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June 17, 2015

Daily Care, Other

Question from Churchville, Pennsylvania, USA:

My son has won a full scholarship for a three week robotics camp this summer. For the past year, he has felt isolated because of his “new” illness and he is beyond ecstatic to attend this camp. The children remain onsite all 21 days. However, we are concerned about overnight lows because we will not be there to monitor him overnight. His blood sugar often goes up, for example, from 170 mg/dl [9.5 mmol/L] to 250 mg/dl [13.9 mmol/L] at 3 a.m. even though he has not eaten for several hours. We suggested that my husband stay there overnight, but the facility was not interested in this. We also considered having the nurse check on him at a certain time for at least the first several days. Since we are relatively new to diabetes, we are quite worried for our son. What suggestions do you have to make this work for our family?


From: DTeam Staff

If you are really getting care from a general practice or family practice doctor, with this much overnight difficulty, I would strongly suggest you consult with a pediatric diabetes team probably in Philadelphia. If willing and able, he can go to camp and get some 1 a.m. and 4 a.m. blood sugar levels by setting an alarm clock and making sure that there is no hypoglycemia, even without a parent present. This might be some hassle but, then, the safety of his going to camp is ensured. Cutting back his insulin peaking in the middle of the night would also be reasonable although there is no information about whether he is using NPH, Lantus, Levemir or exactly what schedule of insulin is in use. If none of these avoid the overnight lows, then using high fat ice cream as a bedtime snack also is often very helpful since the fat slows down the sugar absorption and spreads it out overnight to prevent the nocturnal hypoglycemia.


[Editor’s comment: Given that it is a camp and he will not have much control over his meals, you should make sure you send extra snacks, especially for bedtime, that might be higher in fat. Pre-packaged cheese crackers or mini cookies might be a good idea. You should avoid sending nuts/peanut butter due to potential allergies. Make sure you tell the camp and the nurse that you are providing food for emergencies so they do not confiscate them. Label all his supplies with his name and a phone number in case something is misplaced. Also, ask if he is allowed to have a cell phone. If so, you could get him a disposable phone or regular cell phone and call him at a certain time (such as the 3 a.m. you mentioned) and wait while he checks. Be sure you know a phone number to call the nurse should you need it. Another option is to give your son a phone and ask him to text you his blood sugar every morning at 3 a.m.