FOTF Drop

Ok, after reading enough other people’s posts, it seems that people have DP and FOTF and they get spikes.
I do raise my basals at night some because of changing BGs, but the weird part with me is that my FOTF reaction is a drop of usually 15 to 20 points.
And I am not getting up and running around. I can literally just get up, and move around a little bit, and I will see my numbers drop.
When I first got my dexcom, I would often make the mistake of giving too much of a bolus in the middle of the night to bring my numbers down, then when I get up, I drop like a rock!

I kind of understand why others have their BG go UP when getting out of bed. Seems like a natural thing to happen for our bodies.
But for mine to go down, pretty consistently, seems counterintuitive.
I know how to handle this, and I am not worried about it.
I am just curious as to what would cause this?

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Is your pancreas totally out of the picture? Like do you have any residual beta cell functionality?

I know it’s sometimes a bit different for adult onset.

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No idea really.
I highly doubt there could be much left though, judging by the way my body acts.
It has been doing this for years.

I was diagnosed in 2014 (41 years old then) as a Type 2 (typical VA wouldn’t TEST me!). It wasn’t until 2016 until I got the correct diagnoses of T1 and was put on insulin. I had pretty low C Peptide numbers at that time, but haven’t been tested since.
I guess there could be some lingering functionality. Just didn’t think it would last this long.

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I’ve seen something like that and for me it seemed to be associated with nighttime boluses. I consistently see a bolus in the night not having much, if any, effect on my BG. Something which would noticeably affect my BG within 30 minutes during the day does nothing. As morning approaches my BG starts going down. It goes down at a moderate rate, so by morning I’m sort-of OK. This is good because I invariably show DP; that starts at about 7AM, when the sun rises but also the coldest time of day, it accelerates after I get up and start moving around.

I’m with you on your analysis:

But I suspect that the other side of this coin is that inertia simply slows down, massively slows down, our rate of insulin adsorption. I do, almost invariably, do correction boluses at night; I’m not talking about a raised basal, I mean 4IU or so boluses. I suspect these are massively delayed because I’m not moving much.

Nevertheless I don’t have an authoritative answer. Maybe there is one out there; surely someone has researched insulin adsorption rate variability?

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It’s hard to say. I guess if your basal was not correct it could cause it. Or maybe when you wake up and move around, your insulin absorption is faster.

:man_shrugging:t2:

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I have my basals higher at midnight, stepped down at 3am, and stepped down to my lowest at 5am.
It doesn’t seem to matter WHEN I get up, this is truly a FOTF thing.
And this happens whether I am doing correction boluses or not.
I figured it out BECAUSE of late night correction boluses.
But it still happens if I have a low or ZERO carb dinner, no boluses or corrections.

Btw, this happened before I got Control IQ, so I cannot blame it for increased basals at night.

I do think the movement triggers something in my body. But it happens if I literally sit up an read a book, or get up and get ready for work. No real difference. Which, you would think there would be something proportional about the effects on my BG drop.

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What happens with C-iQ. In other words is it still happening (I guess yes, but just checking) and what does C-iQ deliver overnight?

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Yes, still happens with Control IQ.
Didn’t really change from basic pump, Basal IQ and Control IQ.
No idea before pump, as I got the dexcom at the same time I got the pump.
midnight starts 2 units. Drops to 1.25 units at 3am, and down to 1 unit at 5am.
I used to have a lower rate at midnight and ran it that way overnight.
But I ended up changing it to account for higher protein dinners, or just late dinners. And it kept me from having to have too large of boluses for dinners.
It had the same effect before though, so I am really unsure.
And like I said, if I ever manage to sleep in, I still drop if I get up at 4am, 7am or 10am. Doesn’t really matter on timing for that part. Just triggered by me getting up (and waking up and just laying there does NOT seem to trigger this affect.)

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I get exactly the same every morning. I get out of bed and my BG goes down. Usually it’s temporary and will have gone back up close to where it was by the time I’m dosing for breakfast. Other variables (last meal, basal rates, any corrections or treatments in the night, how well I slept, time waking up, time getting up) don’t affect it. I have never read a plausible explanation.

I also get an unexplained rise when I fall asleep, again usually just a small blip but sometimes larger. I can pretty much pinpoint bedtime on my Clarity charts. It might have something to do with a change in movement, but if I nap in the daytime I don’t get the same sleep/FOTF response.

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I have seen mine come up a little after the drop, but not consistently. Not often enough to count it as a trend in any manner.
Makes sense for it to come up, just like everyone else, your body is telling the liver to dump some glucose to get the day going.
I don’t have any instances that I can see when I go to sleep like you though.

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Sometimes I experience that initial drop then my BG either climbs back to the starting point or stays dropped. Sometimes I get the FOTF bump of 20-30 points and sometimes I experience dawn phenomenon starting around 4:30-5 a.m. It’s the inconsistency that makes D management hard to deal with in the morning. :flushed:

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@daisymae, how’s your FOTF strategy working out for you?

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Hi There CatLady, thanks for asking. I found a way around the morning spike: I made my basal rate ridiculously high starting at 5am bc every day (without fail) I get up at 7am. I dont bolus for bfast until 8:15. So I can now wake up between 65-85 and not spike more than 30 points. I know that there are probably a lot more efficient and effective ways to combat this dilemma , but so far its been working for me. At least I figured something out that works. (and I have to admit, that not every day is perfect, but most days are pretty good)

Thanks again. I hope you’re well. Maybe someone from our community can benefit from my silly trick.

Daisy Mae

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I have no clue, but separate line of thought, I wonder in your scenario with an initial incorrect diagnosis, if you would be able to claim the Disability Tax Credit for the years you weren’t eligible? Might be worth investigating if you’re a) interested in claiming it at all and b) haven’t already looked into this.

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Oooh, we need that here.

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@Hammer
I have something similar, but I tend to trend down all night. I often have to treat a low before breakfast. My diabetes PA thinks it is my long acting insulin (Lantus). It happens even if I decrease the Lantus dose (taken at bedtime), just not to the same degree.
I don’t vary the time I get up much, so I don’t have that comparison.

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I don’t nap often but today I did AND I had a FOTF spike, which is not typical. Go figure! :crazy_face:

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Perhaps it results from the length of time of prone position or reduced activity that then sets off the spike?

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I am also prone to FOTF. I typically get a spike each and every time I wakeup throughout the night.

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@Trying – that must be so frustrating!

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