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Big jump in the midnight hours

Discussion in 'Parents of Children with Type 1' started by simom, Jan 20, 2009.

  1. simom

    simom Approved members

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    My son is pumping. We are seeing a big jump (150 points or more) in the hours between 10 pm and midnight. So - when we do his post supper/parent bedtime check, he'll have a nice in-range number with some insulin on board. Check him at midnight and he's way up. Correct him, and he's down in range before wake-up. (Example - last night, 180 at 10 pm, 3 hours post bolus, 360 at midnight, corrected - he was down to 240 within an hour, and then he woke up at 120)

    He did this for a few weeks before Christmas, although he was a bit high at our bedtime check. We changed his sensitivity because it seemed like the corrections were ineffective. I now think that he was having this jump, and that's why the corrections didn't seem to work (because later corrections were more effective, and we even knocked him into the bottom of his range a few times). Then, he had some nice steady night time numbers, and even some later-night lows - so we didn't change the basal then.

    We are gradually upping the basal in te 10-12 time-frame, but I am concerned that when he stops having this jump, we're setting ourselves up for a nasty middle of the night low.
    I do not think the jump is diet related, as we are seeing it consistently without regard to his dinner.
    I would welcome some thoughts.
    Thanks!
     
  2. Gwyn

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    We see these kinds of jumps every so often with our DD. They last a week or so and then are gone. I usually attribute it to growth spurt and give a pre-emptive bolus once we see her inching up after to 10 pm hour and then check to make sure things are back in range at midnight.

    Sometimes though, especially if it's a once of twice a week thing, it can be due to a "sneaky snack" which is more easily dealt with if you can find out what the snack was before you give the extra insulin.
     
  3. jcanolson

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    I often find that when I up one basal rate I need to lower the following basal rate especially if I've seen a big dip after the high.

    Good luck!! Trying to get the overnight figured out AGAIN here also.
     
  4. wilf

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    How old is he? Our DD has the same late evening spike, and it seems to be puberty-related (growth or development hormones). We are giving extra insulin to cover those times. You'll need to up the basal and then just have to make a point of measuring nights at 11 pm or midnight, so you won't have any surprises..
     
  5. sarahconnormom

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    Connor spikes badly from 10-midnight. His highest basals are from 10pm-1am and they are double what most of his daytime basals are.
     
  6. mmgirls

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    I think I have the same thing going on here. S far I have just been correcting, but if I can I am going to do some extra testing tonight since we had an earlier dinner and bedtime snack and food and IOB will not be as active in those late hours. I thought at first it was rebounding, but a I am pretty sure it is not. She already has higher basals for this time and I am with you in the fear that you will finally make the increase and then see lows.

    I have to get past that fear of making big changes and not take so long.
     
  7. wilf

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    The key to managing the D is to adapt as quickly as reasonably possible to excursions in BG, either high or low. We correct with every meal-time bolus injection, correct any high over 200, we will increase or decrease basal by 2 units (10%) per day if she's stuck high or low.
     
  8. StillMamamia

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    AMEN to this Wilf!
    I finally got over this fear as well...and, in the process, realized that the reason my son did have 3 ketone episodes so easily in the past may partly (if not greatly) have been because we were afraid to make changes quickly enough. I am convinced of that now. (I only speak for us, not implying that this is anyone else's case).


    Sorry for the highjack
     
  9. MelissaC

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    Avery's basals during the day are set at .25 - she jumps all the way up to .70 from 9pm - 12am and then drastically back down to .25 by 2am... Crazy huih? And she has ALWAYS been this way - it seems like as soon as she falls alseep those hormones start ragin'

    Dont be afraid to up those basals just be prepared to check check check...
     
  10. simom

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    Thanks!

    I must have left my signature off - my son is 4, and I do believe he is growing- those pant legs seem to be magically shorter. Glad to hear that this is not an uncommon experience. Sounds like my "gut" to just up the basal and then watch for lows is the way to go. We've been having some luck with daytime numbers, so if we could iron this out, we might make some overall progress!
    Thanks for your help, all!

    Barb
    Mom to:
    Ellen 6, non-D
    Simon 4 diagnosed 11/07, purple minimed with crayon skin
    Aurora 1, non-D
     
  11. Isabelle's Mom

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    DD has been doing the same thing. I have to give her a full unit when she falls asleep, regardless of her dinner or it's timing. It usually does the trick. Funny thing is, when she takes an afternoon nap, I don't see the rise AT ALL. Our endo agrees with me that it is growth hormones. If it's the same for you, take note of his napping and see if that has any effect!
     
  12. annaluvspink

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    We've been dealing with this since October. At first I had every excuse in the world: sickness, fatty foods, etc.. Then I figured nothing was working, not even correcting in the middle of the night. Finally increased basal by 1/2 unit every 3 days until --voila!...she's in range again! She did start having 2 lows a day after a bout with diarrhea--the lows lasted about a week or so, we backed down a little on the basal and things were great. Now, we have a head cold and I think she's growing again. More highs at night, ugh! So, increased the basal again and adjusted some of the I/C ratios. Just love playing this game...not!

    Michelle
    DD Annabelle-6 dx'd 3/29/07
     

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