Testing Basal Dose

[Jess Howard]

hi guys I've been advised to test my basal dose with a carb free meal or miss a meal altogether. I was going to see what blood is in the morning and then skip breakfast and not inject any Novorapid and see what the outcome is at lunchtime ....... On thinking about it though blood sugar automatically increases in the morning preparing your body for the day, so this might not be wise.

Can anyone please help me with some advice.

Many thanks

x

 

[Robin]

I think if you're being thorough with basal testing, you ought to do several, on different days, at different times of the day. It's as valid to know what your sugars do in the course of a morning ( mine certainly rise of their own accord) as knowing if they're steady at other times. People on pumps can adjust their basal to cope with the differences, those of us on Lantus etc have to find the 'best fit' or compromise.

 

[Jess Howard]

Hi robin
Yes I'm in Novorapid /lantis which I've always found adequate. When you've had to do this yourself, do you just skip a meal or eat a carb free meal or does it not matter? I feel quite anxious about the whole thing if I'm honest.

 

[HOBIE]

I adore to miss a meal . From the age of 3 along time ago I was on fixed insulin per day & had to eat 50grms of carbs 3 times a day. My mother could not persuade me to eat & I used to drink 6pints of milk a day. Strong bones & teeth . Now on a pump & love to miss lunch 😎

 

[Robin]

Hi robin
Yes I'm in Novorapid /lantis which I've always found adequate. When you've had to do this yourself, do you just skip a meal or eat a carb free meal or does it not matter? I feel quite anxious about the whole thing if I'm honest.

I've normally skipped a meal, because I find that eventually even protein finds its way into my blood glucose- if I have an omelette, for example, I need at least a unit of novorapid. I try and do it when I'm occupied with something so I don't remember I'm hungry. I've heard some people say that having a little bit of ham or a bit of cheese doesn't make any difference to them. Feeling anxious about it is probably your worst problem! I find my levels rise if I feel stressed!
Good luck!

 

[trophywench]

I agree with what's been said - just skip the meal, and test absolutely no less than 2 hours apart. Divide the day and night into 4 chunks of 6 hours apiece, on different days. Then be normal for a few days then do it again, but start and finish each time block at different times. eg if you do 6am to noon first, second time do 7am to 1pm. Or 5am to 11am, but that's not one for me! LOL That way and testing every 2 hours while you are 'fasting' - you get one reading every hour of the day/night, and can then see properly if trends are a permanent pattern or what.

Don't worry about the morning rise - if it happens it happens, but for a lot of us it doesn't seem to be mega although it's there. I wouldn't even know that if I hadn't tested my basal, would I?

Don't stress anyway - none of this is gonna hurt you! Only thing is - if you go hypo - then you must of course deal with it immediately, and scrap that block - do it again in another couple of days.

 

[Jess Howard]

Great thanks so much ............ I was going to start now; I ate at 6.30 tonight, going to test blood 10pm/11pm (like normal) then see what happens between now and 6am when I get up....... Does it mean I would have to set my alarm for every couple of hours to test my blood to keep a record?

 

[Robin]

Well, I wouldn't! Some people might, but youve got to function the next day. It's useful to know what you are at 3am, if you can bear to set an alarm for then, that seems to be when most people's bodies are at their lowest ebb, and lowest BG, and it's always useful to know you're not going hypo in the middle of the night.

 

[Jess Howard]

Cool, I'm usually up in the night for the loo so will just test then, and if I go low in the night it always wakes me up so not concerned about that ............. Watch this space

 

[DeusXM]

hi guys I've been advised to test my basal dose with a carb free meal or miss a meal altogether. I was going to see what blood is in the morning and then skip breakfast and not inject any Novorapid and see what the outcome is at lunchtime ....... On thinking about it though blood sugar automatically increases in the morning preparing your body for the day, so this might not be wise.

Can anyone please help me with some advice.

Many thanks

x

Well, this is sort of the point of basal testing. You say your BG increases in the morning automatically?

Do you know by how much?

I found through basal testing that my basal is generally spot on throughout the day...except in the morning, where without fail, my BG will rise by 1mmol/l every 30 minutes for about four hours and it kicks in only when I get up out of bed.

As a result, my morning routine now includes factoring in a correction dose as soon as get out of bed - regardless of if I am having breakfast or not. This then helps neutralise the rise and means I hold steady on the 5mmol/l reading I wake up on, instead of finding by the time it got into work that my BG is in double figures. That extra shot in the morning is pivotal to my diabetes control and by discovering the problem and tackling it, I wiped an entire percent off my A1c with no other lifestyle changes.

And that's why you basal test. It's to ensure that your insulin intake matches what your body does.

 

[Jess Howard]

Well survived the night ....... Went to bed at 7.7 and was woken at 2am by a 2.7 ...... I'm guessing basal lantis needs to be decreased?

 

[Robin]

Very probably!
The other thing I find is that when I've been mildly hypo in the night, probably not low enough to have woken and tested, my levels rise before dawn, as my liver has pumped out a bit extra to compensate. I've been using a Freesyle Libre, so have been able to read off what I've done overnight without needing to wake up and test. A very useful, but expensive piece of kit.

 

[everydayupsanddowns]

Well survived the night ....... Went to bed at 7.7 and was woken at 2am by a 2.7 ...... I'm guessing basal lantis needs to be decreased?

It would seem so! Ideally a fasting basal test will show BG holding steady within 1 or 2 mmol/L up or down for as long as it lasts. On something like Lantus this is not always possible, but aim to get it as level as you can and if you *know* that certain times of the day see you drifting up or down a little then you can factor that in to your routine.

This write-up is pretty helpful: http://www.diabetes-support.org.uk/info/?page_id=120
And this (for pump users) can be adapted for injections: http://diatribe.org/beyond-basals-–-part-ii

 

[pottersusan]

because I find that eventually even protein finds its way into my blood glucose- if I have an omelette, for example, I need at least a unit of novorapid.

I've been thinking that's happening, but thought I must be losing the plot! It makes basal testing interesting doesn't it

 

[Robin]

I've been thinking that's happening, but thought I must be losing the plot! It makes basal testing interesting doesn't it

That's why I don't do it very often! This Diabetes malarkey, it's a laugh a minute. ( If you didn't laugh, you'd cry!)

 

[everydayupsanddowns]

Great thanks so much ............ I was going to start now; I ate at 6.30 tonight, going to test blood 10pm/11pm (like normal) then see what happens between now and 6am when I get up....... Does it mean I would have to set my alarm for every couple of hours to test my blood to keep a record?

That's what I would do if I was wanting the full picture. 8ish hours is a long time to go with no detail if you are trying to fine-tune things.

Without that info you could be having all sorts of 'wobbles' every night that you know nothing about.

 

[pottersusan]

That's why I don't do it very often! This Diabetes malarkey, it's a laugh a minute. ( If you didn't laugh, you'd cry!)

Its encouraging to know I haven't lost the plot (completely ).