the same stick in the finger!

If he gets a 254 or 354 it very well may not mean either you or him did anything wrong - in fact this is most often the case.  We just check often (Lucas' numbers are all over the place so we have to check 10x a day) and keep correcting back to our target.  I have stopped trying not to have any highs or lows but simply to not let him run either too high or too low for too long a period.  And try very hard to keep my blood pressure down in the process!

On the other hand...your night of 156,104 and 135 would be what we would describe as a perfect steady night!

Take Care - give and get lots of hugs,


One note about highs.  If William has an "unexplained" high, I have him re-test.  I have his wash with soap and water and dry his hands with a paper towel, but even then we can get a bad reading.  Just a small amount of food sugar on his fingers can give an inaccurate high reading, and I do NOT want to overdose insulin because of a bad reading. 

A couple of other considerations.  Glucometers are NOT exact; depending on the meter being used, I've heard you can expect inaccuracies of 10-25%.  Sometimes glucometers get a braincramp, so it's a good idea to have a second glucometer you can check against.  And, be sure to always check new batches of test strips using the solution provided. 

The good news is, the longer you do this, the more you get a "sixth sense" about your child's BS.  You'll start getting that feeling that something is a little off, and re-check your tools and materials.  You'll start knowing how specific activities affect BS and how.  You'll know when you can relax a bit, and when you can't.  You'll start to know when you need to fax BS numbers to the endo for adjustment, and pretty much know ahead of time what that adjustment is going to be.  BS management is a blending of art and science.  The longer you do it, the more attention you pay to the process, the more information you have, the better you get at it.  Generally.  Because there will still be days that throw you off :)

Keep it up!