after last nights basal test, I need some advice on changing basal rates...

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SilentAssassin1642

SilentAssassin1642

Well-Known Member
Relationship to Diabetes
Type 1
So, I am here all zombified due to a full on all night basal test last night

Here's the results

Pre bed: 4.8
23.45 6.2
12.45 7.0
2.30 8.5
4.30 9.6
11.30 8.2 (wake up)

My current basal rates are:
12-1 0.45
1-2 0.50
2-3 0.55
3-4 0.60
4-5 0.60
5-6 0.60
6-7 0.60
7-8 0.55
8-9 0.55

So I'm sat here working out what to change. If I had crawled out of bed earlier my levels would have been much higher, that's through sheer experience so I think I need more as we get forward during the night.

So, I'm thinking of changing my 1-2 basal and upping it to 0.55 (big jump I know, but go with me here) and then going 1-2 to 0.55 to match the 1-3 rates. And then going 3-7 to 0.65?

Or should I just go nuts dyu think and up the 0.6 to 0.7?

This is going to bug me all day, I'm not sure if its my tired brain just hating me and not letting me think so I thought I would ask your advice. Shall I just go with my first instinct and do a 0.5 change on the times I think I need more? Or shall I just throw caution to the wind and go for a 0.1 change?

Thanks all - my logic is totally out of the window today, if I did it without asking anyone I'd probably end up doing something really really stupid.

Sorry for asking so many questions, but with a nurse who is basically incontactable I could do with all the help I can get 🙂
 
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Sam, am working out what i would do then will let you know my thoughts.

What time was your pre bed reading and how long was it after bolus?

also, did you say you change hour before for the effect of basal change wheras i am two hours before?
 
tracey w said:
Sam, am working out what i would do then will let you know my thoughts.

What time was your pre bed reading and how long was it after bolus?

also, did you say you change hour before for the effect of basal change wheras i am two hours before?
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Bolus was at er...6.30pm. Bed was quarter to middnight (I think), hang on and I'll tell you...23.05, didn't actually sleep until 23.45 when I was 6.2 (I'd been panicking about going hypo, so was very pleased when i checked right before bed and saw that lololol)

I've done some initial changes, what I said in my first post, but any more suggestions would be most welcome 🙂

also yes, I go for an hour before cuz thats what nursey said I should do :/ :/ not that I can really trust what she says, being that she's gone MIA lol.

When I checked and it was 4.8 I think there was a 0.1u IOB left, 6.2 and nothing left. Hurrah.
 
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Ok Sam, going off these readings and presuming you change 1 hour before for the affect 1 hour later.

I increase and decrease by 0.05 every time and take it from there, dont be tempted to go too much as it may be just that, too much. Little steps, slowly slowly catchy monkey! 🙂

12- 1 am i would increase to 0.50 to affect 1 - 2 am

1 -2 am i would increase to 0.55 to affect 2 -3 am

3 -4 i would increase to 0.65 to affect 4 -5 am

This is 3 increases overnight so i think you will see a difference. By the way the numbers are not far off are they, well done?

And sorry to say, you need to retest to check the effects, but i will be worth it when you are getting full nights sleep with confidence your numbers are good.
 
Well you have risen there in 45mins, but i would ignore that for now as you may have been affected by food etc?

Personally i do two hours before but if you think its one that affect you then go with that, you will soon find out!
 
tracey w said:
Ok Sam, going off these readings and presuming you change 1 hour before for the affect 1 hour later.

I increase and decrease by 0.05 every time and take it from there, dont be tempted to go too much as it may be just that, too much. Little steps, slowly slowly catchy monkey!

12- 1 am i would increase to 0.50 to affect 1 - 2 am

1 -2 am i would increase to 0.55 to affect 2 -3 am

3 -4 i would increase to 0.65 to affect 4 -5 am

This is 3 increases overnight so i think you will see a difference. By the way the numbers are not far off are they, well done?

And sorry to say, you need to retest to check the effects, but i will be worth it when you are getting full nights sleep with confidence your numbers are good.
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nooooooooo not more testing 😱:D Can I do it next weekend? hehe. In all seriousness though, a full on test I can only really do on a friday/saturday, but I can do a couple of tests overnight on work night. Am gonna schedule a 3am test tonight I think, see how that goes and then do it that way until I can get a full on evenings testing done next er...Saturday now I think, working saturday daytime so friday night is out of the question :/

I am still really scared that even with these changes I'll wake on bad numbers :( I mean, ok so waking on 8,9,10 isnt really too far off being right. But when I get those horrid 14's, I hate that :(

But that blummin' monkey needs to slow down a bit so I can catch it. Bloody thing is too far out of reach right now! hehe =]

Thanks Tracey, thats really helpful!
 
tracey w said:
Well you have risen there in 45mins, but i would ignore that for now as you may have been affected by food etc?

Personally i do two hours before but if you think its one that affect you then go with that, you will soon find out!
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we'll get there, slowly but surely. I just wish it would hurry up :D Because then I can concentrate more on the daytime hehe
 
I think your doing well with those numbers, i really think its only little tweaks you need in the night now.

I do think it would be beneficial to test at 3 am and the next night 5 am just to check? You may need to increase again at the times i mentioned. I know its hard work on the pump but you need to do it hun?

After that i would go for the morning peaks you are getting?
 
tracey w said:
I think your doing well with those numbers, i really think its only little tweaks you need in the night now.

I do think it would be beneficial to test at 3 am and the next night 5 am just to check? You may need to increase again at the times i mentioned. I know its hard work on the pump but you need to do it hun?

After that i would go for the morning peaks you are getting?
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I think you're right. 3am tonight, 5am tomorrow night just to see what's going on. Fingers crossed it's only gonna be a teeny tiny bit more tweaking to get there.

Thanks tracey 🙂 It still seems like a so close but so far moment.

Problem is, lasagne for tea tonight 😱 i wonder if that will provide any bad effects if eaten early enough?

It is hard work, and I can see that light there at the end of the tunnel and its just that last sprint to get it right but jeeeeeez i'm flagging a bit lol. Just a bit more though and I think the nail will be hit well and truly on the head

overnight at least.

OH GOD THE DAYTIME PEAKS D: I actually think they are going to be my biggest challenge! But, I CAN DO IT!!!! 🙂
 
As long as you know your setting for lasagne and you eat it early enough you will be fine by 3am!

good luck
 
tracey w said:
As long as you know your setting for lasagne and you eat it early enough you will be fine by 3am!

good luck
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multiwave, over 2 hours and all is always well :D

except if i decide to have chips 😱

lol I'm kidding

Thanks tracey, I'll update with the 3am test and waking results in the morning :D
 
Sam

Looking at those readings, they aren't too bad at all can't add anymore to changes than Tracey...

But reckon sort out these last changes, and if you are in similar range, it be worth saying right lets put the night-time basal testing on the back burner and get my day time sorted... As once you start on your day time you may find that the night-time fall into place a better with a knock on effect from improved day results...

And you could really do with a good nights sleep...

There is one thing though that may be worth taking a second look at, is your IOB setting, giving a double check whether the settings are correct.. As it may be that your insulin isn't lasting quite as long as you first thought... Hence why such as large rise in BG, it maybe that when your IOB was giving 0.6u of active insulin left, there actually wasn't! Worth a double check me thinks..

Must admit it can be a mindfield at first, trying to unravel what is what, and what is effecting what etc... But keep plodding and it should all start to unravel and show it self
 
Ellie Jones said:
Sam

Looking at those readings, they aren't too bad at all can't add anymore to changes than Tracey...

But reckon sort out these last changes, and if you are in similar range, it be worth saying right lets put the night-time basal testing on the back burner and get my day time sorted... As once you start on your day time you may find that the night-time fall into place a better with a knock on effect from improved day results...

And you could really do with a good nights sleep...

There is one thing though that may be worth taking a second look at, is your IOB setting, giving a double check whether the settings are correct.. As it may be that your insulin isn't lasting quite as long as you first thought... Hence why such as large rise in BG, it maybe that when your IOB was giving 0.6u of active insulin left, there actually wasn't! Worth a double check me thinks..

Must admit it can be a mindfield at first, trying to unravel what is what, and what is effecting what etc... But keep plodding and it should all start to unravel and show it self
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here's a question...

how do you actually work out how long there is IOB? For me, that's the most confusing part of it.

Also, how would I play about with daytime basal tests when its such a minefield with having to guess when to lower insulin for my walk to work? Either that or I do a daytime one tomorrow, but alas I am off out to watch Steve Backshall's deadly day out (sad I know) in the morning so that wouldn't work. Man this makes my head hurt.

So for instance, my sheet of paper from nurse says to not skip breakfast, have it as normal and then test from there...but surely that defies the oibject espesh in my base where i get an epic rise after breakfast that just won't shift for hours. Do I skip breakfast, do a normal 10% TBR for 2 hours and test as of when i get to work?

It's all very complicated.
 
so many question for everyone today 😱 sorry 🙂
 
Sam, I would sort out the overnight, tonight and tomorrow, foget about everything else then move on.

I think you try to get everything right and are changing too much at once, slowly like i say. Like Ellie says once one thing is right, then the next it will all start fitting into place.

As for IOB, this is something you set up at the beginning. My dsn set as my bolus lasts 4 hours, however i know my quick acting can hang around for 4 and half to five hours. So i changed mine to 4 and half hours. You will know yourself how long it lasts for you?

So if for example your dsn set it at 4 hours then this is what is being calculated by the wizzard, its only right if the 4 hours is right? hope that makes some kind of sense.

If your not sure, then test it. give a bolus and keep testing till your sure its not working anymore, you do really need to do this at a time when you know your basal is right though, bit like chicken and egg 😉
 
tracey w said:
Sam, I would sort out the overnight, tonight and tomorrow, foget about everything else then move on.

I think you try to get everything right and are changing too much at once, slowly like i say. Like Ellie says once one thing is right, then the next it will all start fitting into place.

As for IOB, this is something you set up at the beginning. My dsn set as my bolus lasts 4 hours, however i know my quick acting can hang around for 4 and half to five hours. So i changed mine to 4 and half hours. You will know yourself how long it lasts for you?

So if for example your dsn set it at 4 hours then this is what is being calculated by the wizzard, its only right if the 4 hours is right? hope that makes some kind of sense.

If your not sure, then test it. give a bolus and keep testing till your sure its not working anymore, you do really need to do this at a time when you know your basal is right though, bit like chicken and egg 😉
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its one hell of a mountain i see before me 😱 even though its seems so close, it seems so far away too.

Seriously hoping that these changes start showing some improvements.

As for the IOB, I think I'm just gunna leave that be for a while. Too confusing right now.
 
IOB is not something that ever really concerns me to be honest. Im sorry i didnt mean to confuse things, you asked the question and i tried to answer as best i could.

The way i think about IOB is, say you have something to eat and its only 1 hour since your last bolus, you take a reading and its say 10, i would not correct because " i know " the bolus for that is still working, so i just bolus for what im about to eat.

Sam im pumping for a year and still testing basals and changing ratios, so do not worry, you are doing good. I totally get that things will always be changing and you just have to keep adjusting the best you can.
 
Believe me Sam there were times at the beginning when like you, I ponder whether banging my head against a wall would make more sense! As yes the theory all looks so simple all in nice little sections, but practice it?s not as easy to section as is the theory... Bit like unravelling an archeologically dig really, slowly piecing the information together over a period of time...

I won?t go into detail about achieving day time basal testing at the moment as not to fuddle things to much, but will expand when you?ll ready to start it and then hopefully between us all, we can come up with an effective plan to enable you to get the data you need to sort it quickly. I?ve got a couple of suggestion in mind that might well be very helpful..

But keep asking the question though, it helps to know what information etc you need...

As for lasagne for tea, if you do decided to do some basal testing bare in mind pasta does impact for a lot longer than we tend to give it credit for on our blood glucose, so any results gained tonight might be more useful with determining the effects on you when eating pasta than actual testing of your basal dose... No information is wasted just sometimes we need to work out the best way of using it...
 
Ellie Jones said:
Believe me Sam there were times at the beginning when like you, I ponder whether banging my head against a wall would make more sense! As yes the theory all looks so simple all in nice little sections, but practice it?s not as easy to section as is the theory... Bit like unravelling an archeologically dig really, slowly piecing the information together over a period of time...

I won?t go into detail about achieving day time basal testing at the moment as not to fuddle things to much, but will expand when you?ll ready to start it and then hopefully between us all, we can come up with an effective plan to enable you to get the data you need to sort it quickly. I?ve got a couple of suggestion in mind that might well be very helpful..

But keep asking the question though, it helps to know what information etc you need...

As for lasagne for tea, if you do decided to do some basal testing bare in mind pasta does impact for a lot longer than we tend to give it credit for on our blood glucose, so any results gained tonight might be more useful with determining the effects on you when eating pasta than actual testing of your basal dose... No information is wasted just sometimes we need to work out the best way of using it...
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I love the archaeology bit there - speaking as an archaeologist myself, that is a really good way of looking at it. Digging through the layers methodically,

Indiana Jones agrees, oh yes he does

Indiana+Jones+And+The+Temple+Of+Doom+%281984%29.jpg


all joking aside however

I tend to be ok with pasta, oddly. Tend to get a rise after about 2.5 hours, but only a very small one so tend to run a bolus over 3 hours or so.

Agreed, lets leave daytime bits for a couple more days. Hopefully over the next couple of days there are some real improvements from the changes made, and that would make my day 🙂
 
12 this morning, but i guess a number of factors play into this...

lasagne possbly has a longer effect on me
sleeping in.

we'll see how it plays out tomorrow.
 
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