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Fluctuating numbers from 9pm to 1am - at my wits end

Riri

Riri

Well-Known Member
Messages
1,174
Location
Mid Wales
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
The conservative party, people who are cruel to animals and aggressive people
Hia, I don't know if anybody else has this problem. My BSs fluctuate wildly from night to night from 9pm to 1am. Last week I even had the same supper 3 nights running to test things out (same level of activity in the day). BSs 2 hrs after supper - 12.4 night one, 7.2 night two and 15.1(!) on night three.

This has been happening over the past 2/3weeks. I've spoken to my DSN and I've been on a CGM but she has to admit that she can see no specific pattern/cause. I've now been left to my own devices a bit to try and sort it out. What I'm doing at the moment is checking my blood sugars an hour after food and if I see they're higher than expected I put my pump up to 130% for 2-3 hours which does bring me down to 6-7 by 3am. But I cant just up by basal/bolus for supper because these high readings dont always happen. Everything is fine throughout the day.

I just wondered if anyone had any suggestion?
 
What were your readings like on those three nights before eating? Had you eaten anything before supper on any of the nights?
 
Readings were between 6 and 8 (so anything over 7 and the pump would have worked in a small correction as well). Have my supper between 7 and 8.
Had I eaten anything? Every night I come home from work around 5.30 I have a handfull of mixed nuts and a piece of cheese. I've been having these for months though.
 
The only things I can think of are
1. What type of food did you eat? Was it particularly fatty or something that you couldn't accurately carb count for some reason?
2. Could you do some fasting and test your basals that way? ie have an early dinner at say 4.30pm and start testing at 8.30pm to see what happens when your bolus has worn off?
3. If you can't do some fasting tests then try putting either your ratio and/or basal up anyway to see if that irons out the highs. I know you said you couldn't do that because there isn't much of a pettern, but unless you're going low then could you give it a go?

It's so frustrating isn't it? Really hope you get somewhere with it very soon :thumbup:
 
Thanks Pickle. I though about fasting - last resort but will have to do it I think.
No - the meals I chose were specifically easy to count and normally are ok for me - small amount of baked beans on burgen bread with an egg and grated cheese, yoghurt and a digestive biscuit - 57g carbs.
I have been brave (have real fear of lows so it's baby steps for me) so I've upped my basal tonight by 0.25 to begin with.
We'll wait and see what happens - Ohhh the excitement of it all... Not! :crazy:
 
You really need to do a fasting test to find out whether this is a basal issue or a bolus issue..

To achieve a good fasting test, need to have dinner at the normal time and ensure that you avoid high fat or slow carbs at dinner time, then miss tea... If you hungry then eat something like sugar free jelly avoid protein as even though carb free still impacts on your BG later on..

You'll also need to work out what your burn out time is for your insulin, as this could be part of the problem if you working out your bolus assuming that your bolus insulin is out of your system by 4 hours, but in fact it's lasting 5 hours then this could be upsetting your BG's later on with overloading..

Another bolus issues can be created by which bolus you'll using, if something like an extended or multi wave are these correct set or not for the different foods you are eating?
 
Hia Jopar. Yes I agree, a fasting test is what's needeed. We have a pump group meeting in the next few weeks (at least 6 of us have had pumps fitted in the last 3-6 months) and the Medtronic rep is coming to explain all these other options like multi wave etc. as none of us use these options yet. What does still puzzle me though is the different results with the same foods. thanks for the advice everyone.
 
A fasting test is a must - 3.9 tonight 2 hours after supper!!! What i also should have mentioned was that when my DSN took out the CGM sensor last week she did say 'I may be be one of those that will have strange readings - what they used to call brittle diabetes'. I didn't question her further on it because I always want to believe that I'll get there and I'll manage get basals/boluses right in the end. I have been mulling this comment over though - the worst thing she could have said to a worrier!! :thumbdown:
 
Riri said:
Thanks Pickle. I though about fasting - last resort but will have to do it I think.
No - the meals I chose were specifically easy to count and normally are ok for me - small amount of baked beans on burgen bread with an egg and grated cheese, yoghurt and a digestive biscuit - 57g carbs.
I have been brave (have real fear of lows so it's baby steps for me) so I've upped my basal tonight by 0.25 to begin with.
We'll wait and see what happens - Ohhh the excitement of it all... Not! :crazy:
Click to expand...

I've had a fear of lows for a long time too, but am glad to say I'm finally getting over this a bit now I'm on the pump. Yes do things gradually so you feel a bit more confident and in control. And I hope fasting makes things a bit clearer, but it's no fun is it?!

One other thing I wondered (and apologies if it was you I said this to previously!) but do you find hormones play havoc with your levels? You don't need to answer that here if you don't want to, but just wondered if you were in a particular part of your cycle and that may be throwing things a bit...something to consider.

Hope having the group meeting soon helps and you can compare notes with the others :)
 
My DSN has asked me to check and keep a note of dates in case this co-invites with ovulation or periods. I know that for 2 days before a period I need extra insulin but not sure about the other issue?! Also, I guess I'm of an age where I could be starting to come not the change !!! Well that's another few things into the mix to consider - not sure how I'd address the these though as I guess they would affect sugars quite randomly?
 
Riri said:
My DSN has asked me to check and keep a note of dates in case this co-invites with ovulation or periods. I know that for 2 days before a period I need extra insulin but not sure about the other issue?! Also, I guess I'm of an age where I could be starting to come not the change !!! Well that's another few things into the mix to consider - not sure how I'd address the these though as I guess they would affect sugars quite randomly?
Click to expand...

Well it's definitely worth making a note of in my experience. We're planning another pregnancy so I've been taking a long hard look at hormonal issues! Have noticed that the day I ovulate I go low, then from ovulation, my insulin needs increase by at least 10%, then drop off again when I get my period. Yes I guess things may be a bit more random for you, but I'd still keep it in mind.

Sending you lots of 'stable blood sugar' good wishes!
 
Lovely - same back and good luck with the planning :0)
 
Riri

I'm surprised that you've had to wait 6 months concerning using the different bolus's, I've got a feeling that your clinic wouldn't like me as a patient.. As part from my initial training when I got my pump 4 years ago I've done my own thing, yep my DSN was taken back a bit at my 3 month appointment, to find that I had 3 profile's set up, and using my various bolus settings :)

Hormones can impact on control, whether you'll be able to pick it up and see a pattern will be another thing, I have spent four years trying to work this one out, and no indication on control for ovulation, no indicators before I start and to a certain extent no definite reaction when I do, as most times first sign is BG drop into the boots, but there again they can go high (in my case high mean's in the 7's) so I've given up with trying to pin it down, so that I can use my pump pro-actively and just use the pump reactively during this time...

Have you got John Walsh's book 'Pumping Insulin' very good sources of information for using the pump
 
Hi Jopar - no I've not got that book - I'll have to look out for it. I sent my weekend numbers through to DSN today as she asked for them. I told her that a fasting test was probably required and then she sent me an appointment for 10 May to come and see her and fill in the forms (?) and chose a date to suit! I am a bit confused about this and went back and told her that I thought 'I would just go ahead anf do it'!! Anyway, no fight in me on a Monday so 10th of May it is :roll:
 
Hi, my daughter (34) who has down's syndrome has been on insulin pen- twice a day ( background and sometime later) for 9 months now. We haven't got any decent period of @right@ readings- ever- she's either too high 20+ or having hypos in the middle of the night. Not easy for her to understand. This week when we saw her diabetic nurse, she said there was no pattern and suggested we keep a food diary , and then poss looking at exchange routine . - Bolis? There seems to be no exact science to this- she also thought that going back on to Metformin as well might help. (been on that for 6 years as type 2- now type 1.5 what ever that is) Any advice ??????????????????? :?
 
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