I have been on the pump for a little over 3 months and with a few changes here and there, I'm doing quite well....except for my overnights. No matter what I eat before I go to bed, how rigid I am in carb counting and even increasing my 12:00 am to 6:00 am basal, my blood sugars spike after I have been up a couple hours. I am not eating breakfast yet, just having black coffee and doing a little computer work before I shower and get ready to go into work. For example: I normally get up at 3:00 am to work from home (yes, it's part of my job schedule and I don't mind) and i checked my sugar when I got up and it was 100. I rechecked at 5:00 because I will be leaving home to drive in 1/2 hour and my sugar is 204. This happens 6 out of 7 days usually. NO rhyme or reason. I can be perfect one morning, eat the same snack; have the almost same bg before bed and be totally different the next night. Anyone else having this problem?? Almost every morning, I have to take a correction bolus. Very frustrating for me. I know everyone will say up the basal overnight, but what happens to that one or 2 nights where i am ok? Could it be because I get up early, my body is pumping out more glucose from the liver because I am active instead of sleeping?? Any thoughts??
You sound somewhat similar to me. I would catagorize myself as having a large and everchanging dawn phenomena. Here are things that might help. Do you have a CGM? I would be concerned to aim for (near) normal BG levels at night without one. It will beep at me more nights than not with a high or low warning. I will then wake up in the morning and review my CGM data over the last few nights and consider basal rate changes. I would guess I make a nightly basal rate change just under every 2 weeks to combat my changing DP.
I try to wake up at the same time everyday. I wake up at 7 and shortly after my basal increase to help fight the waking DP increase. I have read that other take a unit before their feet even touch the floor to combat it. Little to no breakfast (especially carbs). I am so carb sensative in the morning that I fear even eating 10g of carbs? I just cannot accurately predict what carbs will do to me in the morning. I would also suggest not telling a nutritionist this as they will not be happy.
I would also suggest that you realize that mornings are a difficult time DP, growth hormones, etc. and try to have reasonable expectations. Good luck I understand your frustrations completely.
Thank you for your reply. At least I don't feel alone with this problem. I was thinking my doctor would be upset that I keep having to do a correction bolus every morning. No, I do not have a CGM. I tried to get one but the insurance company did not feel I needed it. This morning I woke up at 3:00am with a 98 BG which is good. 2 hrs later I was 148. in checking my BG at 6:15, I am now 247. I should of just did a small bolus correction but wanted to see what would happen. So i will wait to come down before I attempt any food this morning. Maybe I will have to take a unit before my feet hit the ground in the morning too!! : )
My basal goes .875U/ hour at 12:00 AM, .95U/ hour at 2:00 AM and 1.05U/ hour at 5:00 AM and led to:
which I was pretty pleased with. I'd been up to some stuff over the summer that led me to crank it up more so this was the first day with another round of lowered settings and I was pleased with the result!
Wow!! I am at .775 from 12:00 am to 6:00 am and then I switch to a temp basal for work of .725. 9 hrs later i go back down to .500 for the rest of the evening. I do great during the day. I see my doctor on 12/11 so I will hopefully get some help in figuring this out.
Two things: you should probably increase your basal 1/2 or so before your normal wake-up time (w/ dr's help of course) or eat something when you wake up. I have horrible DP. Here's my normal basal rates:
I typically wake up around 6:45 or 7am. If I don't seriously pump up my basal at least 30 minutes before waking, it climbs. And I eat ~6-8g of carbs for breakfast around 8am.
I need insulin when I get out of bead, my pump basal handles my 1st stage DP but the 2nd stage kicks in when my feet hit the floor and it can rage on until about 11:00 am if I do not dose some insulin. I have my I:C set higher for my breakfast meal to cover this and if I delay eating I will still bolus a portion of my meal bolus when I get up. If I eat something when I get up then it's not as extreme...skipping breakfast is usually a disaster for me.
Yes, I've noticed that if I do not get my BG down by breakfast, I am fighting with it until afternoon.