So that sounds similar to my sitiation. But…
…if you had a pump integrated with the CGM, and it had stopped your basal at midnight when you dropped in your example, do you think you would have come back up? Or at that point is it too late for you?
This is the first time I’ve seen a low trace like that without a super high rebound. If it were me, after treating with glucose tabs at 4 a.m., I would have rocketed up to a very sticky 14 for at least 4-6 hours. My body’s counter-regulatory effort would not have pulled me out of the hypo but it’s aggregate effect would have meant a long period of frustrating hyperglycemia. It’s like I have to live with the worst of both circumstances.
I need to count my blessings, however. I have survived some mind-numbing sustained severe lows.
Jen, you must have slept through the low alarms. I hate when that happens.
I’m a type 1 (25 years now) and I have lows like Jen’s with no rebound. Usually after a long low like that though, I find that I’m much more prone to continued lows actually for the next 12+ hours—I think because my liver does try to fix it, depletes its store of glucose early on without success, and then I’m releasing much less for the next many hours until it replenishes.
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I also find I’m often more prone to lows after having one. But I’ve always attributed it to the cause of the low—too much insulin, increased activity, etc.—persisting for a time before it either wears off or I’ve made appropriate adjustments to my pump settings.
I did. And last night I slept through a high alarm all night, and woke up at 11.5 (207) to see an eight-hour high on my CGM (proof that my pancreas doesn’t do anything for highs, either!). In my attempted to avoid a low (since I’ve had one two nights in a row now) I was a bit too cautious last night and had a snack with no bolus.
I think I’ve just gotten into a habit of sleeping through the alarms that is very hard to break. The fact that I usually get them every night (as opposed to on occasion) doesn’t help that issue.
I’ve had them when that definitely doesn’t seem to be the case though, and it’s usually for a fairly extended period afterward (like I have a low in the afternoon due to my overdoing a bolus and let it run for a while, then run low that night for no other obvious reason). My endo confirmed lows can deplete the liver glucose store, and I believe it, because it seems very similar to the effects I get when my liver output is inhibited by alcohol.
I’ve never tried this. However, an interruption in insulin delivery takes at least an hour or two to have any impact on my blood sugar, so I generally don’t think of it as an effective treatment for lows, because you do not want to be waiting around for over two hours for a low to come up. However, with the upcoming AP systems, I believe that they predict an oncoming low and suspend delivery before the low happens, which I think would be more effective. The limitations of “fast acting” insulin are a challenge. I will be curious whether the new Fiasp insulin will be faster enough to make a difference in this regard (I hope to get a prescription for it in the next few months).
That’s b/c one can’t just take a dose of this insulin, then split a dose add another dose, then split again. It will not and does not work this way; it messes up your body, liver etc…I think you can actually take too much where it can cause like an insulin resistance scenario. Its overload has no clue how to use all these doses. It’s happened to me too…the more I took the higher my bgs went and would not come down. Tresiba has NO flexibility at all.
Yes, this is what happens…typical low patterns
But…we’re type 1s…if we go high basal doesn’t fix the high, if we go low basal doesn’t fix the low. We have to manually fix lows and highs with either glucose or insulin…basal won’t do any of this
To your body, insulin is insulin. It does not matter if you call it basal or bolus.
And people are using basal adjustments to fix both highs and lows. That is the premise of things like Tandem’s Control IQ or Basal IQ algorithms.
I once did this as teenager with a combined dose of R/NPH (AKA the “eat now or die” regiment) in my excitement about going to Cedar Point that morning. Consequently spent the whole day in their medical unit instead, fighting them not to send be too the hospital when no dose of glucose or glucogon would keep me up. That was the day I learned the magic of french fries! They were my miracle cure that day and got me back to having fun. 
This sounds like the perfect scenario to indulge in those notoriously slow digesting and difficult to bolus for foods, like pizza!
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My motto, never let a good low go to waste.
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