happy valentines day peeps! a question for all of you on mdi-im on mdi and there is no chance in hell of getting a pump or cgm. none. is it a realistic goal to want to have morning fasting numbers below 100 on a regular basis?

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That's a good goal. I never really managed to hit it very regularly on MDI. Oddly, the only times I seemed to reliably have normal/ good BG in the AM were when I drank *a lot* the night before. I only used NPH though so I can't really speculate on Lantus/ Levemir.

Oddly? The liver has invested itself in saving your life. Thus it will restore and rebuild itself after a some hours. After drinking at night this usually happens in the morning hours and this will supress the dawn phenomenon.

i know! i have a couple of glasses of wine and i wake up in the 80s! thats even eating a snack before bed! i joke ill have to become an alcoholic to get good am numbers, but maybe theres something to it...

This is a topic I'm interested in delving into to some extent. I don't want to use diabetes as a reason to drink more than I should, but having one too many sure as hell does seem to help with the glucose levels the following day, doesn't it?

god, yeah! lets me pig out with my hangover hunger!

I am on MDI and I use Humalin-N (NPH) and I aim for low 80s and I am nearly always below 100, and mostly 80-90.

I may not be typical - maybe just lucky....

Have you tested your BG from 3 to 4 am? With a target of 80 you might have overslept many lows. When do you inject your NPH?

Occassionally have tested 3 am and its usually fine 80-100 range.

I inject 12 units at 10 - 11 pm, 8 units at 7-8 am. For whatever reason, it seems to work really well for me at night and keeps things stable. I can only guess that the profile of NPH fits how my body works. When I was pregnant I needed 35 units at night and regularly tested at 3 am, and it was fine. No lows.

Dinner seems to have a big but delayed impact on my fasting numbers. Starchy carbs or a big meal at night nearly always make me higher than target the next morning - even if my 2 hr numbers were perfect (80 - 100 range).

I want Sally's Diabetes!

I'll gladly give it away for free!

I am a geek about managing it and really experimented to see what works for me. But I have been lucky enough that I really could find things that worked.

At the moment I'm experimenting with intermittent fasting (ie. putting all my meals into a shorter period of time during the day - only lunch and dinner, and the effects of endurance exercise...)...

Last time I saw him, my dr asked if i wanted to change to 1 of the newer insulins. I said thank but no thanks. I am really happy with how things are managed now. If ever, I think I'd like to try a newer insulin during the daytime basal, but still stick with the NPH at night.

Nope, then you'd be stuck with mine! Even with a pump, with working my butt off, I couldn't possible stay between 80-100. Oh well, could be worse!

You must be still honeymooning, Sally. Your residual beta cells are still acting as a buffer. If the NPH is overly active your beta cells will compensate that by reducing their output. Thus you do not see the profile of the NPH activity in your numbers yet. Hopefully you are LADA for life (high level of residual beta cells).

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