was going to do some glucose number crunching today, got myself all stable for several hours with a median 92. isn't that gorgeous? i felt great. and then i was going to eat something and not take insulin to make sure my numbers are still accurate. my insulin use is up 30% this year and it's mostly corrections. my doc and i are stumped.
but then i woke up and got out of bed and this happened. without eating anything or doing anything. just bam!
seriously, my liver is in a bad mood or something today.


Views: 8

Tags: CGMS, navigator, spike

Comment by Gerri on November 28, 2010 at 11:00pm
Not following why you would eat something & not take insulin to see if your numbers are accurate.

You woke up from a nap at 230. That's frustrating!
Comment by marti w on November 28, 2010 at 11:35pm
get stable blood glucose, eat a known quantity of carbs, watch the numbers climb until they stop. then i can do the math and see how many points i rise per gram of carbs. then i know how carbs are affecting me now and if my numbers have changed. then i can take insulin and verify my correction rate.
actually i work second shift so i was only sleeping in a little bit on this holiday weekend. i'm nocturnal mostly. so that was waking up at 1pm with a BG of 92
Comment by Brian (bsc) on November 29, 2010 at 5:05am
I believe that most have found that it is best to start with basal testing, getting your basal levels set. Then determine proper I:C and correction factors. Usually, an increase in insulin use will be reflected in insulin resistance and a change in your I:C ratio. Doing the test as you have done has probably confused everything with huge liver dump. Two good resources are "Using Insulin" by Walsh (or "Pumping Insulin") and "Think Like a Pancreas" by Scheiner. Gary Scheiner has recently started offering on-line courses, which for $25/session, seems like a deal (http://www.type1university.com/).
Comment by marti w on November 29, 2010 at 8:55am
i didn't do the test because of my liver dumping glucose. and my doctor and i have been working on my basals since i got the CGMS in february- they're all set.
i have read both of those books, thanks, and that's how i determined my original numbers, three years ago when i was diagnosed. it seems that maybe my gastroparesis is complicating some of the ways i determine my numbers so that's why i was going back to basics on the number crunching - as per a discussion with my doctor.
Comment by Tim on November 29, 2010 at 10:17am
For me, the most reliable way to set off dawn phenomena is to NOT EAT anything.

And the most reliable way to thwart it, is to eat something.

It can be so ridiculous that sometimes I need more insulin if I don't eat anything, than if I do eat something carby for breakfast.

As a result anything found by doing a "basal test" involving fasting is just garbage. IMHO. The fasting is an excellent way to see the dawn phenomena if that's what you WANT to see!!
Comment by marti w on November 29, 2010 at 10:26am
ah, tim this was separate from dawn phenomenon. i have a line graph for that one too and happens to me around 8am. this was hours later, after i had stabilized again.
i've done these tests before and they worked for me just fine to resolve my numbers. the problem is that when my gastroparesis worsens it messes me all up across the board and i need to re measure. part of the test process for me is also the 'how long does it take to digest' result. i have to do that periodically anyway to get multiple results for new foods since my GP is different from day to day based on how my multiple sclerosis is acting. my GP is an MS symptom and when my MS flares up it aggravates my vagus nerve more than usual.
so for me it's a constant state of experimentation and info gathering
Comment by Gerri on November 29, 2010 at 11:00am
Tim, same with me. If I don't eat in the morning, BG sky rockets.

Marti, I have gastroparesis also. Can relate! The frustration of working around unpredictable digestion is beyond belief. My personal best (worst) is 8 hours to digest a meal.
Comment by marti w on November 29, 2010 at 3:20pm
Gerri, yeah, it's not fun. so far the longest i've gone is ~20 hours and even then it didn't digest. that's just when my stomach decided to return to sender. it plays havoc with the numbers and since i don't even feel hunger or anything anymore, i have no way of knowing if there's food hanging out waiting to trip me up
Comment by Gerri on November 29, 2010 at 6:41pm
So sorry, Marti. I can sometimes feel when my stomach empties & I run for the meter. Gastroparesis sucks!
Comment by Jen on November 30, 2010 at 7:52am
I also find my blood sugar will start to rise in the morning if I get up and don't eat right away. Yet if I'm sleeping it's fine. This is different from the dawn phenomenon—I also have DP but it happens every morning and I have my pump basal rate set to cover it so I remain flat overnight. I don't have gastroparesis or anything and this still happens.

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