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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. >>
> 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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