Calling on all my D-Peeps for some help here. Fred and I are stumped beyond belief at a trend of numbers Elise has been having lately. I blame it on my proclamation that we are "freaking rock stars".
Anyway... for the last three days, when we check Elise for her pre-bedtime snack, she's in the mid-300s. We give her a snack and her bedtime NPH, and usually somewhere between 9:30 and 11:00, she falls low. We give her some carbs and she rebounds into the 300s during the night, waking up in the mid-200s. The timeline looks like this:
5:00 pm - shot + dinner. Usual carb ratio.
7:30 pm - bedtime check. In the 300s.
Between 8:00 - 9:00 pm - bedtime snack (15g) and NPH.
Between 9:30 - 11:00 pm - Elise's BG is in the 70s. We give her carbs.
1:30 am - BG in the 300s.
Is it possible that her fast-acting insulin she gets at dinner (diluted Humalog) is peaking 4 - 5 hours after she gets her shot?
Is it the combination of her DH and NPH making her go low (are we giving the two shots too close together, which is approx 3 1/2 hours apart)?
Is the NPH now peaking earlier than it ever has?
Keep in mind, we are doing EVERYTHING the exact same as we have before. Same schedule, same carb ratios, same snack. I just don't get it. The weirder thing is the numbers are pretty much IDENTICAL for the past three nights (for example, last night at 7:30 she was 331 and tonight at 7:30 she was 331... WEIRD).
As far as I've been told, Humalog starts to work in about 20 minutes, peaks around 2 hours, and is gone by hour 4. NPH (in most people, we've found differently with Elise), starts to work in 1 -3 hours, peaks by hours 4 - 9, and is gone in 14 - 20 hours.
So... anybody have any pearls of wisdom for us? We're going to try giving her a few more carbs for her bedtime snack to see what that does to her BG at around the 10:30 mark. Otherwise we're out of ideas.
I never should have opened my big "rock star" mouth.
2 days ago