Caleb is my second of three children. He was diagnosed with type 1 diabetes at the age of three in January 2007. He has used the OmniPod Insulin Management System since April 2007 and the DexCom Continuos Glucose Monitor since September 2009.

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The Answer for Overnights…

Screen Shot 2015-10-27 at 5.46.10 PM…I don’t have it.

I’ve been working hard towards learning it though experience for nearly nine years, or 3,200 trials and lots more errors. I’ve searched and asked many questions regarding it, but no clear direction has been discovered.

Overnight care is the final ugly beast of diabetes that wedges itself between Caleb and his full autonomy. There are other things that he doesn’t do – he hasn’t changed a Dexcom sensor by himself, he doesn’t call customer service when there are issues, he doesn’t manage basal program or sensitivity adjustments independently – but these are things I know he can learn and don’t present imminent danger. This overnight thing is different.

Sleepovers and extended field trips – these include periods of sleeping. Caleb is on the ball when he is awake. When he is asleep, well, he’s asleep and does it for numerous hours at a time. Diabetes works in 2 or 3 hour cycles. Sleeping in increments of 2 or 3 hours or even 4 hours is not healthy. I haven’t been able to balance these opposing needs after more than 3,000 attempts.

This is not to say that every night for the past nine years I’ve been up actively managing his blood sugar every 2 or 3 hours. Particularly with the use of Dexcom G4 Platinum, there have been a number of nights when I wake to just check the CGM number and go back to sleep until morning. But there has not been a single night that I have slept through uninterrupted. Over the past year I was lured into a feeling of safety because it was more the norm than exception that I could just do that eyeball thing at 1 or 2 am and all would be well. These past couple of months have rattled me back into the fear of how ugly overnights can be – highs that don’t correct and lows that won’t rise.

This isn’t new. It’s not pleasant, but I can handle it – or handle it well enough.

I don’t know the best way to prepare Caleb for these nights. The ones after long days of varying levels of activity that show up in overnight lows to an extent you cannot reasonably predict. The ones after uncommon and fatty foods are consumed in quantities that vary from the usual routine that release seemingly never-ending gushers of glucose into his bloodstream.

We’ve been able to normalize so many things. Special trips are the hardest to deal with and present the biggest danger because there are so many variables, yet are the times when he should be able to stretch his wings and leap and fly and learn from his mistakes.

It’s the fear of the magnitude of the mistake that has me on edge.

How do you manage overnights?

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