Same here. Metformin helps a bit with mine. I think this is one reason they’ve been prescribing it to T1s as well as T2s.
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This is the exact reason why I’m now on a pump. I take scary amounts of insulin in the morning to correct for high fasting blood sugar, and feel like the insulin just does nothing (like wake up take 25U and see my blood sugar go nowhere for the next 4 hours). With the pump, I have 3x higher basal settings overnight to prevent my blood sugar from doing this and now I don’t need to wake up and correct anymore.
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I am a Type 1 for the last 35 years. I worked with a diabetic educator in NC recently that fixed that problem for me. I am on a Medtronic pump, and she set up different correction rates for different times of the day. This has helped tremendously! You might need a higher correction rate in the morning vs. the same rate in the afternoon. Hope this helps!
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Wonderful news for you @Jenn_T! What a relief it must be.
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While I have used insulin pumps for a long time, I have only recently starting using more than one insulin sensitivity factor (ISF) based on time of day. It’s worked well for me, too. I have three correction factors ranging from 32:1 to 42:1 (mg/dL change for 1 unit of insulin).
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I have 2 - 1:9 for the AM and 1:15 for PM
My routine generally finds me in the 90’s at 4am, I’ll have a cup of coffee with cream and bolus for 5 carbs to stave off the dawn phenom BG rise till breakfast and my best friend metformin at 6:30. Have these hours cause I have furry kids to feed and they appear to have alarm clocks. Any day I’m not as active as usual will require additional insulin.
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My son is on the omnipod and is getting a lot of pump failures form occlusions and the like. A couple per week. He 13 very lean wont wear it on his back side any more. Mostly thighs and occasionally on upper arms. Any tips on reducing this problem besides more vigilant site rotation?
Hi, @Brian37.
What insulin are you using? In what direction are the Pods placed - north/south, east/west?
Sounds like typical “Dawn Phenomenon” to me, where the liver dumps glucose stored glycogen into the blood in order to “help” wake up. Thanks liver, that isn’t that helpful these days…
Eating low-carb is good for dampening this effect, because if you don’t consume carbs in “normal” quantities, your liver will become depleted of glycogen over time (thus not having any glucose to dump). Metformin is also really good at keeping your liver from dumping significant quantities of glucose into your system in the morning. Other common solutions are to eat a snack before bed (doesn’t work for me), use pump to increase basal in the morning when the effect happens (doesn’t work for me; not on insulin yet), or just take a correction dose in the AM.
One of the ways this pans out for me is that if I wake up early (like at 3:00am to catch a flight later in the morning), I’m often in the 70-80 mg/dL range assuming I went to bed in normal range. If I wake up “naturally” between 5:30am and 6:30am when my son wants a change and a bottle, my fasting BG is invariably 90-100 mg/dL. When I tried going off Metformin for two weeks, that fasting BG rose to 120-130 mg/dL while keeping everything else (diet, exercise, etc.) the same. Although I don’t have a CGM, this is good evidence to me that I have the classic Dawn Phenomenon going on: my liver tries to help every morning around 5:15am by lending me some glucose to help kickstart my day.
We are using Apidra and facing south. Thnx for any insights.
You are seeing errors stating, “Occlusion?” Different from seeing highs and concluding the Pod is occluded?
My son is 14, and has been using OmniPod for 10 years. It is very very rare that we ever see an official “occlusion” alarm. Maybe 10 in all that time, if that. But we are quick to pull Pods that we don’t think are working based on blood sugar, so that may be why.
Caleb, my son, recently switched back to Novolog after seven or eight years of Apidra. We were seeing highs on day two that I could not otherwise explain. We also saw that when he first started Apidra and so we began changing his Pods every two days. When the smaller Pods were introduced, we had success for years going the full three days with only the occassional exception.
I don’t know why it changed, but the Novolog has definitely made a difference. Those second day highs have vanished.
Placement may or may not be an issue. I find north/south puts less strain on the cannula than east/west for arms and legs. I’m thinking that is probably not the issue, though you may want to alternate north and south to minimize risk of scar tissue down the road.
There’s more info on the degradation of Apidra mentioned here.
Lorraine, Thanks this is very helpful advice. Good luck to you and your son. Best, Brian
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whenever i have to go to my mother-in-laws my BGs jump through the roof. i can wake up at 70, and then by the end of the day, no matter how little carbs i eat, my BGs can get as high as 300. generally, once i am home, relaxing with my husband, my BGs start to get back into normal range. but i have noticed this consistently for 25+ yrs that we have been married. i have come to expect it. (and i have learned that no matter what i try to do during this period, i have not yet found a solution, other than not going to visit her.)
(i find that when my pumps correction didn’t help at all, i inject with a syringe instead. i usually see results within an hour.)
Which shouldn’t make any difference whatsoever as far as I can tell. But yeah, same for me frequently.
people have told me that this should not make ANY difference at all, but it has proven consistant for me every time. maybe i am not hitting any old scar tissue? also, i find that when i stick the syringe in my tummy, i get better results than in any other part of my body. i am very very lean all over; maybe that has something to do with it? when i insert my pumps infusion, i use the 13mm needle and i need to really insure that i angle it (manually) to just slide in just beneath my skin. otherwise, i hit a capillary or a nerve, which hurts like hell and then i have to take it out and re-do the entire process. who knows why this works. i just accept it with many thanks.
Different areas can differ significantly in absorption rates, that’s pretty well established. The one thing injections have over pumping, at least tethered pumps, is that there are a lot more locations available. It could be true in my case that when I do opt to use a pen injection for whatever reason, I tend to use one of those spots that I can’t use for an infusion set. So that may be part of it.
i always use my tummy for my infusion sites. and when i correct with a syringe i also use my tummy. it works, but i am curious about using different locations for the injection (arms, thighs, tushy, etc.) also, i am able to do a shallower injection with a syringe than with my pump infusion site b/c the needle is so short. perhaps that kind of sub q injection is absorbed faster/better???