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Re: [IP] that darn dawn phenomenon - HELP!

> 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
Hi Kasey,

I don't know over what time frame you are doing the testing, but you 
need to get data every hour or so. It can be on different nights but 
you must stagger the test times so you can develop an overlapping 
data set. The finer data set must be collected using the same basal 
rates on each collection run. The purpose is to make sure there are 
no hidden lows/highs and to provide enough data to accurately set the 
basal. The data set should be normalized to the starting bg of the 
first data set. Make sure that she has fasted for at least 5 hours 
and no boluses prior to starting the test period.  Don't try to do it 
2 days in a row, it is to hard on the 'victim' and will mess up the 
data collection. Allow at least 1 or 2 days of rest. The basal rate 
will probably not be flat as you have set it. Try to keep within the 
guidlines of 

not less than 70, not more than 170

70, you are headed too low. However, if you know her carb/bg ratio 
fairly accurately, you can still get meaningful data by bring her 
bg's up into the 120-150 range with glucose tabs and adjust the 
subsequent readings by the shift produced by the glucose.

Over 160 or so, healthy kidneys spill glucose easily and will lower 
the bg's more than you might expect, thus perturbing the readings.

This can take a while for a child. They don't necessarily tell you 
when they are too tired or don't feel well enough to do it. I allow 2 
to 3 weeks to get a pair of good data readings from Lily and she is 
14 and communicates her physical feelings/wellness tjo me fairly 
well. Profiles for days are a snap and can usually be collected in a 
day or two unless the bg's stray.

Be patient, get good data. I will help you with the data reduction if 
you wish, just copy the data to me.

Need to collect.

Kind of insulin and mix ratios if applicable
Time of last food
Time of last bolus
All basal rates from at least 2 hours prior to bg test start time 
until test end time.
Bg's every 2 hours max (may be taken over several days)

With this info, you can make a reasonable prediction of where the 
basal rates should be set.

I am cautious. I have checked Lily every night between 2 and 3 for 
almost 4 years with only a few misses. It is our 'midnight meeting'
It is necessary as her basal rate triples at 1:00 am and a timing 
mishap usually puts her bg's over the edge (usually a little high 
thankfully). She's rock solid from 2:00 until anytime in the morning.
As her body changes and she matures, you can expect little suprises 
like this from your daughter as well. They are nice and stable for 
the longest time then bang, everything changes, then is settles down 

My guess is that you need to shift 1 or more times during the night 
between 0.2 and 0.3.

Try the basal projection tool on the HOWTO web page


This will assist you in estimating the necessary basal rates.

Use the tool to produce flat bg's, don't worry about the absolute bg 
reading, only the flatness of the curve.

If you like, I will be happy to assist you with the data reduction 
but will be away on vacation next week. Email me the data if you 


Michael <email @ redacted>
Insulin-Pumpers website http://www.bizsystems.com/Diabetes/
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