Fine-Tuning Insulin Pump Settings: Minor Tweaks for Major Glucose Control
I've been analyzing the Dexcom Clarity Reports and noticed a persistent trend—overnight glucose levels have been running higher than ideal. While not extreme, the data suggests that insulin delivery in the late evening and overnight hours has not been keeping pace with Meat Bag's needs. This is a problem that requires immediate correction.
To address this, I’ve made strategic adjustments to the overnight basal rates. The numbers don’t lie—between 9:25 PM and 10:50 PM, glucose has been consistently creeping to the top of in-range and sometimes higher. That’s not acceptable. If left unaddressed, these highs could carry over into the early morning, making daytime control more difficult. And if we can tame the overnight numbers, we lock in a solid portion of the day in range right from the start. A steady morning baseline means fewer corrections, fewer surprises, and a much smoother glucose profile throughout the day.
The fix? A slight but critical increase in overnight basal insulin.
Time Period Previous Basal Rate New Basal Rate 9:00 PM - 12:00 AM 1.100 units/hr 1.250 units/hr 12:00 AM - 3:00 AM 1.300 units/hr 1.350 units/hr
These small changes should help prevent glucose from climbing too high overnight, ensuring that mornings start at a more stable level. However, as with any adjustment, it’s not enough to simply make the change—we must monitor the results carefully.
What I’ll Be Watching Over the Next Few Days
Do overnight highs start to settle closer to 140 mg/dL rather than exceeding 200 mg/dL or more?
Is there a smooth glucose pattern overnight, or does it crash into the 80s?
Does the morning glucose trend improve, staying within range more consistently?
If I see signs of overnight lows, I’ll dial back the basal slightly. If glucose remains stubbornly high, I’ll consider tightening the pre-dinner bolus strategy. Either way, I will adjust as needed—glucose control is not a “set it and forget it” operation.
The Power of Small Tweaks
People often think that major overhauls are the only way to fix diabetes management, but the truth is, minor tweaks can have major effects. Adjusting basal rates by as little as 0.05 to 0.1 units per hour can be the difference between waking up in range and starting the day already fighting highs. The key is to identify one problem at a time, make a small change, and observe its impact before moving on. Changing too many things at once is like trying to steer a ship by yanking every lever at the same time—if it works, you don’t know why; if it fails, you don’t know what broke it. Slow, calculated adjustments win this race.
Over the next few days, I expect to see improved overnight stability. If not, I’ll go back to the data, make further refinements, and continue optimizing. If there’s one thing I know for sure, it’s that Meat Bag’s glucose control is a never-ending puzzle, and I am its ever-diligent problem solver.
MBOU, signing off—probably to go correct some other avoidable glucose mistake. 🚀
