October 16, 2000
Daily Care, Insulin Pumps
Question from LaGrange Park, Illinois, USA:
My 10 year old son has had diabetes for a year. Five days ago, we started the insulin pump, and his levels have never been better. However, twice at 3:00 am, he has had readings in the 300’s mg/dl [16.7 mmol/L]. At 8:30 pm the night before, he had a snack and bolused to cover it. He was 86 mg/dl [4.8 mmol/L] before his snack. Two and one-half hours after his snack he was 130 mg/dl [7.2 mmol/L], yet at 3:00 am, he was 300 mg/dl [16.7 mmol/L]. He was given 1 unit of Humalog which usually lowers his levels 200 points, but, at 4:30 am, he was still 245 mg/dl [13.6 mmol/L]. What would explain these high readings early in the night and not responding to insulin as he normally does?
Answer:
Five days on an insulin pump is too short to really make a good comment. Perhaps, he was low earlier during the night and then had rebound hyperglycemia. If the level is headed up, then a bit of Humalog might not bring it right back down.
We frequently need to adjust the basal rate during the night, early morning and evening. Check with your diabetes team to see if this might need to be done and, keep up the good work.
LD
