Hi, I’ve been a member of this community for half a year now and I’ve noticed a trend that is worrying me. Everyone else when they talk about their basal rates seems to have higher basals at night. I see some sense to this as you’re less active. My basals work the opposite way though. I’m actually on a continuous glucose monitor trial right now and have had to decrease my nighttime basals yet again because I was dropping low every night. My basal right during the evening is currently set at 1u/h. Over the morning it works it’s way up to 1.35u/h for the majority of the day and then back down to 1u/h by 11:00pm. Is this strange? It it because I take so much insulin anyway? I’m just looking to (hopefully) hear that I’m not completely opposite from the rest of the group and if I am for some ideas as to why that might be.
Everyone is different. It could be that you require more insulin during the day because of your body’s natural hormone and stress levels cause this fluctuation.
One of my friends who is a ultra-long distance runner actually has to increase his basal rates while running and take almost full bolus amounts for carbs he eats while running, where as me and a lot of the other diabetics I talk with actually have to decrease our basal rates a lot during physical activity (and may not bolus at all for carb intake).
It’s completely variable by the person. Just because you may not fit the cookie-cutter ‘higher basal overnight’ profile doesn’t mean there’s anything wrong As long as what you are doing is maintaining or improving your glucose control, I wouldn’t worry about it at all!
You should read up on the “dawn phenomenon” and “Somogyi effect”. Here is one good, brief overview: http://www.dlife.com/dLife/do/ShowContent/inspiration_expert_advice…
I think a lot of people experience one or both of those on a regular basis, and that is why they get confusing morning BG measurements.
I did a CGMS trial many years ago (back when CGMS was not even available to individuals, only as a special procedure through a lab or doctor) and it showed an obvious dawn phenomenon; now that I’ve been on OmniPod for 1.5 years I have noticed that I need to lower my basal rate in order to keep my BG around 100 in the mornings - that seems to be evidence that contradicts a dawn phenomenon diagnosis, go figure!
I tell you this to make the point that, not only are each of our bodies different (different reactions to insulin, different behaviors of the other hormones that are involved in blood glucose regulation, etc.), our individual bodies can change as time goes on. Not to mention that receiving insulin (both basal and bolus) via a sub-cutaneous pump is a lot different than receiving it via occasional injections.
Bottom line, don’t sweat it if you are “different” - we’re all different and I would not worry about having to lower overnight basal rates - in fact, I’ve already done that!
My Basal has to dramatically increase at 4am due to what they call the dawn affect. I would have lows sometimes and sometimes not up till bout 3am and but most of the time woke up with 300 plus.
I wouldn’t worry a second over how your basals stack up against anyone else’s. As long as your BG is steady, then your basals are working. If your BG is dropping, then you need to reduce your basals accordingly. For my default basal program, I have 6 basalt rates through the 24-hour cycle, including a major increase overnight to combat my hefty dawn phenomenon. But it works for me.
I have yet to hear of any two of us that are the same…
Mine are lower through the night. My highest during the daytime is 1.20 and my 12a-3a is .80, if that’s any indication. Not a huge change, but certainly lower. You’re not backward. I have a lot of basal rates, too. Maybe 7? I don’t remember offhand and my PDM’s in the other room.
Everyone is different, of course. Some may deal with the dawn phenomenon kicking in much earlier (before they wake) and need a higher basal from 3-6am-ish to compensate and wake up with a better fasting number.
Take a deep breath…now let it all out slowly. You’re fortunate in that you’re on a CGM. That’s an ideal situation to establish some basic basal and bolus rates. Don’t sweat it. As some of the others have said, we’re all different.
I agree that you need what you need and there is nothing to worry about. You have the CGM and it’s giving you the exact info you need to determine your basals. Because Caleb is a child, I realize this is largely irrelevant to your scenario, but his basal needs are the lowest between 11PM through 6am and decrease with each hour. His greatest need by far being bt 6 and 8 am, and otherwise is largely stable somewhere in between for the rest of the day.