hyperglycemia when going to bed

Cenynpedr

Member
Messages
12
Hi there, my 4 year old daughter was diagnosed 2 weeks ago with type 1. She's on pump and is doing brilliantly. We've managed to stabilise her blood glucose (BG), but are having one problem area that is really puzzling us.

BG are all between 4.5 and 6 all day, except when she goes to bed, where they start creaping up from about 8pm, untill they are around 18-20mmol by 10pm.

I've tried to look at all the variables, but I just can't thing of why she has such a dramatic spike.
*Her BG is normal when she goes to sleep, I've checked it at regular (30 mins to 1 hour intervals) before and after bedtime to check that she's not going hypo and having a rebound. Everything is ok.
*pump was disconnected for a bath on first 2 occasions, so we didn't give her a bath last night - and it still did it.
*her hands have been washed before bed so there's no glucose on her fingers.
*her last bolus is at between 5 and 6 pm, so worn off or diminished by bedtime.
*I double checked her meter readings on different fingers -same result. Also checked the meter on my blood - reading was fine.
*once I've given her a bolus at 10pm, her sugars come down beautifully and then remain stable all night - 4.5-5 mmol on waking every day.
*her basal is at 0.175units/hour during the day, then increased to 0.225 from 20.30 until morning.

I will increase her basal for the period between 20.30 and 10.30 tonight, but I'm confused as to why her sugars rise so much during this period. I know of the dawn phenomenon and nocturnal hyperglycemia, but this is new to me.

Any suggestions please??

Thank you all for reading and helping out!

Elinor
 

Riri

Well-Known Member
Messages
1,174
Type of diabetes
Type 1
Treatment type
Pump
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The conservative party, people who are cruel to animals and aggressive people
Just to let you know that this is the time I am still struggling with Elinor. Had a pump fitted last November and the 11pm until 2pm is still an issue and my DSN are still increasing it gradually (they don't wand hypo situations starting again during the night so it's a bit of a slow process). I jump from a basal of 0.60 to 0.9 at 9pm onwards .....so we're getting there. I've no idea why this is though - I suffered from the dawn phenomen and also middle of the night hypos but I must admit on injections I didn't notice this so much - maybe that was the time that my long term insulin used to peak?

One thing I would say if they start creeping up at 8pm my DSN tells me that the basal needs to be reflected about 2 hours earlier so maybe the increased basal rate needs to start earlier - you could try 7pm and see if that makes a difference.
 

Cenynpedr

Member
Messages
12
Thanks Riri, I've changed the pump to start the higher basal from 19.30 as suggested. Cross fingers I'll see a difference.
 

Riri

Well-Known Member
Messages
1,174
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
The conservative party, people who are cruel to animals and aggressive people
Hope you let us know how you get on :D
 
Messages
8
I had problems with hyperglycemia at bed time when I first went on my pump. It would depend on what I had eaten, and I soon discovered that if I took a longer acting carb meal than adjusting the dual bolus on the pump bought it down a bit. My hypo dog alerts me when my BG is over 14 or below 4 so I dont worry too much as he will wake me in the night and I can take a bolus if I need to (which is not too often now) I am sure that adjusting it little by little you will get it right. Good luck.

:)
 

Cenynpedr

Member
Messages
12
Well I tweaked her basal from 19.30 to 22.00 hrs and got it working perfectly, until she went to bed a bit later and ended up hypo, with a massive spike later on!

It appears that I'll have to either set a temporary basal whenever she goes to bed, or do a combo bolus. What an awkward time of day to have a glucose surge!

Re:your hypo dog diabeticwithdog, we're getting a dog for her (she's earning doggy points for every jab!), and I've been wondering if I could train it up to detect hypos (I've trained lots of sheep dogs, so figure I could give this a go). Was there a particular method of how they went about teaching the dog? And, other than labradors, can other breeds work well (was thinking of getting a spaniel crossed with a poodle to avoid the shedding and for ease of training, but might go for a labradoodle now instead). Sorry to bombard you with questions, just can't believe my luck that I found someone with a hypo dog to speak to!
 

SophiaW

Well-Known Member
Messages
1,015
Type of diabetes
Type 1
Treatment type
Pump
Regarding the hypo dogs, no specific breed can or can't be a hypo dog. Any breed of dog, provided it has the talent, can be trained to detect hypos. Equally, any breed of dog may turn out to be unsuccessful, the talent lies with the individual dog and not the breed of dog. However having said that I suspect some breeds may be more successful than others, but the breed doesn't guarantee success. I'd also like to say that don't be fooled into thinking a poodle cross anything will not shed, some of them may not shed but some can. Someone I know has a labrador cross poodle (labradoodle) and it sheds plenty. Don't get a dog because you want it to be a hypo dog, unless your daughter needs an assistance dog, then get one through the charity that is already trained and comes with proven success. If you want a pet anyway, and it would be a bonus to have it detect hypos then that's fine but be aware that whatever dog you get it may not have the talent to do the work so don't be disappointed if it turns out that way.

:D