Two additional factors can complicate the regulation of insulin levels. After about 20 weeks gestation, insulin resistance increases and there is often a rise in blood sugar and, therefore, a rise in insulin requirements between 4 a.m. and 6 a.m. related to the release of cortisol and growth hormones(de Valk & Visser,2011). The potential hyperglycemia from this “dawn phenomenon” and the changing basal insulin requirements make the use of CSII with individualized programming of different basal insulin delivery rates especially appealing. The addition of continuous glucose