Thursday, November 30, 2006

What's your favorite blood sugar range to start the day in?

And I start with this question for a reason- I've been quite frustrated recently with my fasting blood sugars. They have ranged from 170-300 without apparent predictability. I've done some night time testing and I know up until 3am I'm at or near normal range- right around 100. So am I spiking after 3 then? But it isn't consistent, and I live alone, so I fear waking up low. It doesn't seem to matter whether I've had a snack before bed and bolused appropriately or not. I know that my hormones to tend to make me more resistant to insulin in the am especially- my insulin to carb ratio is 1:3- and no that isn't a typo! So, I thought I'd asked my wonderful blogging community for some thoughts on what to do- I've adjusted my basals some but it's a tricky thing when I can't be up every hour checking to see what my BG is doing. Plus, the rest of my numbers lately have been pretty darn good-working on getting that 8.7 HbA1c down by Jan 18. But these mornings are counter productive. Any suggestions would be appreciated.


MileMasterSarah said...

When I started on the pump 11 years ago, they suggested waking up every 2 hours to test your night time basals, while fasting. Sucks but you get a clearer picture than if you don’t do that.
I can’t talk, I haven’t done a night time fasting in probably five years, but it is something you can try.

Nina said...

Do you have a CDE that you can talk to? I would wake up with readings in the 60s until she looked over all of my rates and decided what the best basal would be for me between 3 and 7am.She also had me wake up in the middle of the night for 3 nights to see where I was. It's pretty much the only way.

Kate said...

Funny thing is that after posting this comment I woke up at a wonderful 112 this am. I had needed to change my pump before bed which I try not to do (in case it isn't a stellar spot) because I was due to change it and I had had two high BG's- the correction obviously worked but it should have been out of my system in 2 hrs. I have done some overnight testing- it is annoying but it just hasn't given me very consistent results.

Scott K. Johnson said...

That is frustrating - when you can't get any consistent numbers.

I also appreciate the fear of going low at night when living alone. That is a real fear and one that can't be so easily ignored!

I had a couple of thoughts of what might be going on. One, it could be the dawn phenomenon causing the rises after 3am. Or, it could be rebounding from a low that you're not catching.

Maybe shooting for a target of 150 at night might give you a little more room to see what's happening?

When the CGM systems are more available, accurate and affordable, you'll be able to get a better picture of what's going on. Until then, we just have to do the best we can!

Bernard said...


What time is your evening meal at? If it's after 7 PM, might it help to have it earlier?

It does sound like a dawn phenomenon problem. You could try setting a slightly higher basal rate for just a half-hour (to start), remember there's about a 90-120 minute lag on those basal settings. So if you increased your basal by say 40% between 3:30AM and 4 AM, that extra might kick in around 5 AM - 6 AM and pull the numbers down a little.

Then if that works (give it at least 3 days to see what happens), consider moving the time of the half-hour slot or increasing the basal amount, or basal duration.

In the end you may have to spend one or two nights getting up every hour to test and see. From my experience, that's painful, but informative.

Kate said...

Thanks for the suggestion Bernard, I have increased my basal a bit starting at 3 because it does seem like a dawn phenomenon to me also. I'm going to gently increase it though by about 10% at a time because that seems to be the best for me. Some recent after 3am tests have shown a jump from normal to high numbers, so now I just have to see what basal works.