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Re: [IP] that darn dawn phenomenon - HELP!
I've got a question, a suggestion or several, but really no answer ...
What kind of insulin is Kayla using? I seem to recall that she's on
Humalog, but don't know for certain. This is important.
It might be helpful to "stagger" the times which you check her BGs, to see
when the BG shifts start to occur. In other words, check at different times
on different nights. Perhaps midnight, 2:00, 4:00 and 6:00 one night and
11:00, 1:00 and 3:00 the other night. (that's easy for me to say - I don't
have children and frequently forego sleep ;-))
Did you start Kayla with a single basal rate, then change, based on test
I don't see a "dawn phenomenon" in the typical sense. Other than the spike
at 12:00 one night on a .2 rate and the one at 9:00 p.m. while on a .3
rate, her BGs seem to actually drop between 12:00 and 7:00. The rise
between 7:00 and 9:00 on the .3 rate may have been due to the low which you
treated earlier. The BGs may not be optimal, but I think what you are
looking for here are "trends" or patterns, rather than targets right now.
Could it be that the dinner bolus was incorrect? Is she snacking at bedtime?
For some pumpers, it's possible to dilute the insulin, so that it has less
"strength" per unit than currently being delivered by U100. I know of at
least one person who does this, but for different reasons. Diluting the
insulin allows her to use a higher basal rate, but deliver less "actual"
insulin. She does it to help prevent clogging on very low basal rates. I
wonder if this is possible for Kayla?
mailto:email @ redacted
>Her daytime basal rate is 0.1 units per hour. Her carb ratio is 1:25.
>Her insulin to blood sugar ratio is 1:120 during the day. From 6:00pm
>until 6:00am it's 1:200. For some reason she's super sensitive to
>insulin boluses during the night. I'm hoping to figure out the right
>nighttime basal rate so she won't need boluses while sleeping, but
>that's what I'm having trouble nailing down.
>We had her on a .2 basal from 9:00pm through 9:00am then tried a .3
>basal for the same time period. The results were:
> .2 basal .3 basal
> 9:00pm - 148 9:00pm - 235
> 12:00am - 266 12:00am - 101
> 3:00am - 214 3:00am - 47(gave 2 glucose tabs = 80pts)
> 7:00am - 190 7:00am - 70
> 9:00am - 186 9:00am - 150
>I tried a third day with a .2 basal from 9:00pm until 12:00am and a .3
>basal from 3:00am and she went over 200 again at the 3:00am reading.
>What I see when I look at these results is that .2 is too little and .3
>is too much. Both of these rates were done after "vanilla" days so
>there aren't any other variables to deal with.
>What do you all see?
>email @ redacted
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