What do you do when BG won't go up or down?

Every once in a while this scenario happens:

Wake up in the night, check my T1D 8 year old's Dexcom...it will say something like 280. I'll give a correction. Wake up 3 hours later. Dexcom says something really close to the first number, like 280. Correct again, 3 hours later...the same number.

So, you can conclude that the insulin/pump site couldn't be the problem, otherwise the BG would be going higher, and there would be ketones, which there are not.

We recently did an overnight basal test and the basals were nice and steady.
Generally at nighttime the ISF is working fine. This scenario happens often, and it's probably related to a growth spurt or maybe a small virus (??). She doesn't appear to be starting puberty yet, she's only 8.

And it's not like I can forsee the future and give an increase in temp basal to combat this. I just wake up in the morning and think to myself, "hmm, I wish I would have set a temp basal, but I didn't know she was going to be unusually resistant tonight and I didn't want to sleep through a crashing low".

Does this ever happen to anyone? What? When? Why? How? Please?

My daughter was diagnosed at age 9, and is now 12. I remember asking at the classes right after diagnosis why this happened, and everyone (with younger kids) didn't seem to understand what I was saying. I think she was beginning puberty hormonally even though we couldn't see signs yet.

Now, this is normal for us. 100% increases are not uncommon for a few days/weeks. We do different things, but there always seems to be the tradeoff between treating resistant highs and going low. Sleep is a real issue.

Sometimes, we set the temp basal and set an alarm for 3 hours all night.
Sometimes we trust the CGM will wake us.
Sometimes, one parent corrects at 11 pm, and another wakes at 5 and corrects again.

I remember asking my CDE the same thing - How I am supposed to do this? Is there a puberty class? She laughed, and said it would end in a few years!

Given what you say - you have a pump and cgm, and can test basals and adjust doses - I bet you'll start to make your own rules as this goes along. Like driving stick shift - you get a feel for it rather than going strictly by the numbers.

Thank you. I feel better now just knowing it happens to other people and I'm not doing anything wrong.

Since writing this I set her at 100% temp basal. She's been at this rate for 9 hours and we finally have some normal numbers. But, now it's time for bed....will she crash? That is the question.

Beginnings of puberty? Oh, no...

She actually has a hoarse throat right now, but she doesn't seem worn down or very ill at all...it's the only thing I can think that's causing this persistent high - a small virus.

Try +50% overnight and see?

Set dex to alarm at a higher number so you can a) turn off basal for an hour or b) give juice before she’s low?

Could be virus. We started getting more and longer “is it a virus?” instances until we decided it was puberty.