Overnight basals need to be fixed first. When you’re on an insulin pump, that gets drilled into your head as you work with your healthcare team to get your blood sugars tightened up. If you don’t get them straightened out, the rest of your day is shot. I’m proof of that.
The basal rate that you start with changes over time (I’ve been pumping since 1999, so that’s pretty much a guarantee that it’s not the same.). If your weight fluctuates, if you’re chronically stressed, if your activity level increases or decreases, you can find yourself crashing or soaring repeatedly. Not having a solid and stable basal pattern saps the energy out of you and no amount of caffeine is going to make you feel alert. Again, I’m proof of that.
My overnight basals have been off for a while, but it took my Dexcom to show me where I was off - and it wasn’t what I thought.
Without my Dexcom on, my 2am BG reading was within normal range but my 7am was in the 200s or the 300s. I was convinced that I was Dawn Phenomena-ing it (That rise in hormones, including cortisol and epinephrine, that causes insulin resistance.). I would wake with fuzzy head (which matches fuzzy hair and fuzzy slippers, so it’s a complete ensemble) and correction bolus nudge myself downward to an afternoon and evening of relatively normal blood sugars.
But it wasn’t Dawn Phenomenon. Dex showed me that around 3 to 4am, I was slowly creeping down to the 60s and 50s and staying there for a while until my liver pumped out the sweet goodness that it offers, shooting my blood sugar up just in time for me to curse the alarm (or even worse, my daughter) for waking me up in a groggy state.
I’ve adjusted my basals and changed my Dex notification to “HEY GET UP! GET UP!”. I’ve worked with a CDE and we’ve adjusted them yet again.
Here’s the story now:
One rate is too low, keeping me at 150 to 170 most of the night. Yes, no low blood sugars, but in the long term, not acceptable. If I adjust it 0.025 units/hour during the time I need it, I crash at least once per night. Also not acceptable. I’m exhausted and running out of Glucolift tabs.
Never “just right”.
I think I’d rather sit on a tuffet. Or scrub seven little pairs of socks.
And I’m more of a Cream of Wheat girl than porridge.
These basals will get straightened out eventually, but when you’re in the middle of the fairy tale and you can’t skip ahead to the “Happily Ever After” part (Although I don’t think Goldilocks has one of those.), it’s frustrating. Why? Because I know once I get this overnight basal to work, my body’s insulin needs will change. Again.