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Re: [IPk] erratic bg

>My biggest problem since using a pump is my bg often goes high during the
>evening even though my pre-evening meal bg is at a good level, 6 or 7.  I
>think I count the carbohydrates and work out what bolus to take quite sensibly
>but my bg still goes sky high (18 - 20) by 10pm and I am having to do
>corrections in order to bring it down.

Hi Marcia -

If I were experiencing these sort of problems, what I would do is this:

First, I'd check my evening basal rate was correct. That means taking a
normal evening, and skipping dinner altogether (and so having no bolus). If
my bg still went sky high, I'd know it was my basal rate that was wrong at
that time of day, and I'd increase it appropriately. Basal rates can vary
at different times of the day, and until you are sure it's correct, you
can't trouble-shoot your meal bolus.

If my basal rate was ok, then perhaps my carb/insulin ratio is different
for my evening meal, compared with lunch or breakfast. This happens for
some people. So over several days, I would increase the amount of insulin I
bolus with the meal, till I can stop the high, but without going hypo later.

As Melissa said, sometimes there are funny foods which do funny things to
the bg - almost as if the usual carb counting rules don't apply. If that is
the case, you've got to find that out by experience.

But at the end of the day, if a correction bolus brings it down, putting
that correction bolus in with the main meal bolus should solve the problem.
But if it makes you go hypo after the meal, you might want to add it as a
square wave bolus.

Do you have telephone support from a pump nurse? Probably worth having a
chat with them, as they may be able to help you through this problem

Have fun :-)


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