[Ariel22]

ok, so i recently got on the pump, and i'm liking it for them most part. except i seem to have a lot more lows now than i did before.

my doctor says i shouldn't really be having lows at all anymore, we just need to get my basal rates adjusted.

so we've adjusted them a few times, and i got rid of the lows in the middle of the night, but they're still there in the early morning.

for example, last night i monitored my BG throughout the night, and it was steady from midnight on. 124, and then 116 at 4:30am.

but, at 7 am it was 58. so it dropped.

the day before, i woke up at 8am with a 65 bg, drank some juice and went back to sleep. it worked, but at 11:30, it was back down at 67.

so, clearly there's something happening btw about 5am and 12pm. i have two different basal rates for the period 5-8am, and 8am-12pm.

should i lower both of them? i hate having lows and having to get up all the time and drink something

[networkguy]

There are some people with 5 or 6 different basil rates throught the day. Everyone is different. Women are a little tougher too (no not a slam hehe). It sounds like a trend-youre going low at the same times. That means you need to lower you basils for that time (well, 90 mins before actually). Best to talk to your trainer about it. And if you havent done so, do some thorough basil testing. Dont stress about it It takes patience but you'll get dialed in

[Lizzie G]

Originally Posted by Ariel22

ok, so i recently got on the pump, and i'm liking it for them most part. except i seem to have a lot more lows now than i did before.

my doctor says i shouldn't really be having lows at all anymore, we just need to get my basal rates adjusted.

so we've adjusted them a few times, and i got rid of the lows in the middle of the night, but they're still there in the early morning.

for example, last night i monitored my BG throughout the night, and it was steady from midnight on. 124, and then 116 at 4:30am.

but, at 7 am it was 58. so it dropped.

the day before, i woke up at 8am with a 65 bg, drank some juice and went back to sleep. it worked, but at 11:30, it was back down at 67.

so, clearly there's something happening btw about 5am and 12pm. i have two different basal rates for the period 5-8am, and 8am-12pm.

should i lower both of them? i hate having lows and having to get up all the time and drink something

Hi Ariel

The pump does indeed take some getting used to! Rest assured that once you get used to it the ability to change your basal rates throughout the day is one of it's best features.

Everyone is different but when you look at graphs showing the typical insulin needs within certain ages groups and sexes, these tend to be quite similar and move quite a bit during a 24 hour period. I actually worked out the periods based on these rates. I find that personally my insulin needs are highest in the early hours - between maybe 4 and 8 am, and lowest late afternoon. This is fairly typical for a 32 year old female. Personally, I would find that I would need to switch the basal down around 7am to prevent lows ( see later), and that a gradual curve works best - the programmes i currently use, which result in a consistent blood sugar are as follows - im not trying to suggest you use these but look at the pattern and maybe try breaking your own basal needs into these periods and testing the periods

00.00 0.425
01.00 0.450
02.30 0.525
04.00 0.675
07.00 0.550
08.00 0.425
10.00 0.400
15.00 0.325
18.00 0.375
22.00 0.400

Its also worth noting that I have extensively tested the overnight to noon period as this is the one that has given me the most trouble. I have found that changing the change time by an hour or so can make a vast difference, for example i used to have the 0.55 rate running until 8am, then i realised I was dropping a lot between the testing I was doing at 7, 8 and 9am; also i recall i used to have the 0.425 rate running until about midday, and was finding myself dropping around 11am. I find the morning to be the most difficult time of day - early morning Im very insulin resistant so need to be quite agressive but that changes so quickly that if i dont pinpoint the exact time then im vulnerable to lows.

Another thing i noted with the DP stuff - i find if i eat before about 830 or 900 am my ratio is 1 unit per 10g, but as soon as i leave it a little later that drops back to 1 unit per 12 to 15 grams (havent exactly pinpointed), so worth bearing this in mind - you might not find this at all but im sure its fairly common!

i think the best piece of advice would be hourly basal testing (im sure as an old timer on the site you have the links!) and also to take a look at the graphs (im sure its subby, deus xm or blue sky that has them in posts) showing the curve of insulin requirement during the day - also john walsh's 'pumping insulin' has these i believe.

sorry about the rambling post and good luck!

Liz x

[Clint]

I agree with the others, you just need to adjust the rates at the times you are going low and slow it down.. I would bet after that, you will be golden.

[Mindstorm]

Just a thought, have you changed where you put your infusion sites for the pump vs where you used to give yourself shots?

Just wondering if this is an issue that's being complicated by insulin resistance/sensitivity.

[It Ain't Over]

When I was trained to use the pump the trainers and md's all assumed I had to cover for dawn phenomenon. So I was given a higher basal rate for the hours prior to the expected surge in bg's. As it turns out I have no dawn phenomenon and I needed to lower the basal rates from about 2:00 AM on till mid morning. Went through some tough times until I sorted that one out.
The other is that there have been a few reports showing that at least some pumpers will find with the overnights will rise if they end the day above 110 and will drop if they end the day under 110. That was absolutely what I had going on. The way around that one was to lower my basals overnight at different times. Always remember to lower or raise them 1 1/2 hrs in advance of your findings. This requires some night testing and that is a chore, but it is well worth it.

[poodlebone]

You should make the basal changes about an hour or two before the time you see the BG drop. If you drop at 5:00am, setting a lower basal starting at 5:00am will not prevent the drop. Setting it at 3:00am is better.