My 15-year-old son (diabetic for 4 years) would like the "luxury" of sleeping late every day during the summer. He currently injects 13 units of Regular and 37 units of NPH when he finally awakes. His waking time varies between 9:30 and 11:30 a.m. (as contrasted with his school year waking time of 7:00) and this practice has really screwed up his readings for the rest of the day. How do others handle late sleeping and insulin?
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This question was referred to our pediatric endocrinologists, who have each given an answer:
Answer from Dr. Lebinger:I usually tell teengers it is okay to get up late during the summer, as long as they get up every day at approximately the same time, and have their snacks and meals delayed appropriately so that the spacing between meals and snacks is the same as usual. Of course this also assumes that it is OK with the parents to start the day late and eat at times which may be different from the rest of the family.
Answer from Dr. O'Brien:This may or may not be a simple problem. I would try a simple approach to begin with, although it may be a little late to achieve much this summer.
Is the problem that your son is watching TV until two in the morning or so, or is he just insufficiently occupied during the day? You could still encourage him to get into a sports program, e.g., tennis, which most cities and many clubs run at this time of year and many of which are free. Diabetic camp might still be an option.
If he's going to sleep late, you might settle for insulin, blood sugar and breakfast at 7:00 am and then back to sleep. Or you could also try to set a stable but different routine by having brunch at 11:00 am with insulin and blood sugar, then a midafternoon snack and supper at the usual time. If you went for this, ask your Diabetes Team about changing insulin doses to match the changed mealtimes.
Answer from Dr. Robertson:A very common problem for the parents of teenagers with diabetes. You will be relieved to learn that sleeping late (called long lies in the UK) is okay.
In some ways it makes things easier that your son wants to sleep late every day because it gives you the chance to recognise a pattern in his blood sugars. I expect he also wants to stay up late in the evenings. You should simply look at his sugars and move his food and insulin around to suit.
For instance, he may need more food and more insulin (regular) to cover a longer evening. If his sugars are high every morning when he gets up then it's better to tackle this from the night before by giving more NPH at the evening meal than by chasing the sugar with the morning injection. This is very much an individual thing and you will find a pattern that suits him - ask your diabetes team for help in interpretation of the blood results.
Original posting 9 Aug 96
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