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Night time insulin resistance

D

Drahcir

Newbie
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2
I would be interested to know if others share this problem and if they have any solutions. Commonly when I go to bed my bg is 10 or even higher, but the pump (Medtronic) reading says that I have sufficient remaining active insulin to bring it down to my target of 5.5 so there is no need for a correction bolus. . However in the morning my bg has not gone down to anywhere near my target. It may be almost the same in the morning as it was when I went to bed! The active insulin seems to have done nothing. I have tested my basal overnight
and it keeps me pretty stable.
 
Must be down to settings on pump. Not on medtronic but, on the combo you have to enter how much 1 unit will drop you. If your pump thinks 1 unit will drop you by five but in reality 1 unit drops you by 2 it will give you wrong advice.

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Apologies, after re reading this , if your waking up what you went to bed on thats perfect. Might be your evening qa dose needs looking at as to have a better before bed reading.

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Hi, you need to test your BG at 3am or when your pump says you have no active insulin left. Adjust or set a new nightime Basal a little higher that will keep you within the range so that your morning BG reading is around 7. It may take a few nights to adjust it, but it does sound like your overnight Basal rate is too low.



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Hi I had the same problem. I also use Medtronic. I had to increase my basal in the night. No idea why my basal rate in the night is now almost the double than in the day (I would not consider this dawn effect as I had to increase between midnight and 4am). I managed to correct easily my basal using a CGM.
Another important point to consider, in my opinion, is how much you have eaten and how slow your digestion is. The Medtronic may well think you have right insulin based on your reading but it is not considering that you still have carbs to be absorbed. This happens to me from time to time when I eat some foods. Hope I have not confused you further.


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Thank you for these thoughts. Last night was a good example. Bed time bg was 11.5. Pump showed small correction of 0.5 needed, but in fact I gave myself an extra unit on top of this. This morning my bg is still 11. The active insulin from the evening meal and an extra unit and a half have dropped me just 0.5 mol.

My HbA1c stubbornly refuses to come down below 8.3 and once again breakfast is off until my bg comes down.
 
Hi Drahcir,
Could you give us a bit more information. Have you done a fasting test were you have missed your evening meal and tested throughout the evening? If you have what were your levels? If they were high and then rising your basal needs adjusting. If they were high but stayed the same maybe try doing a fasting test were you have breakfast but skip lunch and test through to evening meal? If all your basal settings are fine then lets look at your bolus. Some people require different ratios of carbs to insulin throughout the day, I have three and if I don't stick to them it really mucks me up. Also what type of thing were you eating how many carbs how much fat, fibre, protein. These can all have an effect on how long your bg will spike up after you've eaten. It may be that you need to use extended or multi wave bolus functions. When did you bolus in relation to when you ate your food? Before, when you ate your food or after you had finished? All of these factors can have an impact on your bg levels.
Also just thought that sometimes with different carb ratios some people need to adjust their correction dose ratio depending on the type of day as well. This is something I do except I have problems in the morning(dawn phenomena) not the evening, It can also be more pronounced during the time of the month as well or stress.
Laura
 
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