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Re: [IP] Nighttime mysteries

     The only way to really know what's happening at night is to test your daughter's blood sugar every hour during the middle of the night.  The data you will collect will be priceless.  These numbers will tell the whole story.  Upon doing these tests be sure your daughter does the same thing during the day, such as, exercise, food consumption.  Make sure your daughter doesn't eat at least 4 to 5 hours before bedtime.  If she eats supper at 5, or 5:30 eating nothing else would be okay upon going to bed.  Also try to keep the fat consumption in food down to a minimun.  From my own experiences fat in large numbers say 50g-100g at any meal especially at supper before going to bed greatly leads to insulin resistance, meaning it will take a fine working basal pattern during the middle of the night and ruin it to where you think you need to raise the basal rates when in fact the large amount of fat is raising the sugar which should have been accompanied by an increase of insulin, such as temporary basal increase or a bolus extended over a certain amount of time.  This seems like alot of work, it is, but geting up every hour will yield excellent benefits for your daughter.  Blood sugars tend to increase at 3:00am and go up from there.  A simple .1-.3 increase at that hour every hour till she gets up you will find might work.  Remember fat has a tremendous affect on blood sugars several hours after eating that should be accounted for. One more thing,  an occasional high during the middle of the night can be dismissed as long as it doesn't repeat itself often, blood sugars can not always be assumed to be a certain number at any certain time.  Keeping blood sugar under controll is a very complicated process that our body's do(non-diabetic) with ease, somtimes there isn't a reasonable explanation for any one number, nor should we feel pressured into giving one.  Hope this helps.    
----- Original Message -----
From: email @ redacted>Anita Kuchera
To: email @ redacted>email @ redacted
Sent: Wednesday, November 24, 1999 10:52 PM
Subject: [IP] Nighttime mysteries


My 5-year old daughter Elisabeth went on the Disentronic pump at the end of September. We have worked real hard to figure out her basal, coverage scale, and bolus ratios. All is well during the day for the most part with very little highs (over 300) and very few lows. I feel pretty good about the days because they are mostly predictable. However, night-time bg's are a mystery and scary. For example, she can go to bed with a bg of 170 and wake up in the 300's or she can go to bed with a bg of almost 300 and wake up at 170. A good number of nights she wakes up with the same bg that she had when she went to bed. The other night for the first time (on the pump) she had a low in the middle of the night. I'm still checking her at night so I caught the low. I have collected lots and lots of data which I really don't know what to do with at this point. My husband and I are dragging because of lack of sleep. Any ideas on what could be affecting her bg's so dramatically when she is sleeping and what I can do to figure out the right basal rates so that she does not go low.

I have read quite a bit about the dawn and "dusk" phenomena on this list. Could this be what Elisabeth has? If so, how do you work through getting the best basal rates?