I have a MM pump and CGM. I went back to the CGM recently after a major low.
I began having (over the last week) lows every night around 2:00am, and then again around 7:00 am. The CGM would alert me, I would treat with 6-8 ounces of apple juice at 2:00. Same at 7:00. The CGM readings were 50-60, as my pump is set to alert me to a low at 60. When I tested at 8 am, I was in the 90-100 range regularly.
Yesterday, I changed my overnight basal from .3 to .275, from midnight to 7:00 am. Between 2:30 am and 7:30 am my CGM readings went from 104 to 182 with a meter reading at 7:30 of 199. That is only an insulin reduction of .175 units over a 7 hour time period.
1. I cannot believe that lowering the basal by .175u could make that much difference and 2. I cannot make any intermediate dosage changes from .3 to .275.
I know I will be asked. I had a normal, low fat, low carb meal at 5:30 and tested at 71 when I went to bed at 10. I did drink about 4 ounces of apple juice, as I hate to go to bed when trending down.
I am flummoxed. Opinions, please!?! Thanks.
This was the post I was looking for today. I have the same problems. A small tick in basal change makes more of a change than I think. And I agree that you need to wait 2 days at least to make sure the change is stable. Often I get too excited and change it again after 24 hours. I need to tell myself to be more patient.
Sometimes the problem isn't with the amount of the change, but the time zone. Many people just have two time zones - day and night, so a small change makes a big difference. It helps to break it down to smaller time frames.
Smaller time frames also means that your changes in basal rate are less abrupt. I find this makes control one hell of a lot easier to achieve. You are more likely to correctly match your basal requirements. Those basal rate graphs in "Think like a pancreas" are quite convoluted.
Re the timeframe issue, I use 12:00 midnight to 2:00 AM, 2:00AM to 5:00AM and 5:00 AM to 6:30. I've been cutting them back lately, a couple tries, and it's working ok. I do .85 @ 12, .875@ 2, .975 @ 5 and then go back to .85 at 6:30. Whether the basal is up or down, it seems like I get the big bump from 2-7AM. I like the idea of confirming your observations but I don't like waking up at 180 I might try the different timeframes.