At least twice in the past week, I’ve awakened for an early-morning bathroom trip with excellent BG, as reported on my Dexcom, then gone back for a last hour-or-so of sleep, only to wake to a BIG 100+ point spike.
I don’t wake up at that time every night, but have, occasionally, at other times, without such a spike, and I have my pump settings dialed in well enough that I otherwise don’t usually see spikes like that - or even much smaller - in the morning hours, unless there is food involved.
On both of the mornings that resulted in highs, I fell back to sleep more on the side where the infusion set was inserted than not. I cannot prove it, but I am thinking that I either choked off the tubing or interfered with the insulin delivery at that time, resulting in the subsequent highs. There were no occlusion alarms from the pump; however, I did have an occlusion event later in the day the first time this happened. Both times, a correction dose taken from the pump after checking and discovering the high BG corrected the situation fairly easily.
So… Any thoughts? Is my thinking on the right track? And suggestions as to how to avoid sleeping on the tubing and/or infusion site?
I have never noticed an issue while sleeping on my infusion set/tubing but certainly believe it to be possible. Wish I could tell you how to avoid it, but it could also be a fluke since it has only happened a couple times.
I have heard of “pressure” highs…where putting pressure onto a site can cause a high because the area is pressed. The two times I heard about it was in women talking about wearing Spanks or compression underwear.
I have no scientific proof of any of this or any articles or studies to point to…but thought I would mention it because it might be helpful in your quest for answers.
I have never notice any problems sleeping on infusion or CGM sites. But most times I’m on the stomach area or back area and I usually sleep on my side . So sorry no help with your question.
If you’ve eliminated food (didn’t have any) and dawn phenom (pump is dialed in for that) then yes, it sounds like it has to be a delivery problem unless your CGM was just being flaky. Did you back up the Dex reading with a fingerstick?
Re how to avoid sleeping on the site, I decided early on that there wasn’t a damned thing I could do about that and I would just roll with it, so to speak. Same with sensors, manufacturer’s warnings notwithstanding. I’m constitutionally incapable of lying on one side all night just because of where these things are located. Just not gonna happen.
If I had to guess, though, I would hazard that it’s nothing to do with Spanx. You don’t strike me as the type. Not that there’s anything wrong with that.
It’s weird that you didn’t get an occlusion warning but that’s not a perfect science with these devices. My biggest problem with the Snap pump when I was on it was that it was way too sensitive in this regard, and it definitely didn’t like me to sleep on the infusion set. Whereas my Medtronic doesn’t seem to care where I sleep, but has not infrequently given me occlusion warnings from having my tubing kinked under my clothing.
I sleep on my pump, tube, and site all the time and have never had trouble. I do, however, notice that if I get up to pee (or whatever reason) and then go back to bed for awhile, I spike. I’ve always assumed it was a sort of Dawn Phenomenon…like the getting up and moving around causes a liver dump in preparation for “starting the day”?
I can see that and would have thought that to be the cause – except that it only happened (recently) on the days discussed. Even this morning - I got up “early” - this time it was because I had a low alarm. It was a very “iffy” low (right around 60), did a VERY light correction - more to satisfy Dex, then waited it out a bit to make sure my BG was where I wanted. I went back to bed for that last hour or so - and my BG was a friendly 82 on waking. No big jump, no evidence of DP. - just a nice, small rise that corresponded to the few carbs I had.
I suppose the argument can be made regarding THIS morning that those few carbs I had prevented DP; however, there have been many other similar circumstances that did not involve any carbs and did not result in but spikes.
Mostly an academic question, I suppose, but sure would be nice to avoid 100+ point spikes, if possible.
