Can't get overnight highs to come down

I’m 30 weeks pregnant and have been having blood sugars of 200+ from about midnight on every night lately despite gradually increasing basals and lowering carb ratios. Correction boluses with pump or injections with pen do nothing to bring bs down. Also waking up with moderate to large ketones. I know insulin resistance is happening, but it seems that I can’t get on top of it. I have checked all technical functions of my pump with Animas (One Touch Ping) and all appears good. After about noon, blood sugars are good and stable. My endo. said this much continued insulin resistance is not normal for Type 1.

Was wondering if anyone else has had this problem, and what they did to get sugars lower and stable?

I’m not there yet (I’m 20 weeks), but was struggling with nighttime highs last week. We increased my basals and that seemed to take care of it (for now). Did your endo recommend increasing your basals more? Even if you already increased them, it seems that they would need to be increased more.

We are all different with our insulin needs. I would be surprised if your endo would not recommend further basal increases until these highs go away.

As far as the ketones go, my medical team felt that there are a lot of factors to look for during pregnancy. If you’re not eating a bedtime snack, you might be producing ketones due to fasting for too long overnight. My OB was adamant that ketones can come on fast in pregnant women if you’re not properly hydrated, too.

I agree with Kristin that further increases to your basals are probably necessary, specifically in that 3-6am period when dawn hormones hit so hard.

What do dinner and post-dinner look like number-wise? Are you in range before you eat? When does the spike begin for you, you think?

Thanks for the replies. I think I’ve discovered that I had 3 leaking cartridges in my pump which led to the string of highs. I’m still puzzled, though, because the afternoon and before dinner numbers were usually in range. And injections with a pen weren’t bringing my sugars down either. I’m just keeping my fingers crossed that that was the problem and using cartridges from a new box will not leak and numbers will now stay stable. It’s really scary that something like a flawed cartridge could possibly harm my baby.

Also, I did increase basals with +30% temp basal overnight to get back stable today. (I had done that the night before with an unknown leaking cartridge with no success.) The continued increase in insulin is still really astounding to me. But, whatever it takes for a healthy baby, right!

Anyone ever have leaking cartridges? I use the Animas One Touch Ping. I’ll go post over in the Animas group, also.

I can’t remember if I’ve ever had a cartridge leak…but I probably did at some point. I remember having some kind of problem with a leaky o-ring when I was on a Minimed, and I know I accidentally loosened the luer lock on my Cozmo once and lost some insulin. I’m on an Omnipod now, so no cartridge to deal with. Hope you’ve discovered the problem and can get it under control now.

I know what you mean about how crazy the insulin doses become. The best advice my perinatalogist gave me was to stop concerning myself with how much insulin I had to take and just take what I needed to bring the numbers back in range. He said “Your uterus doesn’t know you’re a diabetic. That’s a good thing.” The uterus is just pumping out the hormones it thinks it’s supposed to and that causes insulin resistance. In a non-diabetic woman, that just insures that the baby gets plenty of glucose to grow. In us, it’s a constant battle. I found myself taking meal boluses that rivaled my pre-pregnancy total daily dosage. And my basal rates were more than twice my pre-preg rates. So…rest assured, you’re not alone.

Some animas cartridges were very recently recalled! They put out a letter. I bet you received a batch of these!
I hope things improve. I am 29 weeks and constantly having to change my overnight basals.

I find I’m having the same problem, however I just realized last night that my sugars are dipping in the 3’s (55) and than spike into the 8’s (150) about forty minutes later. This is happening at 3am for me. Probably the liver kicking in and spiking from the low. For the last few days I’ve been increasing my basal when really I need to scale it back.

Do you wear a CGM? If so, see if there is a dip happening.