Troubleshooting

[Jen]

So, after last week's "crisis" I sort of put diabetes aside for a week. Now I am trying to get back to it, working on my morning numbers first because I've started waking up really high AND I've started having random lows during the day. So I'm wondering if I've started going low at night and rebounding.

Still no idea what caused last week's drama, by the way, except that I still pass all tests as totally healthy. I am still on a beta-blocker for a few weeks and monitoring my BP at home but otherwise I think it's going to end up being one of those things that is just a mystery and not investigated further unless it happens again. My BP and heart rate have been literally perfect for the past week.

Anyway, so I've been trying to test several times each night to figure out what the heck is going on. I keep sleeping through the alarm I have set at 12:00 which is annoying because that seems to be when the huge dramatic shift happens. I'm wondering if I'm going low so I'm lowering that basal segment to see if that helps.

Nov. 23:

5:00 - Basal rate 1.20u an hour
8:43 - 9.4 (169) - 1.50u IOB
9:00 - Basal rate decreased to 0.75u an hour
10:37 - 7.3 (131)
2:42 - 14.8 (266)
3:00 - Basal rate increased to 1.35u an hour
4:21 - 14.0 (252)
7:14 - 12.2 (220)

Nov. 24:

5:00 - Basal rate 1.20u an hour
9:00 - Basal rate decreased to 0.65u an hour (lowered)
9:28 - 7.4 - (133) 2.00u IOB.
10:51 - 7.5 (135)
2:31 - 13.2 (238)
3:00 - Basal rate increased to 1.30u an hour (lowered)
7:19 - 12.7 (229)

The one good thing is that this happened twice in a row which makes it a pattern I can work with! I think tomorrow night I need to try and go to bed with no IOB and see what happens. I've been going to bed really early lately because I've been reading for a few hours, so I should try and have dinner a bit earlier than usual tonight.

I will plug away at this over the next few days and when I can get it sorted out I will start on my daytime readings. I am getting my A1c done today so I should get that in the next few days and wouldn't be surprised if it's increased a bit. But I am so NOT stressing about this tight control thing anymore. I am half convinced that what happened last week was just from a buildup of stress (from work, school, diabetes, just life in general) causing my body to crash, since they can't find any medical cause, and if that's the case then I do NOT want to trigger another episode.

[acidrock23]

I think that you can conclude that the .75U and .65U are not be enough? If I adjust my basal rates like +/- .05U/ hour, I will get a 20-30 point swing in BG, sometimes a bit more. It seems like you are switching it more like .5U and that might explain those rises? Mine go:

12:00A .9U/ hr
1:00A .85U/ hour
3:30A 1.00/ hour
7:00A .9/ hour
For a while, I had "bumps* set around meals too, perhaps a "cheat" of sorts, but ran into some challenges with weekends when I eat more diversely. With those settings overnight, even though it's adjusted, it results in a *very* flat line overnight, probably at least 5-6 days/ week, with occasional exceptions. I look at it like a large ship (OK, occasionally a spaceship...) that just needs the tiller *nudged* a bit in the right direction?

[Jen]

Yeah I think you are right on those, I will try bumping them up ... Whenever I have lows at night it's ALWAYS during that time slot so I tend to keep them lower ...

I had another "episode" last night that almost concluded in another ER visit ... woke up randomly with a HR of 130 and a BP of 173/104 ... but I took extra medication as instructed and it went away after a few hours so I didn't go to the ER. I did have a chance to check my BG surround that episode, though ... 5.9 @ 12:00 AM, 9.1 @ 1:00 AM, 16.0 @ 6:00 AM, 13.5 @ 7:30 AM ... no food during all of this. I don't know if these "episodes" and BG are related but it makes me feel like my entire body is out of whack. It's partly the reason I'm so surprised my A1c was so good!