Insulin pump Nighttime Highs

[Thomasriggins86]

Hi Guys

I've been on the pump for a few years now and I had amazing success with it for the most part but I've noticed that during the hours of midnight and 3am my sugars start to climb dramatically and no matter what settings I change on my pump I've still to correct this

Has anyone else out there experienced this issue ?

Many thanks

 

[searley]

I did with the tandem, the trouble is the lack of activity means the basal rate needed to be much higher for the time period

I’ve since moved to the Medtronic pump and that does a much better job

 

[Thomasriggins86]

Hi Guys

I've been on the pump for a few years now and I had amazing success with it for the most part but I've noticed that during the hours of midnight and 3am my sugars start to climb dramatically and no matter what settings I change on my pump I've still to correct this
My Diabetes clinician seems to think it's related to a type of Dawn phenomenon when your body is flooded with hormones

Has anyone else out there experienced this issue ?

Has anyone fixed this issue?



Many thanks for any advice

(Mod note/edit - this post has slightly more info and has been moved from duplicate thread)

 

[Thomasriggins86]

Hi
Thanks for posting so fast

I'm on the medtronic 780g currently
At midnight I take 1.20 units and at 2am I take 1.30 to try and combat the 3am rise
But so far no luck
The only setting I've not tried is the insulin sensitivity factor but don't know enough about that setting yet to start messing around with it

Thanks again

 

[searley]

Are you not on smart guard mine just keeps correcting and keeps it there

The basal is what needs adjusting I actually needed 6u an hour where my daytime is only about 1.2u

 

[Thomasriggins86]

No smart guard yet
Clinic wasn't able to get the funding for it
Been dying for the closed loop system for years

 

[searley]

No smart guard yet
Clinic wasn't able to get the funding for it
Been dying for the closed loop system for years

It’s that that really helps me.. but as I say basal rate is what you need to play with higher basal means more insulin so you just need to find how much you need to help keep control

 

[Thomasriggins86]

Yea
That's the setting that I keep coming back to just wish the settings weren't so trial and error

Thanks for the help

 

[searley]

Yea
That's the setting that I keep coming back to just wish the settings weren't so trial and error

Thanks for the help

Without smartguard that’s exactly what it is.. and to make things worse needs continuously change

 

[Nicola M]

You’ve received some great advice and I would agree it’s just trial and error with your settings. SmartGuard does wonders and it’s amazing how pre-smartgaurd my Basal was 15.5U per day and now I’m on between 22-25U per day clearly I was never on enough!

 

[Thomasriggins86]

Yea it can be frustrating with the trial and error
It feels strange when you have to take so much basal during the day
I keep thinking I should be taking less not more

 

[searley]

Yea it can be frustrating with the trial and error
It feels strange when you have to take so much basal during the day
I keep thinking I should be taking less not more

now this is where it gets a little more complicated.. some of your basal your are taking, may not actually be basal as such, it may be compensation for bad boluses.. I think on a pump its more important to see what the total daily dose is

even on smart guard, some of the correction doses are done by increased basal and some with micro boluses, so total daily dose is the only real way to monitor things.. either way its a little irrelevant.. if you need more insulin at a time of day for better control.. this you just need it

 

[Thomasriggins86]

now this is where it gets a little more complicated.. some of your basal your are taking, may not actually be basal as such, it may be compensation for bad boluses.. I think on a pump its more important to see what the total daily dose is

even on smart guard, some of the correction doses are done by increased basal and some with micro boluses, so total daily dose is the only real way to monitor things.. either way its a little irrelevant.. if you need more insulin at a time of day for better control.. this you just need it

True enough
Fingers crossed I'll be on smartguard soon

 

[Melgar]

You have had some great replies @Thomasriggins86 I’m not on insulin so I am no help at all on your question, but I can offer a reason for your raised sugars around 3am, albeit a simplified one. Our bodies run on a circadian rhythm system, the master clock in our hypothalamus and all the periphery clocks in our pancreas, liver and skeletal muscle cells. These clocks orchestrate the gearing up for daytime activity, moving, eating etc by releasing cortisol and growth hormones. Both are associated with an increase in blood sugar. It is a natural bodily phenomenon. Obviously you being on a pump it’s a thing you need to deal with.

 

[Thomasriggins86]

You have had some great replies @Thomasriggins86 I’m not on insulin so I am no help at all on your question, but I can offer a reason for your raised sugars around 3am, albeit a simplified one. Our bodies run on a circadian rhythm system, the master clock in our hypothalamus and all the periphery clocks in our pancreas, liver and skeletal muscle cells. These clocks orchestrate the gearing up for daytime activity, moving, eating etc by releasing cortisol and growth hormones. Both are associated with an increase in blood sugar. It is a natural bodily phenomenon. Obviously you being on a pump it’s a thing you need to deal with.

Thanks Melgar
My Dr has also mentioned this issue but it was always hard to prove

 

[Thomasriggins86]

Hi guys just wanted to give you a quick update
After talking with the diabetes educators we realised that my units per hour rate was too low during the night .
Once that was adjusted my Highs during the night have all but disappeared

Just wanted to say a big thank you to all of you that took the time to help me out and point me in the right direction