So confused regarding highs in the night

[liasmommy2000]

We have Lia's basals really turned up between 10pm-3am and it's STILL not enough it seems. Yet she drops significantly after that. She keeps waking up high and needing a correction.

It doesn't seem to matter what she eats for dinner or what she is at bedtime, but she rises during that time period. I've already got her basal way high during that time, I guess I'll be raising it and lowering the early morning basal yet again.

This doesn't make sense, it doesn't sound like the dawn phenomenon and I don't think it's slow absorbing high fat foods as it happens no matter what she eats.

Any input?

[Lee]

I have been struggling with the same thing for about a week...at 8pm, she goes low if I try to adjust her evening basal...but by 11:00, she is through the roof...then I correct, and at 3, she is low...I was just thinking how we are never going to get this right! So, I would like the same advice please!

[frizzyrazzy]

Laurie EXACTLY same thing going on here. I was just going to ask about it because it's so weird. We have this super high basal from 9pm till 1am and then I have to cut it way back because by 3am he's dropping fast but then I have to raise it because he wakes up high otherwise. Its so messed up but then I have a night like last night where he woke up absolutely perfect 114 and then his breakfast bolus ends up being too high and 1hour after breakfast he was going too low - so much for my trouble with breakfast spikes.

So I was actually thinking that maybe I need the higher basal earlier in the evening. I was just thumbing through the newest pumping insulin and now he's saying to raise/lower the basal times 4-8 hours earlier than needed. I found that a bit odd, but maybe that's what we both need??

[Amy C.]

I would do a couple of basal tests during the night to see if that is the problem.

Start the test 4 hours after the last food and bolus. The test can continue only if the fist sugar reading is between 100 and 150. If it isn't, the last bolus was wrong.

Test every hour for the next four hours. If she drops below 80 or rises to above 200, stop the test and treat.

If she goes low, go back 2 hours and lower the basal .1. If she is high, raise .1.

Repeat the test a couple days later using the other half of the night.

[Mom2Madi]

I was just thumbing through the newest pumping insulin and now he's saying to raise/lower the basal times 4-8 hours earlier than needed.

You know...our new endo is having me do that and I didn't understand at all why. My daughter was having highs in the early morning so she suggested I started a basal from 4pm till 11pm that was her highest of all. Then from 11pm till 4am to lower it. She set us up with blocks of about 4 or 5 hours with the same basal - one would be high - but piggy backed with a lower one after. It worked for awhile but then the highs crept back. It's an interesting concept though....but front loading insulin just didn't seem right to me. I'll have to get out my Pumping Insulin to see what the reasoning for it is.

[Lee]

Our endo had us raise the 8pm basal and she was dropping like a ton of bricks, then going high...

So, I am going to try a 9:30 basal that is .05 higher than her 8:30 and see where we end up at midnight...I swear, if I could get that midnight # to be accurate, I think we are there....

[Heather(CA)]

I would do a couple of basal tests during the night to see if that is the problem.

Start the test 4 hours after the last food and bolus. The test can continue only if the fist sugar reading is between 100 and 150. If it isn't, the last bolus was wrong.

Test every hour for the next four hours. If she drops below 80 or rises to above 200, stop the test and treat.

If she goes low, go back 2 hours and lower the basal .1. If she is high, raise .1.

Repeat the test a couple days later using the other half of the night.

I like Amy's idea, you might find that he's dropping, then going high, so it might be that the insulin needs to be lowered instead of raised...

[kel4han]

We have this same problem only SOME nights!!:confused: Usually half the nights will be perfect then a few nights you will just start to think you need a basal adjustment and then the next night is perfect! I am VERY sure it is not food related. So frustrating!

[Isabelle's Mom]

We have the same thing going on, but it has gotten MUCH better since we moved her evening basal down to her regular daytime rate (0.2 U/hr), and increased her dinnertime bolus, which we ALWAYS do a dual wave on. It usually works. And, if she's in range at midnight, then she's usually fine for the rest of the night.
Maybe worth a try?

[liasmommy2000]

Thanks. I've made some changes and we'll see how it goes. But if it doesn't work I will likely be doing as Amy says and testing the basals this weekend. REALLY do not want to have to do that as the many tests we were doing at night during the pump start totally wreaked havoc with Lia's sleep patterns and we've just gotten her sleeping without waking numerous times (except when high/low lol) again in the last three weeks. She's a light sleeper and on ADHD medications. *sob*

[Mama Belle]

From what I have heard it is pretty common for kids to need a lot more insulin in the middle of the night (around the midnight hour). My daughter has the highest level of insulin needs between roughly 10 pm and 3 am. For reference her basal is set between .35 and .75 during daytime hours. At 8 pm she increases to 1.05 and by 10pm she is at 1.35. We have a small drop at 1 am but by 3 am she drops all the way back down to .45.