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[IPp] nighttime temp basal



> help heres the scenario my daughter 13 pumping 4 years diag 5 years has 
> been having   night highs increased basal rate 2 hours prior to high 
> went down to 32 doctor suggested increasing basal earlier in the night
> still  went very low we are talking very small increments and highs in
> the high  200 so now my daughter wants to take a pump break we are
> getting up at 1;30  every night to check blood sugar and do a correction
> the dr suggested changing  evening carb ratio was 15-1 changed evening
> snack to 12-1 a low of 41 last night  I cant 
>  figure this out any thoughts or suggestions please sorry about the
>  spelling but
> we have been doing this 5 weeks now and im  exhausted 
> .

from one of my posts in 1999

> >physiology behind the phenomena of sharp bg rise when adolescents
> >go to sleep. this was happening to Lily and our solution was to
> >start a higher temp basal rate for an hour or so. Part(all?) \ of
> >the rise was due


I asked Dr. Joe (Lily's endo) 
"Some time ago I recall you explaining to me the underlying 
physiology behind the phenomena of sharp bg rise when adolescents go 
to sleep. this was happening to Lily and our solution was to start a 
higher temp basal rate for an hour or so at bed time."

 ...and he responded:

On Tue, 2 Nov 1999 email @ redacted wrote:

> The growth hormone is the first surge with sleep, and the second is
> cortisone.  Additionally, after a couple of years the intermediary
> metabolism in the liver becomes somewhat disabled since the usual
> high amounts of insulin delivered directly from the pancreas to the
> liver are not present.  100% goes to the liver normally but when you
> give it subcutaneously, whether by pump or shot, only 1% go to the
> liver.  This is manifested by an increasing dawn phenomenon
> exaggerated by the above hormones. 
> > Joe 

and from another old post

Yep, it was us. The way it was explained to me by our endo was....
When a kid goes to sleep, that's when the growth hormones turn on. 
It's not time dependent so you can't really set the pump to do it the 
same every night unless your kid happens to go to bed AND fall asleep 
at the same time every night -- not likely. What we did was to set 
the appropriate basal rate for night time to start at 2AM and let the 
evening rate, which was quite a bit lower, run until that time so if 
she happened to be up, she would not get low. On the all nighter's 
... sleepover's etc.. it was up to her to remember to turn her basal 
down. Anyway, Lily would set a temp basal rate at the regular higher 
night-time rate when she went to bed that extended beyond 2AM where 
the pump would pick it up automatically. this worked just fine and 
also got her in the habit of setting a temp rate when things were 
non-standard   --- i.e. a weekend soccer tournament or something like 
that.


Michael
.
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