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[IPk] High sugars in early morning and after set change

I finally started on a pump two weeks ago, and am currently in the process
of trying to get Basal rates stabilised.  I have noticed two things which
both affect me during mornings.

Firstly, my BMs shoot up when I get up/after breakfast (I haven't yet
determined what happens if I don't eat breakfast).  One morning I tried
testing regularly to see what happens and these were my results (My target
BM at present is 10):
06:30	13.6
06:40  Breakfast (Bran flakes + semi-skimmed milk) 75g CHO, 5.0 unit Bolus
07:00	16.3
07:20	19.5
07:45	16.1
08:30	17.3
09:30	15.2
I wouldn't expect a meal like that to induce such a rapid rise in BM, but it
is completely repeatable day after day.  Has anyone else had a similar

Secondly after a set change (9mm/43" Quickset) my sugars always go a lot
higher during that morning and will usually require a couple of correction
Boluses to get back into normal range.  I am confident that I am doing the
set change correctly, priming the set, and giving a 0.5 unit prime bolus to
fill the cannula after insertion.  Again has anyone seen anything similar
and have any constructive ideas?

The good news is that I have been fully funded for both Pump and
consumables.  This was all done for me by the Pump Clinic at Guy's, who
contacted my health authority (Sth Essex) and arranged funding.  This was
all done before I could see Dr. Pickup for the first time (Which happened
back in January). I had initially been referred at about this time last
year.  Since January, Guy's have tried tweaking a few things with MDI and
using a Glucowatch and Minimed CGMS to look in detail at what goes on,
before coming to conclusion that a pump would be appropriate.  This decision
was then made in May, which meant a new financial year and therefore
re-applying for funding.  Fortunately this came through fairly quickly and I
started on Saline on 9 July, and on Insulin on 15 July.

	Colin - MM 508 2 weeks.
Colin Kerry, Principal Research Engineer, Systems
BAE SYSTEMS Advanced Technology Centre - Gt Baddow
Chelmsford, Essex. CM2 8HN.
Tel: 01245 242136. Fax: 01245 242124 Email: email @ redacted

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