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[IPk] overnight ketones & dodgy A1c

HI all -

I'm a woman in need of advice. I'm trying to sort out my overnight basals 
(yes, yes, 3am test). I have been doing overnight testing (one night I did 
12am, 1am, 2am, slept through the 3am alarm, and 5am). I've been doing this 
for over a week at this stage, and I've never caught anything hugely out of 
range - the readings are anywhere between 4 and 10, but not higher.

However, I also have ketones every night. For example, last night at 9pm I 
was at 10.2, I had an adjustment bolus and insulin for an eggs-and-cheese 
dish. At 1.25am I was at 7.7 and I had a trace of ketones. At 6.57am I was 
at 9.4 and I had small ketones. These numbers are a bit high compared to 
other days, but the ketone pattern is the same.

None of my overnight testing has demonstrated particularly high or low BGs 
over a period of hours.

My head (often a good indicator of what has happened overnight) feels fairly 
fine in the morning. Not particularly muzzy or achy. I'm also not thirsty 
when I wake up in the morning, which I would expect to be if I'm producing 

Question: What would cause me to produce ketones at BGs between 3-12? This 
is the range I've seen over the past week, on different days.

To add to my frustration, I got A1c results back today: 7, up from 6.8 four 
months ago, which was up from 6.2. Last time the nurse has told me the very 
poor BGs I had over christmas week probably caused that large increase, but 
clearly that is not the case because I have been doing well in terms of 
recorded numbers for the past 6 weeks or so. I had an A1c of 6 for a year 
after starting the pump, so as you can imagine I am very concerned about all 
this. Clearly, I have a problem overnight.

So, I'm doing overnight tests, tracking results, and changing basal rates 
when appropriate. Any other suggestions? Oh yes - I will be making an 
appointment with my diabetes day centre, but I'd like an expert opinion as 


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