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Night time testing - keeping your eye on the target

If you haven't heard of Olly Double, I highly recommend you go and buy his DVD. Olly is a British comedian/lecturer - and also has 2 sons with type 1. He did some stand up comedy at this year's Friends for Life UK which had the whole audience in stitches (a clip of it can be seen here).

Olly recently wrote a great post for Diabetes UK, regarding night time testing. The cause for debate/nomination for 'person who needs a slap' comes from the following commenter:

I am not aware of the age of the children you have i am sure i checked your article but could not find them. However after reading it i do feel a sense a paranoia within your household. Why keep testing, surely if the levels are good during the day, then it is more common then not that the levels remain good through the night. I assume you are using long acting insulin, and as long as they have some supper that is usually enought. You must be aware that being permently tired is no good for you or your children and sleep is vital to function correctly. You must also be aware that everyone needs to learn to be a bit independent and learn how to look after their condition to a degree and not allow anyone with diabetes to live their lives by it but to live a life and control it so as not impeed the quality of life. Believe me i have seen many a diabetic so caught up with timing of meals/injections etc that life becomes dominated by the condition. Life is for living whatever medical condition you have. I suggest listening to your doctors and relax a bit, and ease up on testing during the night. (I have had diabetes for over 25 years, have three kids of my own and live with them on my own)!

Several of the parents from the CWD UK emailing list have posted replies detailing everything I could feel the need to say. But it got me thinking - and after reading Tom's post, I too wanted to pipe up a little about why I test during the night and why I feel it is important.

I'm going to go right out there to begin with and say that I am very lucky and have relatively stable glucose levels. They are by no means perfect, but I am fortunate not to suffer with huge swings in BG level, or with my BG levels randomly rising or falling on a regular basis (it happens - just not very often). With me, there is usually an explanation as to why my levels are where they are. Not all the time - but usually.

However, I am still a fan of night time testing. For anyone unaware, Tom is my partner - so we quite often set the alarm for 3am and do a test. Tom does more night time tests that I as he is prone to swinging levels. As he quotes in his post - I am very easily woken and so will usually be up and awake when he is testing even if I didn't mean to be!

So why bother testing at 3am? My aim is to keep my BG levels between 4 and 7mmol/l, at all times. That's my aim. If my BG levels were shooting arrows, I usually land in the yellow/red/blue area. By testing at 3am, I can make sure that my BG levels aren't straying out towards the edge of the target. Some nights I have strayed way off target - usually due to something I have eaten or illness. Other nights I am sitting pretty in the 4 - 7mmol/l range.

But without testing, I can't tell where on the target I am. I'm always going for the bullseye. Some nights I am just not happy with the idea of going from 10pm to 6am without testing...I wouldn't go for 8 hours during the day without testing, so unless I have good reason to think I will be steady all night through (and again - plenty of nights I will go without testing if I have seen in the past few nights I am staying in range all night), I will be setting an alarm, and I will be testing at 3am.

I grew up in the age of bimodal (twice daily) insulin. My parents rarely did night time testing as the insulin kept me very stable overnight (which, having been told that - makes me assume at some point some night time testing was involved to clarify this). However, unlike the above commenter, I am not ignorant enough to sit here and think that technology and diabetes management hasn't changed since I was kid and that everyone is like me and will stay stable through the night. I want to keep my BG levels in range as much as physically possible so that I can write in 50 years and say I still have my eyesight, limbs and kidney function. If that means waking up at 3am most nights to test, I'm there. I am incredibly proactive in my care - however I do not think this means diabetes is 'living' my life as the commenter suggests. Diabetes is just part of me and I'd rather be taking the best care of myself that I can than leaving it to chance (and assuming because I have eaten supper my levels will stay in range all night...!)

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