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From Boston, Massachusetts, USA:

I have a toddler who, prior to diabetes, went to bed around 8:30 p.m. and woke up around 7 a.m. Since diabetes, we haven't been able to make it through the night without having to treat a low blood sugar sometime around 3 or 4 a.m. My toddler is on Lantus and Humalog. If the Lantus were properly adjusted, how long could she go without eating to be able to sleep through the night?


Preventing low blood sugars can be difficult in toddlers. I would suggest reviewing blood sugars with your diabetes team regularly to help ensure the insulin is properly adjusted. They can show you strategies to prevent middle of the night low blood sugars.


Additional comments from Dr. David Schwartz:

You didn't really describe the symptoms and degree of hypoglycemia. This would be helpful to me. If the 4 AM "low glucoses" are actually normal at 70 mg/dL, then I might not suggest to change anything, except your perception of a low. If the values are less than 60 and/or with symptoms, then I would advice something to change.

Possible approaches that your pediatric endocrinology team may consider could be:

  1. adjusting the time of day that the Lantus is given (e.g. move to AM if currently given at bedtime, or vice-versa.
  2. giving the baby a small protein snack around 10 (or when the parents go to bed). This could be some milk, I like giving no sugar added Carnation Instant Breakfast with the milk.
  3. consider other insulin adjustments or changes.

There are other considerations which, I agree, would best be worked through by your own pediatric diabetes specialist who knows you and your child.


Original posting 9 Sep 2008
Posted to Hypoglycemia and Insulin


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Last Updated: Tuesday April 06, 2010 15:10:16
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