Basal? Bolus? Could use some help

So I’ve been having high numbers overnight…so last night I finished eating and bolusing by 6pm so that I could watch my basal overnight to see what happened.

Well I had to go to bed a little before my basal test officially started but I figured Dex would really be the one doing the test anyway so I’d just see how it went.

3 hours post eating - 166
According to Dex 5, 2 hours later, so 5 hours post meal I rose to about 200 then an hour later to about 220 and then stayed btw 220 and 250 (finger stick at 130am at 245) until I woke up this morning, 530am, finger stick at 235 so I definitely stayed steady…

So this isnt a basal issue is it? It looks like I need more insulin with dinner since I bounced back up at the tail end of my dinner bolus? (My active insulin time is btw 4 and 5 hours)

Thanks to anyone who wants to give me an opinion on this one.

Hello. Couple of questions. What dis you have to eat at 6pm? Complex carbs like pizza and pasta can hit you several hour later (I avoid both foods as a general rule). So, the food could have been the issue. However, if you have seen these highs before during these times over the last week, your basal is probably the culprit. I have learned from my pump trainer that I shouldn’t make changes to my basal based on one set of numbers. Better to see if there is a pattern. When you do your next overnight test, try to eat a dinner that is just lean protien and green vegetables, like brocoli. The only bolus you will need at dinner will be to cover elevated blood sugar so your sugars 4 hours after that will be based on your basal only. Then you will have a clearer picture of what is going on.

I feel you on this. I always tended to overreact when I was on injections but now that I have started on the pump, I am learning patience.

Good luck.

Two Awesome responses… Both are very accurate and this is the third vote! If you have been seeing these numbers over several days and seen little difference regardless of the menu, a slight basal adjustment may be in order. Make these adjustments slowly. Don’t jack up your basal rate by several tenths at once. The middle of the night is a sucky time for a reaction. Just adjust by a tenth or two (of a unit per hour) and as Dave mentioned, keep the time line in mind. Repeat your overnight testing after a few days and see what has changed…

Good Luck, Stacey!

Agree completely with the replies from the others, but I’d also look at fine-tuning your bolus because 166 after meals is also high (if you’re consistently around 160 postprandial).

Good advice from everyone. Nothing new to add. Just chiming in with an ‘attaboy’!

You guys are good!

Terry

In case the conclusion after all the testing is that you have to adjust your basal the rule that they have thaught me is that your basal is correct if before bed and before breakfast it does not differ more than 1.7 points.

Hope I make sense

Good luck

Thanks for the info. I’m a new pumper myself. I am adjusting bolus now and basal will come later. Make small changes and lots of patience is in order as I have found out. The more time I spend on Tudiabetes, the clearer the mud becomes. Thanks

1.7 points=31 points acc to the US measurements

Thanks for your input everyone…
My issue seems to be btw 1 and 130am and yes, it is an ongoing problem as a matter of fact it has happened for AT LEAST the last 4 nights. BG’s btw 250 and 350. Everything is fine before I go to bed, last night I was hanging in the 120’s and it looks like that at around midnight things start to go INSANE. Luckily Ive been waking up to Dex screaming at me around 130 so that I catch the crazy before it lasts for hours!

With the info from my original post in mind I changed my dinner carb factor a bit, getting a little more insulin per carb but obviously thats not helping at all. I am on Metformin extended release, and YES I am a T1…Im wondering if that could have anything to do with this?

I can’t do a basal test tonight but will do another on on Wesnesday night.

I’m normally pretty good at spoting and dealing with issues with my insulin rates but this one is making me want to scream! I just doesnt make sense!