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basal q

Discussion in 'Parents of Children with Type 1' started by momof2here, Mar 11, 2012.

  1. momof2here

    momof2here Approved members

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    Hi all!

    I do have a question and am hoping for some brainstorming on this.

    My problem time starts at 2:30a.m. and this is only recently. Last food was at 10:30 and duration of insulin is about 3 hours. BG was taking at 2:15a.m. and it was 91. 91 would typically be just fine to sleep as basals have been made stable using cgm info (whenever there is a change to be made, a change is made and we see it stable through the night again).

    Just recently we are seeing lows in the middle of the night. Turns out he is working out before bed. I told him to tell me when he does that and that he needs carbs for that. I believe we have come to an understanding.

    Without working out, he is strangely going low at around 2:00-2:30 a.m. Basals were already changed and lowered to his lowest all day of .50 and I started the nighttime basal rate earlier, at 10:00p.m. rather than 12:00a.m. (this change gives .60u less of insulin during those nighttime hours) YET he is still low around 2:30.

    The .50 unit per hour has been decreased and decreased - only recently it was .75 per hour, this is the lowest it has ever been. Do I just keep decreasing it?

    Without activity, is there any other reason why a basal would go so low during the middle of the night - lower than it has ever been:confused:? He had a very lazy day yesterday and did not work out before bed. I think I am having such a hard time with this because this basal has already been lowered so much and I cannot relate to such a small amount. Growth spurts require more and that makes sense, then we go back to less but this is so much less it is just puzzling me.

    So, after 'talking' this all out, I am thinking I should just reduce it and not worry about why (even though it is really itching at me!). Is that what you would do?
     
  2. emm142

    emm142 Approved members

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    In general, if I see a pattern then I adjust. It doesn't usually seem to be possible for me to find the reason behind adjustments, I'd just drive myself crazy over it.
     
  3. momof2here

    momof2here Approved members

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    lol... u are right about that... here I am, driving myself crazy!
     
  4. momof2here

    momof2here Approved members

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    Another, more specific question -

    Low occurred at 2:30a.m. - since there was food at 10:30, duration of insulin is typically 3 hours, low occurred at 4 hours and stayed stable until remedied - would you focus only on that basal? If so, what time would you make the change.

    The food that was bolused for was a guess because we were at the theatre and he had popcorn but the low has been going on for a while as I have reduced basals for the time period beginning at 10:00p.m. through the night.
     
  5. KRenee

    KRenee Approved members

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    Your situation sounds very familiar. A person can have a natural low, but I have also found that insulin lasts longer than you think - especially at night and with a larger bolus.

    For a couple of nights have no exercise and no insulin after 8pm. Find out if he still drops. If he doesn't, you know it's one of those two. If he does drop, then reduce basal starting at 11pm or even earlier.

    My dd has a natural drop between 11:30 and 2:30am. Her basal is at .025 from 8pm until 2am. Even at the lowest basal rate she still drops 80 points. She needs to eat carbs before bed just to cover the low.

    I hope that helps. This is the hardest thing we have ever had to deal with mainly because it's at night and one or both of us end up not sleeping well because of all the testing and correcting going on.
     
  6. Flutterby

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    Depending on how hard he's working out it can affect him up to 24 hours. The more work out the more the muscles use up. I would change the basal BEFORE that basal and see how that works.
     
  7. Helenmomofsporty13yearold

    Helenmomofsporty13yearold Approved members

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    Just adding another point to consider in this mix...our endo said movie theatre popcorn can take 6 hours to show up in the blood. It has an insane amount of carbs, fat and fibre.
     
  8. dzirbel

    dzirbel Approved members

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    Our endo said the same and recommended a combo or even extended bolus for this. Partly due to the "grazing" most people do when eating popcorn and the fact that it takes awhile to digest (because of the fat etc) so now you have all that insulin up front that can throw you into a low. Although this doesn't explain the consistent nighttime lows.
     

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