My 12 year old daughter is terrified of going hypo during the night and of late is testing before bed, often with the result that she feels she needs to fuel up before going to bed to avoid going hypo. What is a reasonable blood count to expect or aim for at bedtime with fairly reasonable expectation of not going hypo before breakfast?

In general, I would suggest that a blood glucose above 7 mmol/L [126 mg/dl] will ensure that there is a low risk of going hypo overnight. The only thing to be aware of is exercise. Following exercise, there is a risk of becoming hypo up to 15 hours following exercise, especially if the exercise has been very strenuous.

To ensure that the risk of hypo is reduced, it is important to take some extra carbohydrate than usual at suppertime. A bowl of cereal like Weetabix, shredded wheat, etc. is great. The other thing to do if the exercise is predictable is to reduce the insulin dose at teatime by up to one fifth of usual dose.

JS