[birds_eye]

I'm currently on an MM722 pump and have been pumping for about 6 months now. My sugars are pretty well controlled and are quite consistent, but recently though, probably the last 2 months, I have been experiencing a high BG every single morning.

Even if I got to sleep with a normal BG, I will without doubt wake up high, and if I go to sleep high, after correcting it, I will still wake up high. I have found though, that if I wake up during the night, and I give myself a correction bolus of 2 - 3 units, I wake up normal. I have increased my basal by .10 during the night too.

Could anybody please give me some advice on how to remedy these high sugars that I experience every morning?

Thanks so much, looking forward to your thoughts.

[melissata]

If you need a correction of 2-3 units for a correction, you need to increase your basal. .10 per hour is never going to equal the 2-3 units you are short. You should do basal testing through the night to see when the increase happens and start increased basal rate a couple of hours before that.

[Cyborg]

The bad news is that you probably have DP. The good news is that the pump is perfect for handling it. You'll need to set your basal pattern to increase about 1.5 hours before you wake up. I wake at 7 am and here's an example of what my basals look like:


2:00 am 1.175
5:30 am 2.775
6:30 am 2.625
7:30 am 2.475
8:00 am 1.95
10:00 am 1.650
12:00 pm 1.3
10:00 pm 1.2

[Gordonm]

I agree with Cyborg but you might also have to increase your night time basal also. You need to do a couple of checks in the night time to see what you BG is while you are sleeping. You might be high all night or just as you are waking up. I increase mine at 3 AM then again at 5 AM

[ang]

i agree with what has already been posted. you need to test in the night to find out when you're going high so you can make the adjustments to your basal rate accordingly. but if you know 2-3 units is required at least you know how much. just need to figure out how to break it up and at what times.

[MJM]

Originally Posted by birds_eye

I'm currently on an MM722 pump and have been pumping for about 6 months now. My sugars are pretty well controlled and are quite consistent, but recently though, probably the last 2 months, I have been experiencing a high BG every single morning.

Even if I got to sleep with a normal BG, I will without doubt wake up high, and if I go to sleep high, after correcting it, I will still wake up high. I have found though, that if I wake up during the night, and I give myself a correction bolus of 2 - 3 units, I wake up normal. I have increased my basal by .10 during the night too.

Could anybody please give me some advice on how to remedy these high sugars that I experience every morning?

Thanks so much, looking forward to your thoughts.

I'll give an example of what happens me during the night. Now, what's right for me would not necessarily be right for you. My blood sugar drops from about 9pm and continues until about 3 - 4 am so I reduce my basal of .3u per hr to .2u per hr. Then from 5am the body starts to dump glucose which means I have to increase my basal to .8u per hr for 3hrs.
You will have to take some time testing your BS for each hour during the night to figure out your exact situation. This could be done over a week or ten days. i.e. wake yourself at 2am one night and 3am the next night and 4am the next night until you have covered the whole night. Record the blood sugar for each of these periods and you may then be in a position to sort this. Someone else may come up with a better solution but if not give it a try. I wish you well in your endeavours

[xMenace]

EVERYBODY'S DIFFERENT!

What works for Cyborg may kill you. It probably would me. What you need to do is profile your own basal rates. There is tons of material on the web about doing it. Dr. Google is a great help. In simple terms you don't eat after dinner then get hourly readings of your BGs. Make SMALL adjustments to get them IN RANGE. You still need sleep. Test every 4 hours and stagger those tests over many nights to accumulate a profile.

The problem I find with overnight is that your dawn phenomenon, and EVERYBODY HAS A DP!, can have lots of variation. If you set your basals based on high DP readings, you'll inevitably go low. You need to set them based on low DP mornings. That may involve many many nights of testing. I can wake up in the 3's (60's) or in the 12's (200's). GO SLOW!

You should profile your rates for 4 different time periods: overnight, AM, Afternoon, and PM. As you are finding out, your body changes. I plan on testing my basals periodically to ensure I'm still on target.

Here's my current basal rates for comparison.
1am .60
2 .60
3 .60
4 .60
5 1.20
6 1.55
7 1.85
8 1.95
9 1.15
10 .60
11 .45
12pm .45
1 .45
2 .45
3 .45
4 .90
5 1.30
6 1.45
7 1.55
8 1.40
9 1.25
10 1.10
11pm .95

Good luck!

[Cyborg]

I simply gave an example by showing my basal rates. Please DO NOT copy my basal rates under any circumstances. They are not intended for anyone except me. If you do use them, there will be a royalty involved...

I guess I'd better be more careful, I didn't think anyone would interpret my post as "do this with your basals".

[NoelD]

Originally Posted by Cyborg

I didn't think anyone would interpret my post as "do this with your basals".

I didn't take it that way, and anyone with common sense for that matter shouldn't either.

[xMenace]

I didn't either dude. Just being extra careful.

[Cyborg]

I still want royalties if anyone does...

[SunniD]

I just went thru this and did hourly bg testing one night to see if my basals were set right and low and behold at 02:00 am, my bgs skyrocketed which is a little early for Dawn Phenomena but everyone's leaky liver is unique.
My CDE increased the basals a lot so am running around 1.75/hr basal. Still need to run at 125% basal now so am wondering if it's finally time to get some metformin to help as well? My bgs are still high in morning as well or my sensitivity to the insulin is almost totally gone. Any basal over 2.0/hr is scary to be sleeping with and hoping you'll be safe and wake up.

Perhaps if I went back to work my sensitivity would increase.

SunniD

[birds_eye]

Thank you for all your responses, I will go and give it a go, and get it fixed up.

[Cyborg]

I've thought about the metformin idea myself, but decided against it. For one, I don't want to take another medication. For two, I think my liver does what is natural by dumping glucose in response to hormonal changes that occur while we sleep or wake. IMO, If my pump can provide the insulin required to imitate a functioning pancreas, then why mess with anything?

[issysmommy]

Originally Posted by xMenace

What you need to do is profile your own basal rates. There is tons of material on the web about doing it. Dr. Google is a great help.

Any suggestions on what to google? "Insulin pump basal rates" or "setting insulin pump basal rates"

The information you gave in your post seemed more thorough than any of the info I have found yet on the web.

Anyone have a good website for this information?