Hi my name is Jem I am 32 yr old been Type one diabetic for 21yr been on insulin pump for 2mo as of now and have enlight CGM that I love because it helps with me knowing I have Lowes and high blood sugars with accuracy but there is one thing I am not understanding about my diabetes and I did not ever know until I did the CGM trial for seven days and found out that I have very high trends in the middle of the night that I cannot control no matter how much correction I do because someone give me some pointers why my Bloodsugars run better in the morning but once 11 PM hits their out of control in the 300s and 400s I give my self corrections as bolus wizard recommends and over corrected myself and no success in lowering my blood sugars. Someone please tell me how to stop the sugar party in the middle of the night
@GagaDiabetes. Congrats on getting a pump with an integrated CGM! You are gaining new information that you and your care team can work on. I would probably start with your endo/CDE first, but I do have some questions for you.
What do your fasting BGs look like?
What sort of dinners are you having and when do you eat? Any with high fat/protein (like pizza, Mexican/Cuban/Asian w/rice or beans)?
What do your trends look like @ 9 and 10 PM?
When you say that you “over corrected” does that mean you went low (below 70)?
I second @YogaO’s line of questioning. High-fat high-carb dinners like pizza or Chinese restaurant food are notorious for driving blood sugar high while you are sleeping. Now that you have a CGM perhaps you could do a personal experiment with eating a relatively moderate meal for dinner. Something like bacon and eggs with only one piece of toast. If you do this try to avoid any evening snacking. For safety’s sake keep your emergency glucose nearby. I would also suggest that you set an alarm for 2-3 a.m. so you can check your glucose level.
There are two most likely explanations for overnight hyperglycemia: insufficient insulin for the dinner food or insufficient basal insulin during the evening and overnight hours. It may even be a combination of those two reasons. This problem has a solution. It’s your job to figure it out. A little testing and record-keepping are the best tools you have.
I encourage you to discover the solution because not only will you feel physically better, you will also have learned how to fix things on your own. And that’s a great feeling. Of course, include your doctors in this discussion and listen to their suggestions. I’ve found personal experimentation combined with watchful monitoring and a ready source of safety glucose to be the best situation when untangling the type of BG problem you describe. Good luck!
Hi and thank you for your help And for responding to my plead for guidance with my crazy diabetes basically when I over correct I take more bolus insulin them what the bolus wizard recommends for that certain food that I’m eating and I tent to eat a very light meal at dinner time and I do not snack in between my carbs are at dinner of 50g of carbs my fasting blood sugar’s are 300 when I wake up. the afternoon there between 150 to 200 till dinnertime hits and night time they start running 300 and up level
Do you sleep well? Disturbed sleep can cause high blood sugars. I have sleep apnea and without treatment I actually stop breathing many, many times. This causes stress hormones to be released and gives me high blood sugars. Things improved after I was diagnosed and treated. Do you sleep well? Do you snore? Has your partner every commented that you stop breathing and gasp for air in your sleep?
If your fasting BG is 300 when you wake up, I’d think your basal rate is too low.
Have you read Gary Scheiner’s THINK LIKE A PANCREAS? This book is a must-read. It will answer a lot of questions and offer sound solutions.
I would tend to agree with you, @rgcainmd.
@GagaDiabetes, it looks like your basal rate overnight is too low, but what does your trending look like on the Enlite?
What I would be interested in understanding is what your BG looks like 2 and 4 hours after eating dinner; what do your trend lines look like as you are going to bed?
Put another way, what you would ideally like to see is something where your BG is in your target range before dinner, slightly above target @ 2 hours after and trending down, at roughly the same BG as your before dinner reading @ 4 hours, with a flat trend on your BG. At this point most of your bolus insulin should be gone and you should just be seeing it tailing off.
If there is a lot of fat/protein in your dinner in addition to your 50G carbs, you might start seeing your CGM trend line start heading up at this point. If your basal is too low during or just after dinner, you might see your trend line heading wildly up. If there is little fat/protein and you are seeing a big push up @11PM, and you were in range after dinner, then your basal is way too low starting around 8PM.
If your meal is leaving you @ 300 and your overnight basal is good, then you will end up @ 300 in the morning.
I would want to take a look at Gary Scheiner’s, “Think Like A Pancreas” and do a basal test skipping dinner.
My suspicion is that you have a combination of too low of a basal and higher BGs from your dinner protein/fat. But, I also think you have all the tools to conduct some experiments.
Like multiple daily injections (MDI) of insulin, the pump is just a tool. I strongly encourage you to learn all you can about using insulin. Scheiner’s Think Like a Pancreas and Walsh’s Using Insulin are a good place to start. The more you know combined with a willingness to conduct personal experiments will set the stage for you to successfully and independently manage your diabetes. Unfortunately, diabetes will be with you for a long time. Invest in yourself now.
When I was diagnosed over 30 years ago the doctor told me there was a strong correlation between the person with diabetes level of education and good outcomes. That assertion has stood the test of time with me. Knowledge is power, especially with diabetes. I interpret “education” as not just the formal type but also knowledge gained fueled by personal curiosity about how your body works with diabetes. While diabetes can sometimes seem chaotic with unexplained random events, I’ve found that “unexplained events” can be kept to a minimum. For me, most diabetes puzzles have solutions.
To add to all the great advice so far, you might find it interesting that this is the fault of your Liver. Yep, it’s normal for the liver in your body to control the storage of sugar storage in your body, and that it’s normal for it to start the release of these sugars late at night. This is why sleep is so important for everyone, but more so for diabetics. This is the time the body is doing a lot of work repairing and regenerating for the next day. It takes a lot of energy to do this, so the liver is at it releasing all the stored sugar back into your blood. A normal person would also release a lot of insulin to help this sugar do it’s work. But for a diabetic, this is the time of day that insulin needs to be high enough in the body to handle this extra sugar. And like said before, fat is a great storage start for sugars that can be released at this time. So, high fat evening meals will always trigger this late sugar party. Fat is a confusion thing, not much sugar at first, but lots later. I personally refer to this as the “pizza high”. Plus, high fat which converts to sugar by the body and liver can’t always be controlled easily with extra boluses, as the liver will see the insulin and just release more fats/sugars. Frustrating isn’t it? Anyway, keep your diet strict and make sure to control the night time amounts of insulin needed closely, this will result in much better control and much less complications now and later in life.
Thank you for all your help
I would definitely do more research about the different types of insulin out there in the market and what they do to help you regulate your diabetes
i know this is old, but this might, help out a friend, i have, who is have Problems, like this, with her diabetes.