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Re: [IP] Interesting morning... another twist

Sorry for the long inclusion, but it is all relevant, see below
> << What a morning.  I got up at 7:30 a.m. did a bg check, 135. 
> Started my
>  fast, in one hour (8:30 a.m.) bg was 207.  One hour after that was
>  201, hovered around 200 the rest of the morning when at 11:30 a.m.
>  I said "enough, it's not going anywhere".  And I took a bolus to
>  bring it down. Called my CDE who said "interesting".  She called me
>  back later and raised my am basal to 0.8.   >>
> Roselea,
> I have this phenom too.  My early am basal before waking is 1.0 from
> 4am to 9am, while the rest of the day is .7 and .8.   I tried
> tweeking this 4-9am number for a couple of months, but still had the
> spike, up to 250-280 range, even without eating.  Finally what
> worked was to take a bolus about 1 unit if bg were ok, or more if
> out of range, upon waking.  This did the trick.  A spike in bgs
> requires a spike in insulin (bolus) to cover, and not a slowly
> increasing basal.
> Now the very interesting and frustrating part.  The above worked
> great for the last six months.  The last two weeks, the spike is
> gone.  I crashed for several days straight, lowered the spike bolus,
> and finally did away with it. 
>  Go figure, our bodies are constantly changing.  At least with a
>  pump we have 
> a better tool to make the adjustments.

The presense or absence of the spike has a lot to do with how well 
you are rested and the time of day you rise. Many times you can 
easily reproduce the there/not there phenomena by changing your 
schedule or observing what happens on weekends or days when you don't 
get enough sleep. One solution is to use a "wake up bolus" on the 
proto-typical day when you expect a spike -- Lily has done this off 
and on with roughly a 1.5 to 2 unit bolus to preclude a morning spike 
for several years now with pretty good success -- it's not always 
easy to predict or pre-guess the pattern so if you decide to try 
this, you probably want to make very good records of when it occurs 
and talk to your medical team -- of course!

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