Can't bring BG up overnight

I use a pump. In increments over the last week, I have lowered my overnight basal pretty dramatically for me, down .075u per hour from 7a.m. My total daily basal is 7.00 units.

But I am still low…really low: 55 to 65. Last night I drank 64 carbs of Apple juice, and it barely impacted my lows. I’m stumped on how to fix this. I just keep lowering basals, even eating low carb dinners and taking no bolus.

All suggestions are welcome. Thank you.

This link may help you fine tune, A few are having basal issues the last couple of days, it must be a full moon.:grinning:

Many times in my past I have experienced lowered basal rates leading to even lower glucose levels. It’s counterintuitive and is a bit unsettling.

This is the tactic I would use, too. You might start writing stuff down to help with your analysis later. You will find a balance point where your glucose levels stabilize. From my experience, I can only conclude that the act of taking less insulin leads to even less insulin resistance in many people.

This reminds me of what I call “basal lows,” a hard charging low glucose trend that resists treatment. I think it’s likely that your basal rates were set too high for you. The excess basal accumulates and persistently drives lows.

Our insulin needs can and do change, almost every day. I’m thinking that your insulin sensitivity went up and you needed less insulin. Continuing to infuse at the old basal rates was not appropriate for you. Give yourself credit for making this observation and taking action.

It’s tough aiming at a moving target. Your agility is what counts here and you are training the right treatment muscles. Good luck with managing this volatility. In me these kind of episodes are often caused by positive lifestyle habits like limiting carbs or getting better exercise. I think increasing insulin sensitivity is an asset, troubling as the process it creates is.


Thanks. I’ve been using a pump 16 years or so. I also have a Dexcom and can download to watch the trends. I think you are correct about insulin sensitivity. My daily basal bolus usually runs between 7-11 u per day, as I eat low carb.

I always find your replies thoughtful and helpful, Terry. Thank you.

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This might be a situation where its totally appropriate to eat some carb before bed…at least until you get it worked out. Don’t forget that you can use all your tools - this is what carb is for.


My basal and bolus needs can change when I start a new set in a different part of my stomach. Some areas are more sensitive or absorb the insulin better

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Hey @DonR, How much would you say they change? I think that would be awfully hard to work with. Do you find that it requires consistent adjustments when replacing equipment? Or, does it change around and you need to do it differently at different places?

I like to drop at night and I spike in the morning. You can mostly count on me dropping 20-50 points. To handle my drops at night I don’t go to bed with less than a 130 BG level, then I have my night basal rate set at

11-3 .50
3-6 .70
6-9 2.20 This is to deal with my dawn phenomenon
Then I go to 1.4 for most of the day

This has stopped most of the drops at night although my insulin per carb range is different at night too. Mornings are 1 unit per 3 carbs with a tapering change as the day goes on. So that by night I am at 1 unit per 7 carbs. I rarely even eat in the morning as it’s too hard to control my BG spikes up to about 11am.

This took some fiddling with numbers to find the right ratios for me, where I make most of my mistakes is thinking I’m not dropping enough after a night snack and giving myself an extra dose, that seems to be something that catches up with me right before bed and then I’m having to eat something.

But I was surprised how much I kept lowering my night insulin number, I finally split the night into 2 groups as my drop usually happens from 2-5 am. I can’t lower it even further for me as then I just stay high too much of the night! I tried that too!

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Once I dial in the basal for a new set it is usually good for the session. My best area is toward the front of the stomach and the worst is in the rear area. There can be a 20% difference is the basal setting.

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