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Re: [IP] Re: Basals

> Michael,
> In all my reading on IP, I've never yet heard anyone mentioning
> doubling the basal rate for sleep time.  But this increased insulin
> need can sure happen for Claire.  The problem is that it is so
> sporadic.  Some nights she will be at the low end of normal bgs at
> bedtime and by 1:30 am she will be at 22.0!! (around 400). After
> that time period, she may or may not drop quickly. 

It's not doubling, that was just coincidental for Lily for a few 
months. It had been at other levels that were higher but not 
necessarily double. This was back when she was about 12-13 (started 
pumping at 11 1/2). Her evenings were around 0.5 - 0.8 as I recall 
and her nights varied from 0,8 to as high as 2.0 u/hr. They didn't 
move around, just over a period of years we adjusted them over those 
ranges. Anyway, we found that snacks or meals within 3-4 hours of bed 
time really changed things and that she would be predictible if she 
did not eat after dinner or have a late dinner. You may find this 
true as well.

>  I hate this,
> given that she is only 8 and is not growing rapidly.  I am not brave
> enough to set a double basal rate, as it only happens for awhile,
> and then stops.  But overnights have always been a struggle for us
> since pumping. 
>       Your  Lily was too old for naps when she was dx (I hope!), but
>       your 
> explanation sure explains why parents of toddlers see such high bgs
> after unscheduled naps.

You're right, she did not take naps, at least not regularly. I think 
once in a while she'd fall asleep during the day (weekend or 
something) and almost always notice a high bg afterwards. This is 
consistent with what you've observed.

>  When I questioned the nurse about this when
> Claire was 3, she said it was just due to the inactivity, but I knew
> it had to be something else involved. 

Probably only the endo might know this and then only if he thought 
about it a litte unless he's encountered it already in patients. 
Lily's endo added it to his collection of "stuff" about kids and 
diabetes even though he supplied the explanation. :-)

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