Gosh, Harold!
Any other BIG news?
Not yet. More Braxton Hicks. She’s getting closer. Week 40 started today.
Does he often peak in the middle of the night?
Just depends on the night, the wane of the Moon, ocean tides and possibly stock market performance…
(Yes, but no pattern so never easy making adjustments. Growth hormone is a ***ch.). You guys know that one.
How many basal profiles do you use?
We use quite a few. The problem at this stage in his life is that one night he’ll be perfect, the next I’ll have to give him 5 sugar tablets to keep him up and the next night he’ll be over 300 for hours…all with the same basal profile. There is no pattern so it’s really difficult to make changes. We’ve had months where these profiles work like a charm (I’ve probably made posts about some of those successes), and other months where nothing we do works and it’s as if his body is just hell bent on having steep roller coasters.
Yes, the only pattern is that there isn’t an obvious pattern. Just when you think you have it nailed, blammo, it doesn’t work. I really like the one night that happens between unrelenting highs, and any insulin is too much insulin at night. We seem to usually get one night where there is an absolute flatline, with no effort, and then it either tilts back to unrelenting highs, or swings to a series of painful lows.
The reason I ask is that it can be tempting to just add another profile to perfect all the ups and downs in a day, but what I have found is that when there are too many moving parts it is easy to get off track. If you are able to consolidate some, I would recommend it. What works today won’t work tomorrow (especially with a growing child), so if you can simplify your basal profiles, it may be easier to manage. I like to imagine high BG as a fire and my insulin pump as the water hose. You don’t want to put it out, but you don’t want to drown it either–so it is sometimes easier when you have a steady steam to work with as the intensity of the fire changes.
Anyway, that’s my 2 cents.
I love that rare night 
I ran into the exact opposite the other night, where there was nothing I could do right. Just for a lark, I should publish it, so that we can compete on how many mistakes we can make in one night
All his rates are in a constant state of flux in our house. We do a weekly review of last weeks data (we try to analyze weekly…sometimes we don’t get to it), then we adjust as we analyze. So, I definitely agree and it’s definitely something we’re constantly doing. Trying to adjust, refine and find the right mix of basal/bolus mix to work temporarily. We’ve accepted that, with his age, we are going to go through these times as he grows…we just have to continue working to improve our treatment plans to compensate for these changes.
But it doesn’t make any of us any less tired or sleep deprived!
I agree with the concern of making another, more complex basal profile.
But we have run into the opposite issue, with temp basals. When basal rates are changing, we tend to try a temp basal. We frequently forget to renew them, leading to lows or highs. So, from that point of view, I am coning to the thought that changing a “current” basal profile may be better when you deal with long temp basals (more than 2-3 hours).
We don’t ever make changes based on non-pattern events. That would lead to a disaster. If our current regimen works (which is does most of the time), we just hunker down and ride the waves of those hellish nights. We only make changes when we see patterns for concern. That goes for all aspects of his D management - Basal and Bolus.
The issue, for us, is when you go from a pattern to another. Our patterns last only a few days. Picking up on the change always involves making a bet: it is changing (and by how much), or it is not changing.