This is driving me crazy....
Overall scenario:
Wake up at 8 at a good level, say 107. No breakfast and test at 182 at noon. I have been spiking like this in the morning for a couple of weeks. Even spiked once from 95 to 285 in the same scenario above. Stopped drinking coffee/caffeine completely and there has been no change in this pattern.
Basal: my a.m. basal is the highest of the day at .6 from 6 am to 4 pm, when it drops to 2.5 during drive time. I upped it to .7 from 6 am to 11:30 am when it goes to .6
Other part of the day: Go to bed with a BG of 91 at 9, three hours after the meal. By 10:30, my pump starts to buzz that I am low. I treated with 8 oz of apple juice (32 carbs) and even with the juice, BG continue to go down and am 53 at midnight. Eight oz more juice and starts to go up slowly and I hit 98 at 1:00 am. Woke up with the 107 noted above.
Now bolus and basal. I bolused 1.5 units with a 30 minute square wave (tried square to see if tat helped)last night for about 20 carbs. normal C:I is 1 u to 10 carbs. So I took 25% less than normal. My basal goes done to a minimum .375 at 6:00 and then up to .4 at midnight.
First, I don't get how I can drink 64 carbs of juice over a two hour time period (that is more carbs then I eat in a normal day) and still crash. I am going to lower the 6 pm basal again to .35 and see if that helps.
This has happened in various degrees for the last three weeks. I was traveling, and afraid to make changes on the road. Sound like the right changes? My husband is getting really irritated with the night ones, as they are happening as I go into REM sleep and do not react well to the timing. Suggestions? Ideas?
Thanks!
Replies to This Discussion
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Permalink Reply by Kimberly on -
1) You need to eat something in the morning, preferably soon after you get out of bed. You're experiencing the dawn phenomenon, which will cause your blood sugar to increase all morning, or until you eat. If you won't eat breakfast, you'll need to up your basal drastically. I go from 0.4u/hr all night until 5:30am (an hour before I usually set the alarm) when my basal jumps to 1.0u/hr. If I don't do that, then my blood sugar shoots up within minutes of waking up. I keep it there until about the time I eat breakfast, when my basal drops back to 0.5u/hr.
2) You may need much less basal around the time you go to sleep. I have about 6 different basal rates during a typical day, one of them being 0.05u/hr. It is possible that your dropping at bedtime is a result of too high a basal rate.
You should read up on all of these things in "Think Like a Pancreas". Can't remember the author's name, but somebody around here should. It's basically the insulin-user's bible.
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Permalink Reply by Sam Iam on -
Very interesting. I have many of the same issues. Many would cite the dawn phenomenon as reason for your BG rising in the morning. I think it may have something to do with a glycogen release, due to your stomach being empty. I can't confirm this, though.
I have had the late night drops as well. No idea why.
I admire your control. How long have you been pumping?
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Permalink Reply by Spock on -
For 10 years, with D for 50. Last A1C was 5.6. And I have rarely eaten breakfast since I got my first pump. Actually had plain yogurt yesterday morning and had the same spike. The spike isn't gradual over the morning, but occurs suddenly. Today it began to rise from 110 at 10:30 to 135 at 11:50 and was 182 ar 12:30.
I am going to try eating something in the morning for a consistent time period and see if that helps.
I totally understand dawn phenom, and this is new, so I would discount that theory as it doen't fit with my history, unless something has changed....
Oh, and Think Like a Pancreas is a very good book for any diabetic to read.
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Permalink Reply by Zoe on -
I definitely think people can develop DP if they didn't have it before just like Type 1's can develop IR. It sure sounds like that to me, so don't totally discount it, but keep trying out different breakfast options to see if it stops the reaction.
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Permalink Reply by smileandnod on -
Zoe is right. I am Type 1 for 25 years and never had DP before the last year. Old lady hormones are kicking around and creating havoc for me. With that came DP.
I see the exact same type of sudden rises that you are seeing, with or without breakfast. I've had to adjust my basals to offset the increases. I usually drink a cup of coffee with half/half and eat a stick of cheese when I get up in the morning but if I hadn't adjusted my basals, I would get the spike regardless.
It certainly caught me off guard too. Like you, Spock, I had never had a problem with it. Then all of a sudden, I noticed that from the time I got up to the time I got to work, I was spiking about 80 points without eating anything. Once I did some reading, I realized what was happening.
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Permalink Reply by Kimberly on
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Ooh - sorry. I didn't realize you are an experienced pumper.
I have nothing to give you except that I think everyone gets hit with random insulin need changes. I have all of the sudden had to change my late AM basal because the readings just started rising from breakfast to lunch. Why? I have no idea. And I've also had several instances in the last few weeks of my blood sugar dropping crazy-like during the night. With no IOB. Thankful for the CGM when those occur. Nothing different going on with my life, but for some reason the body decided to change things up on me.
Although I still think it's a good idea to eat something in the morning. Breakfast is the most important meal of the day, after all!
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Permalink Reply by palomino on -
I found myself looking for the 'like' button on this post. I have to remember this isn't FB. LOL.
But anyway, thanks for a helpful post :)
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Permalink Reply by Trudy on -
Actually, palomino, there is a form of like button, located above, right under the original post. You will then find this post on your own Likes Page, which you'll find a little ways down from your Profile Pic.
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Permalink Reply by palomino on
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Thank you, Trudy! :) I feel like I am in need of a 'like' button for certain posts. Or else... I just need to hang out less on facebook. :)
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Permalink Reply by Spock on
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No problem. We all need new input and I took yours to heart, Kimberly, and will try breakfast as a new daily alternative.
I really hate to eat in the morning. I think it has to do with being on such a strict diet as a kid--I had to get up 7:00 am everyday (try that consistently at 12, 14, 16, OH! and 18!), take my Lente and eat my prescribed morning meal: 1 bread, 1 milk, one fat, one fruit.
One time, in college, I actually toasted a sponge (low BG, but who knew with no monitors, added jelly amd stood in the kitchen and tried to eat it.... Obviously, toasting the sponge woke my roomies up and I was saved...) :>) Diabetes has really changed.
Thanks for the input.
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