Overnight Highs

The last month or so I have been experiencing spikes in my overnight sugars. I have a dexcom and can see that it happens at midnight and then my sugar stays high from midnight until I get up and take an adjustment dose. I know sometimes hormones can play a factor in overnight spikes but I think it has been going on too long for it to be that. Has anyone else had this experience?

I have. I got some relief by making sure I didn't eat anything within 1.5 hours prior to bed. My thought was that a 1.5 hour lag, everything I ate should already be in my system and I should catch it when I do the glucometer test and final insulin adjustment just before bed. It seems to work consistently to help avoid the problem.

Yes, I have to tweak my overnight basals a small amount fairly often. Awhile back I posted on here about a more dramatic increase overnight though I'd never had DP. Several people assured me that you could develop DP later or it could come and go. I just increased my basals (quite a bit that time) and it worked then gradually after a couple weeks I believe they all went back to "normal".

You may or may not figure out the "why" but I would suggest starting small increases of your basals at 10PM (two hours before the rise) until you get your numbers back where you want them.

Once again Zoe, you nailed it. That's one of the many benefits of pumping. I'm sure you can recall my tirades about a new Endo changing all of my pump settings to the point where I was experiencing highs I never saw before. I am in the process of tweaking back to my settings - don't want to mess things up with major changes. (Not looking forward to the next apt - especially if I forget to change them back to his settings two weeks before the appt. They only download two weeks of numbers. I do have records showing - yet again - that his settings don't work for me). Oh well, now I've turned a comment that was seconding your advice into a whine. Oops.

Thanks, artwoman. To be real honest, I wouldn't have dealt with that endo trick as gracefully. I believe that they work for us, we are "consumers" of their services. I would have just told him (assuming I agreed there was a need for change) that I would do it slowly myself. Or if he'd already done it and I'd started moving it back I would leave it where I wanted it and show him the results of my changes. But then, I've never been accused of "playing well with others.". Lol.

I kinda wish he was younger than he is, then I could state that I had been living very well with type 1 long before he started med school! I get it that most of the Endo patient load is people with type 2, who may not take it as seriously as people with type 1. But don't lump me in with that group. I've always thought that it is a no-brainer that newly Dx'd PWD1's take it seriously because we leave the appt with Rx's for insulin and SYRINGES!!!. With type 2, they get the old cassette recording: "Lose Weight, Eat better, be more active" Who's doctor doesn't say that at EVRY apt - even non-PWD's. I recall this ne2w Endo commenting 9witha surprised look on his face) that I probably balance my checkbook with every transaction. I said "Uh, Yeah". I would love to gather some of the people here to come with me to my next appt.

I've had DP for a while. What I've done is essentially what Zoe recommends.

My Basil rate is 10% higher between 2am and 8am. And depending on the meal I have for dinner I will use a temp basil to lower that by 10% if its a very low carb meal, or raise it another 10% for a very carb heavy meal close to bedtime.

Seems to keep my in my target for the most part, only had a few lows that way, and a couple highs.

But then, I've only be doing this now for a few weeks. So I'm still tweaking it a bit.

I just have unpredictable highs overnight. Sometimes at 2am or 3am I'm normal or occasionally low, other times it's high say 180s to low 200s. I think it may be due to what I ate for dinner. If it was a meat based meal I can be high, chicken or fish I'm good. Dinner is my main meal of the day I usually eat at about 8:30pm (I'm from England!), so it is still a good 6 hours previously. I have noticed that I need less insulin to bring down an overnight high, my usual correction dose can cause a low BG on waking. Because of all this I have quite a complicated overnight basal pattern. Again none of this is always, I don't seem to have patterns, I wish I did!

What exactly is DP? I never heard that term before.

Dawn Phenomenon. It's when your blood sugar starts to rise during the night and continues to rise into the morning. For some people it will rise until they eat something. The solution is to set your basil rates higher starting two hours before the rise begins. (10PM for you). It's one thing the pump is really good for!

When I talk to others about Type 1 (including white coats) I find myself saying things like "for many of us" or "most of us" find... So in a way I do bring many of the TuD'ers with me!

I sometimes think it would be a good idea for the "white coats" (like that term, Zoe) to visit TuDiabetes. They would learn what concerns we have as well as learn that there are PWD's who do know what they are doing, and worked hard to come up with a system (e.g. pump settings) that work for their bodies. If I were a White Coat, I would find that uplifting.

Someone on here started using that term and it fits. The only endo I've ever seen was a female in Guatemala. She seemed so much more open and minus the god complex we often see in the U.S. She asked if Using Insulin was translated into Spanish and I gave her es tu diabetes for her patients. I wouldn't be surprised if she didn't go on to check it out. We've had a couple white coats of various types comment on here but I do hope there are more lurking. They'd probably be surprised and it would help both them and their other patients to alter their perception about what PWDs can do!

Yes, I have what my Endo describes as Dawn Phenomenon. At about 3:00 a.m. I spike super high and my Dexcom goes crazy. So, we increased my basal rate at 1:00 a.m. (two hours before the spike) to help it. It's crazy but I normally need less than 1 unit of basal. However between 3:00 and 8 am....I need 3.5 units!!!

Gary Schreiner (sp?) handles this in Think Like a Pancreas. He has found that many many people require a larger basal rate overnight.

Please don't lump all Type 2's as not taking diabetes seriously. There are days when I do finger checks up to 10 times. Recently my Dexcom went off as below 55, a finger check showed 39. To fine tune my basal rate for my pump, I am doing basal checking. I do this by waiting until at least five hours after any bolus and three hours after eating and then keep checking for the next six to ten hours. While I realize that I don't have the problems and issues of a Type 1, I do take it seriously.

Try to go to bed with little to no IOB, but when my son had the same problem from 2-3am and on I simply got aggressive with the Basal rate during those times, pretty much increased the basal by 50-60% in a Cpl weeks now wakes up with decent BG's. Basal lowers after 8am again. I would start the basal rate an hour or two before you start getting high to adjust for the lag inherent with the slow basal drip