Question:
My friend has a 13 year old daughter who has been diagnosed with
diabetes for several years. One night out of faith, luck and
premonition, the mother woke up at 2 a.m. to find her daughter in a
seizure. Is there any device (worldwide) the child can wear to alert
the parents of a "coming" seizure in order to respond? Can you
monitor the symptoms in the event you cannot feasibly and comfortably
measure the blood sugar level throughout the night? Open for any
suggestions or direction.
Answer:
Sounds like you've already heard of a device called the "Sleep Sentry." It
has been available in the US for several years. It is designed to sense skin
changes due to low blood sugar, and trigger an audible alarm. It is strapped
onto the wrist, and looks like a wristwatch without a dial. Generally
speaking, the concept sounds good, but in real life, it wasn't reliable and
we're not using them any more.
For adults who share a bed with a bedpartner, the bedpartner can sense the
hypoglycemia, due to the diabetic partner's restlessness and profuse
sweating. But we're certainly not going to advise your friend to sleep with
her 13 year-old!!!
The best treatment for nighttime low sugar (also called nocturnal
hypoglycemia) really has to be prevention. A bedtime snack with
some protein in it is mandatory if there's any risk of nocturnal
hypoglycemia. The size of the snack should be increased if the bedtime blood
sugar is low, below about 120, or if there was unusually heavy
exercise during the afternoon or evening (since sometimes there are delayed
insulin reactions from earlier exercise). And, don't skip the bedtime
snack if the blood sugar at bedtime is high.
Checking the blood sugar level at about 1-2 A.M. is an excellent idea from a
medical viewpoint, but is rarely practical to do on an every-night basis.
Occasional middle-of-the-night blood sugar testing would be advisable in
this case.
Finally, decreasing the amount, or changing the timing of the young lady's
insulin doses might be advised. For example, if she's taking a dose of NPH
or Lente at supper, it's possible that moving the timing of the presupper
NPH or Lente to later in the evening might decrease the risk of
middle-of-the-night lows.
Encourage the young lady and her mom to talk these ideas over with her
Diabetes Team.
Original posting 14 Dec 95