About 530 everyone morning my BSL climbs from around 6-8mmol to about 20 mol by 0900.
This is the absence of any food.
My average hourly rates via my pump is 0.8 units insulin but - I set my pump at 6.0 units an hour from 0530 to 1100 to try and correct this rise. This hardly helps.
I then spend the rest of the day trying to rebalance my BSLs.
I can’t seem to find a professional who has any ideas to help.
In essence - how do you control BSL rises that are extreme. Noting no food eaten so carbs not a contributor.
HELP
I’m getting desperate. All ideas much appreciated.
If your BG begins going up at 0530, you should be increasing your basal rate 1.5 to 2 hours before 0530. If you don’t increase your basal rate until 0530, it’s too late: (the horse is already out of the barn). You should read Gary Scheiner’s Think Like a Pancreas. This book will teach you this and other basics.
Is it every day? What type of pump are you using, and what length cannula? The short cannula seems to give me tremendous problems. Is it the same on day one of your infusion, versus day 2 or day 3? I noticed a sharp decrease in insulin effectiveness as the infusion time increases.
Good thinking. I use shorter cannulas. Maybe time to get longer. Yes - its often the longer the infusion set is in place. So - maybe the longer cannula will help. I will give it a go. THANK YOU.
Take notes of everything, of what works and what does not. Infusion site, infusion day, cannula length, food you have eaten, physical activity, sugar levels, if you are sick or have stress. Try to take notes and you can hopefully see a pattern.
The reason I suspect an infusion problem is because of the numbers you gave:
If I am understanding this correctly, you are increasing your basal rate by 7.5 times! That is almost certainly an infusion or pump problem.
Perhaps others can mention what kind of numbers they use, but my basal never increases anywhere close to that much.
My endo wrote my script for changing sets every other day - that gives me 2 boxes of sets a month. I generally change after 2.5 days - more than that, I see a serious decline if performance most of the time.
I don’t have DP (dawn phenomenon) but many people here do. I seem to remember, one person saying she has to give a big bolus before her feet hit the floor. For her it didn’t matter what time, just when her feet hit the floor. And yes, I agree you need to start the timing 1-2 hours before the rise. And while it is a pretty big jump, if it works, it’s right for you. Keep reading, keep adjusting and keep asking questions. Someone out there has been there and their solution just might work for you. Good luck! I know how much better your day is when you start it off in a good target.
I have learned that same sort of thing, but I learned it the hard way, and only after having joined this forum! I am grateful to have learned it from the people here, because otherwise I would still be struggling with that whole thing! So it is with much gratitude that I thank the forum posters here!!
I can’t believe that sort of thing wasn’t ever mentioned to me or discussed during the training/initial pump setup conversations with professionals! Seems like that would have been a good piece of info to pass along!
Hi Rgcainmd,
I admit I have never worked with a pump but my son raises significantly first thing in the morning for no explainable reason. He is 13, growing like a weed and has done this before at 7 or 8. It could be hormonal. His dr says some people especially those who’s body is under the stress of hormonal imbalances like a teenager would have just sky rocket in early morning hours.
I had to start testing his blood at 9 p.m., 12 a.m., 3 a.m. and 6: 30 a.m. to see what was happening when. He would fluctuate no more than 15 points between 9p.m. and 3 a.m. then raise as much as 150 points between 3 and 6:30 while sleeping. In his case he uses lantus and I could not adjust lantus to correct it because he would dropped major low over night. I also noticed he doesn’t always do it. As best as I can tell when he revs up to grow an inch he sky rockets in the morning but than the high numbers stop and he eats like a army of soldiers. I agree with his dr it has more to do with hormones because of the long term patterns. Your case may be different but I would suggest frequent test to establish a clear pattern.
I ended up having no choice but excepting that once he was hi I would have to cover it and move on but any attempt to adjust for it would cause very low numbers at dangerous sleeping times.
Hi sweetmom1,
Your numbers don’t surprise me. The basal needs at that time can be much higher. And trying to control that with only a single Lantus dose once-per-day are impossible, because the basal needs from noon-3am are not the same as from 3am-wakup time.
It’s not just being a teenager! I’m well past that time!
A shot of NPH at night can cover the higher basal needs at night. And since NPH only lasts 12-14 hours, you can time it to match the increased nighttime needs, without it interfering with daytime. For example, if you take it at 8pm, it will be gone by 10 am, and not be a part of the daytime basal.
I hope I explained that well. Message me, I can give you some better examples of how well I did with Lantus and NPH for my basal.
Thank you for your responds. My son is currently on two doses of lantus 30
in the morning and 18 at night. I tried raising night does to cover the
morning high but he dropped Down at midnight. I don’t use NPH because it
kicks is earlier than it should and only last a little longer than humalog.
And since his growth hormones come and go in spurts lasting a few days to a
few weeks I don’t feel safe adjusting any of his insulin to account for his
morning high until I see it.
For instance last week he was high in the morning every day but for two
days this week he woke up low (67) and then high again this morning. If I
had previously accounted for an expected high in the morning he wouldn’t
have woken up at all those two days. But I have seen this before during a
heavy growth period.
This one is very harsh on him because his insulin needs for meals are 1
unit per 5 grams and 1 unit per 3 grams early morning and late night. My
poor baby can’t have a beef stick and slice of cheese without raising his
blood sugars to at least 250.
Here are a couple things to look at. Gary Scheiner is an extremely well-known guru with these things. He is considered one of the best/smartest in this field.
And take a look at this image below, which Gary created for his book. It shows that exact same 3am-6am time you referenced above, and shows the NPH covering that time. I am just encouraging you to look at this because it really helped me!
Here is a quote from the link I put in above: "During a person’s growth years (up to age 21), basal insulin requirements tend to be heightened throughout the night. This is due to the production of hormones (growth hormone and cortisol) that stimulate the liver to release extra glucose into the bloodstream. "
