My daughter has a problem with going high in the night but low in the morning. For example she was 181 before bed last night so we gave her a half snack of 8 carbs with protein with an extended bolus and she was 178 at 2:00am and 90 at 4:30am. So we had to give a snack to get her thru the night. Another example would be 103 at bedtime and with a snack of crackers with pb she went to 295 @1:52am and 78 in the morning…does anyone have a suggestion how to get thru the night without the highs and then lows? Our morning bolus is set as low as it can go already!
Maybe not eat right before bed? It certainly adds to the variables!
Also, does she have different basal rates set for during the night to manage her different basal needs?
From your brief description, I would consider the following, but these are all shots in the dark (sorry for a bad pun):
- 3AM test.
- Basal rate testing to get the overnight basals more finely tuned. This will mean temporarily eliminating the snack. As an aside, given a 103 @ bedtime, I would not give a snack unless the basal rate is to high and causing the early AM lows.
- ISF testing to get a better handle on how much insulin to give for corrections.
- Consider variable insulin to carb ratios - but only if your basal rate tests show the basala are set correctly. Overall, my take is the basal rates are skewed and this is throwing off what you are doing on the bolus side.
Keep the faith! You are doing an good, but exhausting job, but you are doing good, you are learning a bit more each day and applying it, Unfortunately, our bodies are not exact machines and every day will be a bit different than the next - sigh...
This is one of the benefits of being on a pump… Your daughters basal rates really need to be varied for the different times of the night… So that she is getting more basal when her body needs it, and less when it doesn’t.
I’m assuming being 178 at 2am was more than 2hrs after the snack and bolus… So dropping from that to 90 in 2.5 hours is definitely too much basal. I would work with your endo to modify your basal rates to step up and down throughout the night and morning (and all day if needed).
I would highly recommend reading the book pumping insulin by John Walsh… The website from the book also has a good worksheet to help with setting your basal rates and that can be found here: http://www.diabetesnet.com/pdfs/pi5/11_5-Test_Your_Basal_Rates.pdf
For a few weeks after getting on the pump, I pretty much tested every 3 hours through the night to get things dialed in for overnight basal rates, and you will probably have to do this as well… But it well worth the effort to not wake up low in the night or morning
Keep at it… It will get easier and your daughter will feel much better once things get dialed in!
I definitely swear by basal testing! (or basal assessments). You really can’t figure out the root of the problem until you eliminate extenuating factors. My CDE told me I really shouldn’t make big changes to my basals without doing an assessment, because otherwise you might miss the real problem. Her problem could be her I:C ratio or her ISF and not her basal at all! Ask your endo or CDE if they have a basal assessment log you can fill out and bring back to them 
I agree as well, but at night, all that is occurring is basal rates, no bolus, therefore isf and bolus changes won’t help… But basal changes will impact your bolus rates as well… They all go together but under true fasting through the night, you need to look at your basal rates…
Thanks y’all! We are definately working with the basal rates…thanks for all the input and help!