Highs at night question?

[kjksmom]

My son's numbers are great during the day, through dinner. His target is 120, and we bolus to that. For the last week, he's been eating dinner later, so instead of testing at bedtime (too close) we check him before going to bed. Six out of the past seven nights, he's been 250 or more! We do ketones, check the line, etc. etc. and do a correction. Several hours later, he's still over 200, and we go through it all again. Could it be his basal rate ineeds to be increased at night? We're somewhat new at this (09/06) and I hate the answer "sometimes you never know why his numbers did that. Any thoughts would be appreciated.

[wendyc]

Does he have a bedtime snack? It could be that his I:C ratio needs to be upped. I would try that first. Or since he's having dinner later, then try upping his I:C for dinner. If that doesn't help, then definitely up the basal (small amount) see how it goes for at least 3 days. If it doesn't improve up it again, give it at least 3 days for his body to adjust.

OT- We're coming your way Sat:) We go to Brewster every summer.

[Mama Belle]

Holy moly, do my daughter's insulin needs ever increase at night. Just to give you an idea ... currently at the mid-day to late afternoon time frame her basal rate is .60, at 10 pm she is over 1.10 and from midnight to 3 am she is 1.20. So in the midnight time frame her basal rate is double what it is in the middle of the day. If it were me, I would first try upping the basal rate starting a couple of hours before you see the high BG. If that doesn't work or throws off his numbers, go back to the old basal and try a different I:C ratio.

[Heather(CA)]

If your testing 3 hours after dinner shot, w/o a snack and he's still high...Sounds like he needs more fastacting at dinner. Seth gets more fastacting at dinner then the rest of the day...Of coarse YDMV;)

If he's getting an uncovered snack at bedtime, that could be the problem...

Once he's good 3 hours after dinner bolus, you will be able to tell if he needs more basil by whether he goes up or down from there...

Sooo, if he's not getting an uncovered snack, try upping the I:c carb ratio at dinner:)

Hope his helps...NICE job through out the day:D

[kjksmom]

Thanks for the feedback. Of course, last night was the same with a late dinner, then he was 92 at 11:30, instead of 250+. And this morning he was 192. So while yesterday I thought it was the I:C ratio, today I'm thinking basal. Oh well, he leaves for Joslin Camp on Sunday, so we'll be regrouping when he returns.

[tuckerk]

This website is a God-send. I was having the same concerns. My thoughts were that the basal needed to be adjusted.
However, I have noticed that if Caitlin's BS is around 200 or less, I can only give 1/2 carb at bedtime so that her morning BS is not off the charts.

I am still learning how to adjust her diet and snacks.

[jdr]

Based on his numbers at 11:30, and the next morning,I would say that his basal rate should be increased for sure during that time.

[kel4han]

I would say try the basal increase 2hours before the sleeping highs. We call this the falling asleep high in our house. As soon as sleep sets in, we used to have to do a correction. We worked the 2 hour before basal to get the sleeping highs. Try testing this with a low fat dinner to be sure its not the ratio:p