Saturday, May 12, 2012

weekend basal tinkering, etc.

I've always known that the differences in my weekend sleep schedule should warrant some sort of change to my basal insulin routine, but I never had results that were consistent enough to really work off of. I'm starting to see what I can do differently.

Normally I get up at 5am. In order to counteract dawn phenomenon I have my basal higher by .3 units (approximately) from 2am to 6am. I've been finding that on the weekends if I sleep past 5am, (which I always hope will happen) my blood sugar starts to drop because the DP hasn't gotten rolling as usual, so I'm heading low by 6am.

This AM, for example, I woke up at 5:49AM with an alarm from my CGMS saying that I was 70 mg/dl, but I was really 52 mg/dl. I'm thinking that my solution may be pushing everything forward about 2 hours and seeing if that fixes it. Sleep two hours later, correct DP two hours later? I'll try it tomorrow. (The good news: dropping very slowly and scraping the 50s didn't cause me to have a rebound day.)

Other basal musings:
 Also, I think I've become more sensitive to insulin, so I may need to reduce my nighttime  basal overall. I've been waking up at the low end of my target range during the past week or so.

I have to say, I sleep really well when I'm in the 70-80 range, when it's stable. Probably because that's close to standard fasting BG for non-diabetics.
This graph looks so organic and biological, and my basal rate looks clumsy and geometric in comparison...

Ever since I saw this graph in Think Like a Pancreas, I have wanted to see if I could get as close as possible to the natural basal rate that is observed in human biology. It's fascinating to see that everyone basically has the same rhythms taking place in their system, based on age and time of day. It doesn't seem as much like a guess anymore when you see this average graph. My standard basal rate is fairly close to the dark square plot right now, and it's working for me.

One more thing... it's taken me a couple years to figure out all the features in my pump and CGMS. One of the things I started to use recently is the "silence alerts" feature when I'm sleeping. The alerts that I don't care as much about are the high alerts. If my BG is highish overnight, I normally have already taken the correction and am just waiting for it to take effect. I don't need to be reminded hourly that I'm still out of range. My "high" limit is set fairly low, so it can be annoying to have it tell you when you near or cross the 150 mg/dl line. I have hovered at 150 for hours before and gotten alarms constantly.  With "silence alerts" you can silence only the lows or only the highs, or all of the alarms. I find that silencing the "highs" for 7 hours during sleep allows me to only be awakened if I'm having an unexpected low. Carol has appreciated the reduced disruptions to her sleep as well. Even when the pump only vibrates, she is aware of it. Little tweaks like this can offer surprising improvements to your quality of life.

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