Curly, on the other hand, experienced the Somogyi phenomenon. He dropped low in the middle of the night and rebounded to a higher level by morning. Increasing his basal insulin would make the problem worse, not better. A reduction in his basal dose by 10%, or possibly adding a bedtime snack, would make the most sense.
Giving basal a little respect
Having the right basal insulin program and setting the right doses is important for anyone who uses insulin. Taking too much basal insulin, or taking it at the wrong times, can result in frequent (and perhaps severe) hypoglycemia, not to mention weight gain. Taking too little basal insulin will produce high blood glucose and make it very difficult to set appropriate mealtime bolus doses. However, a properly set basal insulin level will allow you a great deal of flexibility in your schedule and should allow you to go to sleep confident about where you’ll be when you wake up.
Fine-tuning basal insulin can be complex, so don’t hesitate to ask a member of your health-care team for help with this task. An endocrinologist, certified diabetes educator, nurse practitioner, or insulin pump specialist can usually help you put your basal insulin on the right track.
