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[IP] basals/laura

laura wrote:
>  have had  very high morning bg. It's between 240 and 300. 
>  That's fasting after sleeping. I have gradually changed nighttime boluses

I assume you mean you have gradually changed your basals...

>  days. My rates are now:
>                12a.m.- 2a.m. - .5
>                2a.m. - 7a.m. - 1.o
>                7a.m. - 12a.m. -.5

My first question would be, what is your 3 am bg?  i would try and test for a 
few nightws between 3 and 5 am and see where you are startin to go up...Dont 
change your basals JUST based on your waking up bg.  It is VERY likely that 
you could be getting too much insulin between 2 am and 7 am....you could be 
CRASHING and not waking up to catch it, adn by the time you do wake up, your 
liver has dumped in all kinds of sugars to keep you going...and you are 
high...I know it seems crazy, but sometimes LESS insulin is better...

dont 't change anything until you do a few ealy am checks and see what it 
happening...look at the web site for info on how to do a fasting basal 
test....easiest to do on the weekend...have a low fat dinner...then test 
every 2-3 hours through the night...you shouldn't waver much from your target 
zone...if you crash during the basal test, you will know that your basals are 
too high...correct with a few dex tabs and keep going...see the web site for 
further details

I learned first hand what too much night time insulin can do bakc in my MDI 
days.  I was in the hospital being regulated - pre pump with R and NPH shots. 
 Woke up 3 days running wiht higher and higher blood sugars, though bed time, 
12 mid night and 3 am sugars were all fine.  Doc kept increasing bed time 
NPH...I could not understand why my night time insulin was practically DOUBLE 
it had been before entering the hospital.   On 4th night, nurse comes in with 
orders for 12 units...the night before it had been 18.  I asked was she 
sure...she snapped YES...I drew up the insulin...she looked at it to make 
SURE i had done it correctly...(I wouldnt allow them to touch me except to 
draw blood), and injected.  

Next morning I was perfect.  Doctor comes in crowing "see I  told you you 
needed more insulin..." I said "then how come I woke up normal with LESS 
insulin?"  He
said, "no you took 21 units of NPH last night and you woke up normal."  I 
said, "NO, I took 12 units of NPH last night and woke up normal" He said "I 
ordered 21 units of NPH last night."  I told him  someone must have dyslexia 
and that I would be taking 12 units again that night to test this theory out. 
 He storms out of the room and returns with my chart  and puts it in front of 
me - "You got 21 units of NPH insulin last night according to this chart."   
"well, whoever filled that out LIED, then" I bellowed back - 

I told him to check with the nurse from the night before...Evidently he 
did...cuz she came in that night ALL contrite and apologetic that she had 
given me the wrong insulin.  I was like, hey, 21 units might have killed 
me...THANK you for screwing up...

I figure I must have been going low from the evening NPH sometime afterthe 3 
am check...which is about the right timing for NPH and when they were 
checking at
6am, I was already rebounding with glycagen galore...passing thru normal on 
the way to outta sight...

so...test in the wee hours...maybe you need less insulin...JUST A SUGGESTION

Sara SP
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