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Overnight trouble-basal v. correction factor

Discussion in 'Parents of Children with Type 1' started by Lorraine, Oct 27, 2007.

  1. Lorraine

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    I recently posted a thread seeking help with overnight basals. I was experiencing significant difficulty with Caleb's BGs bt 8 and midnight. He would experience significant highs, I would correct, but they would sustain. I would gradually bump up his basals, finally get good numbers and then have a series of nights of lows. And then the cycle would start all over again.

    I had started to attribute the problem to growth hormone making his BGs unpredictable. However, I have concluded that the issue was less his basal than I thought. Since I have changed his correction factor during this period, the "swings" are less dramatic. This is still the most difficult period of the day for me, but it it far better since I adjusted the correction factor.

    I had thought that since his correction factor worked perfectly during the day, the fact that a slightly different one wasn't working at night was because his basals were terrible off, so I would erroneously increase the basals which eventually resulted in the lows. I'm also always nervous about making increases at night bc he does not wake up to lows - the thought of increasing his CF during this time by so much was a little terrifying. But when I finally took the plunge and made a big change in the CF, it worked.

    His day CF is 250. His CF for this nighttime period is 155 (I had been using 200 - 220 during this time which wasn't enough). His basal needs for this night time period are also the most significant.

    So although growth hormone likely results in variation in BGs during this period, that was not the whole story.

    I just wanted to share for anyone else who might have a similar situation. It seems pretty obvious to me now that the correction factor should be significantly different during periods of significantly different basals, so perhaps it's obvious to everyone else, but I just wasn't getting that at the time.
     
  2. Boo

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    Good points Lorraine! My son's correction factor actually goes down at night, but that just goes to show that, as the philosopher Badshoe says, YDMV.

    Another thing to consider is that if your child eats a bedtime snack, the insulin to carb ratio during that time might need to be changed.

    Always so much for us to consider!! :rolleyes:
     
  3. Ivan's Mum

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    So far we have 3 different correction factors. The morning one (1:8) the lunch one (1:15) and the bed time (1:4) and I suspect we will have many more as this journey continues.

    Then of course the wind might change direction or he might get out of bed on the wrong side and I'm stumped.
     
  4. Norajane

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    Hmmm. Interesting. We might have to do this as well. We are having similiar problems. I'll keep it in mind when making changes. Thank you.
     
  5. Boo

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    I'm confused...those seem more like I/C ratios than correction factors. My son's correction factors are 35 during the day, and 65 at night (meaning that, when he is high, 1 unit of insulin brings him down about 35 points...or 65 at night). Are we perhaps talking about two different things?
     
  6. kiwikid

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    Rachels correction factors are 1:9 (162) during the day, and 1:7 (126) during the evening. I have to be very accurate with the evening meal, because if she gets even slightly high then its really hard to get her back into range. We don't have the same problem during the day.
     
  7. nebby3

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    That's interesting. Thanks for sharing. We have had similar nighttime patterns but it never occurred to me to change the correction factor for that time of day (though we do have a different one for breakfast time). I noticed that 2 people from New Zealand expressed their correction factors in a different way--numbers like 1:8 instead of 1:150. Can you explain how you calculate that?
     
  8. kiwikid

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    Hi Roberta,
    In NZ, Australia, Canada and the UK (I don't know about Europe?) we use a system based on mmol/l rather than mg/dl. The difference is obtained by multiplying or dividing by 18 :cwds:
     
  9. AJsmom

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    Thanks for reminding me of this! We have been on the same correction rate for a while. AJ has been waking up high all week...he's adjusted his 4 a.m. basal, but that hasn't helped...waking up in the 300's!! I'll have him change his night time correction and see what happens. Even after 13 years of diabetes and 6 years on the pump it's great to be reminded!
    Thanks for sharing!
     

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