A favorite mantra of our first Certified Diabetes Educator was, 'one day does not make a pattern.' She was right. One or even two unpleasant 250's could be caused by any number of factors: a bad site, a new cereal, an oncoming illness, bad luck.
Seven makes a distinct pattern, though. In most cases, three or four should really be enough. Yet sometimes we're a little slow to react to patterns, particularly of high blood sugars, particularly at night.
As a child with diabetes grows, insulin needs grow too. The only way to know when to make adjustments is to watch for strings of high blood sugar.
If the issue is occurring during school hours, I get to work pretty quickly. The daily 10 a.m. and noon calls from the school nurse begin to annoy me, and I act.
Overnights, on the other hand, are my downfall. Regularly checking blood sugars during the night is not the problem. My husband always visits her before he goes to bed, and we check again at 2 a.m. We even correct highs at those times, though not too aggressively. It's the next step that trips us up. Any significant changes in insulin during the evening or at night require more work and less sleep. The dangers of nocturnal hypoglycemia are real. During the day, my daughter can tell us if she feels low, or someone around her should notice the signs. At night, she's asleep, alone in her room. Therefore overnight changes must be done slowly, and with more frequent monitoring. It takes many incremental changes to see results.
The coffee budget becomes strained.
Yet letting my daughter's blood sugar linger in the 200's all night is clearly not a better choice, so eventually we address it. I just procrastinate a bit, rationalizing that I need to make sure it's really 'a pattern.'
Reacting to these numbers before a week or so has gone by is my one thing to improve for diabetes blog week.