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[IPk] Pituitary and BG



Does anyone know how hypopituitary problems might affect BGs and 
basal rates? Emily has secondary hypothyroidism (TSH 1.64 normal 
range 0.35-3.5, T4 7 normal range 8-21, low thyroxine dose, 25mg). 
She has some symptoms of cortisol deficiency but they are pretty 
general and could be symptoms of something else. I'm wondering if her 
change in basal rates suggest anything more definite, either for or 
against cortisol involvement.

A year and a half ago Emily's basal insulin made up 34% of total 
daily insulin (55 units). Now it's 21% of the same total. The basal 
rate pattern seems similar between 2am and 2pm (steady until an 
increase from 6am, peaking at 8am, dropping back down by 11am). The 
rates between 2am and 2pm used to be between 0.5 and 0.8 with a small 
peak at tea time and rising again from 10pm. Her basal rates now are 
0.1 from 2pm until 12 am then rises each hour to 0.4, 0.6 and 0.8 at 
2am. Despite the low basal rate during the evening she is having 
hypos between 10/11pm and 1am with no links to too much insulin, 
exercise, etc. For eg. last night her last insulin was 1.5 units at 
7pm. Her BG at 10.14pm was 9.1 and she was 3.5 by 12am. This was 
after a lazy day. 50% of Emily's hypos happen during this late 
evening/early morning time now compared to none a year and a half ago 
despite the much lower basal rates during the afternoon and evening.

Does anyone recognise thy type of problem? Emily is just 14 and 
currently takes about 1unit/kg/day.

Thanks,
Jos
.
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