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Re: [IP] Overnight highs

There are several of us here that have done enough monitoring to say with
confidence that our bgs do rise with exercise -- in my case intense
exercise, with the rise occurring steadily afterwards to a point where
ketones are present.  This is not the norm for most, but another good
example of YMMV.  I would suggest that you continue to confirm what is
happening, try some alternate basal adjustments, and see what happens.  I am
able to exercise again -- YEAH!!  Feel free to email me privately if you'd
like, I'd be happy to share how I have managed to exercise and stay on a
more level field.
Take care,
dx '71, MM507 1/98, Humalog
email @ redacted
-----Original Message-----
From: James Watson <email @ redacted>
To: Insulin Pump List <email @ redacted>
Date: April 12, 1998 08:49 PM
Subject: [IP] Overnight highs

>My first thought that my morning highs were due to  a Symogyi effect.
>However, when I tested at 2:00 am, my sugar was already high.  I had tested
>at about 10:00 the night before and my sugar was ok.  On most evenings, I
>would have a snack, bolus, and go to bed.  Still when I set a temporary
>basal of 70%, my sugar was even higher.  When I have these highs, my
>ketones are negative.  My endo said that if you have a Symogyi high,
>generally you should find ketones due to the biochemical reactions
>involved.  He couldn't come up with a good explanation, but though that
>some hormones were responsible.  I have a similar odd behavior when I play
>soccer.  I play goalie and therefore am not running too much.  During the
>first half of a 1 hour game, my sugar will tend to be on the low side of
>ok, around 70-90.  At halftime, I will have a small snack.  By the end of
>the game, my sugar will be soaring.  As the season is approaching, I will
>soon be trying to find a strategy to control this.  Again my endo saids
>that adrenilin is possibly involved.
>My point is that exercise is a tough thing to manage.  Highs and lows are
>possible for reasons that I still grapple with.
>Date: Sun, 12 Apr 1998 10:01:49 -0400
>From: Ted Quick <email @ redacted>
>Subject: Overnight highs, was: Re: [IP] Mystery challenge - Where did the
>9.9 units go?
>James Watson wrote:
>> I cannot help explain where Lily's 9.9 units went, but I can say that
>> we go skiing, I often have highs that are very hard to explain.
>> I can ski and test throughout the day and generally do ok (target
>> and my bg's can be good through the evening, my problem is overnight.  I
>> can have my sugars soar well over 300.  I often have to set a temporary
>> basal of 130%, just to keep my sugar reasonable.  I think that the
>> is the cause, but I cannot offer specifics.  If you come across
>> I would be interested.
>Are you sure the exercise didn't come back to haunt you in the middle of
>the night? A hypo at 3:00 AM can lead to the Symogyi Effect, where your
>emergency response to the low will dump a lot of glycogen (which ends up
>glucose) from the liver to save your life, but it's almost ALWAYS too much.
>This leaves you with a high in the morning NOT based on too MUCH bg during
>the night, but too LITTLE.
>Suggest you set an alarm for 2:00 or 3:00 AM after a day like that and see
>if you were going low then. If so, REDUCE your dose during the night,
>it can be dangerous!
>Ted Quick
>email @ redacted
>Type 1 for 42 years (as of today), MM506 pump with Humalog
>Insulin-Pumpers website   http://www.bizsystems.com/Diabetes/
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