The last few months I’ve had very high night time bs. I’ve upped my basal rates and have gotten it down to the 160-140 range. (From over 200!) I’m more successful if I use a temp basal all night (about 130% for several hours) but I think that constantly setting a temp basal is indicative of a change to I need to make in basal rates- which I keep trying to do.
The other thing is for dinner/after dinner I’ve been dropping low (3 hours before bed) constantly and I wonder if the two things are related?
My next step I think is to set a new ICF- give myself a little less insulin at meal time? I just don’t know. Crazy how things can be going so well and then my body tries to do something weird.
And NO I don’t want my Endo’s opinion. He would just tell me to get into Auto Mode with my 670g. Which DOESN’T WORK. I’m not interested in being 200 all the livelong day and night.
Yes, lows preceding highs are often tied together. Let’s start with your dinner. What do you typically eat and at what time? Do you pre-bolus? If so, how long?
One thing you might consider is eating a low-carb meal for dinner and then carefully follow your post meal glucose. By careful, I mean fingerstick checking every 30 minutes. If you are approaching sinking below the hypo threshold (for many people 70 mg/dL or 3.9 mmol/L) then immediately treat with about two ounces of liquid carbs, like juice. That would be about 5 grams of carbs.
It’s very important to not overtreat in this situation. The standard of 15 grams of carbs is often too much. If you do go slightly hypo and treat, I’d then fingerstick every 15 minutes and treat again with two ounces of juice until BG starts to rise. I’d increase the juice to four ounces if your BG falls to < 54 mg/dL or 3.0 mmol/L.
Keep a written record of events. It’s much easier to draw good conclusions later if you don’t depend on your memory.
Diabetes is a dynamic disease. None of us remain constant in our glucose metabolism, even gluco-normals. Learning how to roll with the metabolic punches is a critical part of our game. The more quickly you detect a change and adjust, the better off you’ll be.
I can remember when it took me weeks to neutralize a changed glucose situation. You can get better with practice. And practice you’ll have since a cure doesn’t seem imminent.
What are you eating for dinner? It’s possible the food is digesting hours after eating it, so you are going low because you have too much insulin up front for the meal and then high later as it digests all night. I often find the digestive system works slower at night, and many meals, not just pizza or pasta, will hit me 6-8 hours later! If that’s the case you would need less insulin for dinner, but more hours later either through a square wave/extended bolus or temp basal increase. I often adjust basal based on what I’ve eaten, this is normal.
