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Type 1 Diabetes
Tresiba, Dawn Phenomenon, Split Dosing
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<blockquote data-quote="kitedoc" data-source="post: 1802350" data-attributes="member: 468714"><p>Wow Mel. That is awesome control ! I wonder whether on the not so good occasions your BSL just dips a tad too low, as in the second BSL graph example and the response includes a larger cortisol response at 4 am which might explain the increased BSL and perceived resistance compared to the 'better' days along with the lack of that small correction dose. ? But yes, the tyranny of the 4 am or so dose cannot be fun. The waking up may be the effect of the cortisol rise. But waking up itself is a stress of sorts too.</p><p>With an insulin pump it may be possible to 'sculpt' the basal rates to deal with the 4 am rise and stabilise that time of the day saving you having to wake up to give the correction dose. Only a trial would tell, I think. So much of these up and downs are like being in a boat. If nothing rocks the boat too much things stay even and steady but a little bit too much rocking sets up a momentum which takes a long time to dampen. But staying exactly in the middle of the boat has its limitations too. Making the most of it and continually learning the ropes to pull and tweak to settle the momentum is the trick. Repeat times 3 miliion and more !! Best Wishes. If the boat metaphor sounds ideal, the kite one is a potential nightmare. That is me after 51 years and on a pump !!</p></blockquote><p></p>
[QUOTE="kitedoc, post: 1802350, member: 468714"] Wow Mel. That is awesome control ! I wonder whether on the not so good occasions your BSL just dips a tad too low, as in the second BSL graph example and the response includes a larger cortisol response at 4 am which might explain the increased BSL and perceived resistance compared to the 'better' days along with the lack of that small correction dose. ? But yes, the tyranny of the 4 am or so dose cannot be fun. The waking up may be the effect of the cortisol rise. But waking up itself is a stress of sorts too. With an insulin pump it may be possible to 'sculpt' the basal rates to deal with the 4 am rise and stabilise that time of the day saving you having to wake up to give the correction dose. Only a trial would tell, I think. So much of these up and downs are like being in a boat. If nothing rocks the boat too much things stay even and steady but a little bit too much rocking sets up a momentum which takes a long time to dampen. But staying exactly in the middle of the boat has its limitations too. Making the most of it and continually learning the ropes to pull and tweak to settle the momentum is the trick. Repeat times 3 miliion and more !! Best Wishes. If the boat metaphor sounds ideal, the kite one is a potential nightmare. That is me after 51 years and on a pump !! [/QUOTE]
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