FOTF and other Spikes

Every day IS an experiment!!! No way around it; and believe me, I’VE TRIED!!! :zany_face:

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If you can work out what the required bolus is from the temp basal (i.e. 1.6IU/hour x number of hours for the figures you gave) you can just bolus that if the pump lets you (that’s what I do) but if it insists on carbs and probably better anyway just multiply the bolus by your IS, which is in grammes/IU so that gives you grammes of carbs.

Because the problem is extra carbs (from the liver) I guess it is better to enter the carbs for an AIDS but a straight bolus probably won’t mess it up too much; certainly no more than a temp basal to do the same thing!

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There are 3 problems those of us with diabetes mellitus, regardless of type have to deal with.

  1. Dawn phenomenon - this is the result of a normal hormonal process that gets all mammals ready to wake. Human growth hormone, cortisol and adrenaline are secreted causing among other things the pancreatic Alpha cells to secrete glucagon. This stimulates the liver to convert glycogen into glucose. This is meant to supply needed energy as we wake. In normal mammals the rise of blood glucose is met by an increase of insulin secreted by the Beta cells to allow that glucose to be used. For those with T1 - no insulin, for those with T2 insulin resistance.
  2. Somogyi effect also causes an abnormal rise in BG, aka “chronic Somogyi rebound” was originally thought to be a reaction to an episode of hypoglycemia that was over compensated, but new data because of CGMs is calling that into doubt. My quick reading of this paper is that it is really dawn phenomenon. https://www.ncbi.nlm.nih.gov/books/NBK551525/
  3. Feet on the floor syndrome FOTF is, in my opinion, dawn phenomenon that is triggered by actually standing up. It is driven by the same hormones that cause the liver to dump glucose, but as we lack insulin secretion are are resistant to it there is a rise in BG.

I haven’t had DP issues in the 6 years I (T2) have been on a T:Slim pump with C-IQ. My sleeping BG tends to be perfectly normal with my basal lower than the set rate. Upon rising BG rises, basal goes to the set rate and it is not enough. Here’s a screenshot from Tandem app for part of last night and this morning.

You can see the basal is lower until 5A when I got up. BG steadily rose to 138mg/dl and I did a correction of 1.2 units at 6:44. I am still fasting.


I like that with the C-IQ system that I can do corrections and even override them as needed. No need for “ghost carbs.” :ghost: :cupcake:

Stepping away from the lectern :graduation_cap: :zany_face:

I wanted to go on a bike ride, but we just go 3” of rain. I guess I will do householdy stuff,

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Saw my endo yesterday afternoon, coincidentally. Since Im new to the OP5, she explained some things to me. One of the things that I miss most about my pump is the dual wave bolus function. She told me how to achieve that in a way that I could remain in Automated Mode which works for me: just do it the way I did with syringes. Some % up front, and then the % balance later. Im gonna test it out tomorrow when we go for sushi/sashimi at my favorite Japanese restaurant for my birthday. Fingers crossed!!! :folded_hands: :crossed_fingers:

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Thanks jbowler. Math scares me, but when you explain it, the answer is obvious.

I thought it was going to be pizza​:pizza::bento_box: regardless enjoy your special day.

My Dad was combat infantry in Europe WW II. He loved his birthdays. I think because he thought he would not see hiss 22nd. His attitude taught me that every birthday is a treasure.

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