Mystery of the Varying Overnight Basals

Last week was an exhausting week for many reasons that had absolutely nothing to do with diabetes.

Yet surprisingly, my blood sugars have been cruising along at the best they’ve been in weeks.

I’ve been struggling with my overnight basal rates in recent weeks. There have been some uncomfortable overnight lows, and then there have been other mornings where I’ve woken up frustratingly high. Alarms have been going off 2 or 3 times each night, instead of the usual one.

Things have felt rather inconsistent of late, so I decided to slap on a new FreeStyle Libre sensor last week to try and nut things out. I think I have finally cracked the mystery of the varying overnight basal needs.

If I go to bed sitting in the 7s or 8s, my overnights look something like this.


Looking at the gradual rise from around 4am, I’d be ready to make a basal change.

But when I go to bed sitting in the 5s or 6s on the same basal rate, my nights end up looking like this.

So it seems that my insulin sensitivity is far better when I go to bed in the 5s and 6s. I cruise along much more smoothly during the night, and my blood sugars get off to a much better start when my day begins in range.

So I’m now trying to be a little more bolder with my corrections at bedtime, in the hopes that I can replicate these levels and a decent night’s sleep more often.

Diabetes has so many little intricacies. It always keeps me on my toes, and I’m still learning new things about it after seven years.

One Year Pumping!

I’ve now officially passed the one year mark since I began using an insulin pump! It was a huge leap of faith at the time, but one that I knew I had to make for the sake of lower and more stable blood sugar levels.

The biggest reason I switched was because I never felt I could get my background insulin dose quite right. Some nights, particularly if I ate more than normal, my Lantus dose wouldn’t be enough to keep my levels steady. Other nights, it would be too much and send me low.

Today, that problem is all but gone. The pump delivers a basal rate of insulin that can be customised to the time of day. I have a higher rate running from 1am to mid morning to offset dawn phenomenon, and a flat rate running through the remainder of the day. Night time basals have been the most challenging, with upward tweaks needed every month or two. But thankfully, the remainder of my basal rates have remained unchanged since I first figured them out last year.

Before I started pumping, I was guesstimating a lot of my insulin doses. I guess I wasn’t very motivated to do otherwise. I wasn’t really thinking too hard about what I was putting into my mouth, and there were a lot of emotionally exhausting highs and lows.

I began diligently counting carbohydrates and weighing my food since starting on the pump, and surprisingly I haven’t slacked off since! With a properly tuned basal rate, insulin just worked when I bolused to cover meals, rather than staying frustratingly high. The pump’s bolus calculator was extremely helpful, and of course having the pump attached to me made bolusing a lot more convenient when out and about.

As anticipated, the pump was a huge learning curve. My biggest hurdle in those first few months was site failures. The 90 degree insets that I was using at the time continually failed on me, causing regular bruising and bleeding on the stomach. I’ll always remember one tumultuous night where I ripped out my infusion site to discover the cannula had kinked on the way in. I eventually switched to the comforts which sit on an angle and have a manual insertion. Today, site failures are rarely an issue. 

The insulin pump is hands down more work than injections. Infusion sites need changing every three days, insulin cartridges need to be refilled, pump lines need to be inspected for air bubbles, batteries need changing, and basal rates need adjusting for activity. You really need to be on top of your game with a pump, and that might not be a commitment everyone is able to make.

The insulin pump definitely gave me a renewed drive to better focus on what was some very lousy diabetes management.

From there, the rest of what I’ve achieved is down to my dedication to observing and learning more about my diabetes and the different variables that affect my blood sugar. So in this regard, I feel that I could just as easily have reached this level of management on Multiple Daily Injections as well.

I can’t express just how much of an investment this was – and I’m not sure I would have been able to do this if I were still at uni or had a more demanding job. But overall I now feel more knowledgeable, equipped and experienced to navigate my way through different scenarios. This level of management no longer feels like such a stretch.

While I don’t talk numbers on this blog, I will share that it took me six months to get my hba1c to where I wanted it to be. When I first hit that target in November, I really felt like I had squeezed everything out of myself to get that number. Today, I’ve been able to comfortably maintain that number – and hopefully even better it going forward.

It’s been a huge year for my diabetes, and one that I feel is definitely worth celebrating.

Happy pump-aversary to me!

(And here’s hoping diabetes is a bit easier on me this coming year)

That Damn Clip

What’s the worst thing about wearing an insulin pump?

It’s not the feeling of attachment all the time.

It’s not the constant attention required towards infusion sites, batteries, pump lines and insulin cartridges.

I’m not even bothered that the pump is still not a freaking cure for diabetes.

What bothers me the most about my pump is that damn clip.


It wobbles. All. The. Bloody. Time.

Despite my many repeated attempts to tighten that tiny screw that holds both parts of the clip together, I’m lucky if I’m rewarded with a week free from wobbliness.

It doesn’t stay clipped to my clothes properly unless I actually thread the fabric inbetween those two bits of plastic.

It’s a bloody pain to pull apart from my clothes when I want to have a glance at it. Which, let me tell you, is quite a lot. Not to mention having to thread it back on again when I’m finished.

My affection for this delightful clip escalated yesterday when the two parts of my clip, held together by a screw, snapped apart.

When I called the Animas helpline to see about getting it replaced, I learned that this clip is only covered under warranty for six months. Yet the $9,000 pump is covered for four years, despite it already looking quite tired after one.

I can’t say I’m keen to waste another 30 or more dollars on a new clip that I don’t like, and which I know won’t last.

I’d love to buy one of those awesome clips on eBay that I could simply stick to the back of the pump. But of course then I’d be blocking the little infrared patch, which I need access to when I upload my pump data to diasend.

So last night, I went out to the shed and attempted a little DIY repair on my pump clip.

I’ve put the clip back together with a putty called Knead It, that dries like cement.

Cement will hold better than screws, right?