Anyone else winding down their basal at the moment?

[Sally71]

We were doing fine until about a day or so ago when she started bouncing around all over the place, so have just cautiously dropped the whole basal by 0.05 per hour and we’ll see what that does. DSN would probably have done more but I can’t get my head away from the fact that when she was young a change of 0.02 would make a humongous difference so I’m always cautious! it has been 29 degrees here for the last two days though so almost certainly that’s having an effect

 

[SB2015]

I think the automated system with looping takes a bit of time to cotton on to what has changed, so had a couple of hypos today with: hot weather, guessed carbs, walking lots, ….

With the Medtronic system, I don’t have the chance to change the basal profile but can change the target Bg. I am thinking that I need to lift it with hotter weather in order to reduce the basal a bit as with the heat
And/or
Now wondering whether I need to change my basal ratios for hotter weather? Does anyone else do this?

I definitely know to make one change at a time.

 

[soupdragon]

I"ve gone with about a 20% decrease in basal (based on the maximum I had to change by when on MDI). Thought it might be too large a reduction but I've managed a day without a hypo or eating huge amounts of carbs to keep levels up.
Hoping it works again tomorrow!

 

[everydayupsanddowns]

Played a gig last night which was ridiculously hot - had 2 separate and quite rapid unexpected dips. Thankfully I had full sugar coke on stage for a rapid top-up before things went too low!

I may need to wind things down again - but tonights evening meal dose seems to be behaving OK so far.

 

[soupdragon]

Played a gig last night which was ridiculously hot - had 2 separate and quite rapid unexpected dips. Thankfully I had full sugar coke on stage for a rapid top-up before things went too low!

I may need to wind things down again - but tonights evening meal dose seems to be behaving OK so far.

Glad the coke did the trick. I've been getting through a lot of cans of it in the last few days.

Are you able to change basal doses on your system, Mike? Just realising that I'm not really sure how much input the user has with a loop.

 

[everydayupsanddowns]

Are you able to change basal doses on your system, Mike? Just realising that I'm not really sure how much input the user has with a loop.

It depends on the system. But yes, on tSlim the loop‘s decisions are based on your currently active profile - so you can adjust the basis on which Control IQ makes changes.

Medtronic‘s system sets basal for you I think - so you have to wait for the system to make the adjustments for you.

But I guess the downside of the tSlim is that the onus is on me to make the changes (and then more changes!) in a timely manner. 😛

 

[soupdragon]

It depends on the system. But yes, on tSlim the loop‘s decisions are based on your currently active profile - so you can adjust the basis on which Control IQ makes changes.

Medtronic‘s system sets basal for you I think - so you have to wait for the system to make the adjustments for you.

But I guess the downside of the tSlim is that the onus is on me to make the changes (and then more changes!) in a timely manner. 😛

Thanks for that info. It's interesting to hear about the differences between the two systems. Obviously pros and cons to both...

 

[Mumpie_olgran]

Thanks all for the shared insights. Very helpful fir a relative newbie like me. And just to state the typical diabetes contradiction, I'm actually considering increasing basal...
Been eating minimal carbs last few days, posting tennis, staying active and still feel like I'm fighting high levels most of the time
For now I'm staying put as I haven't really had consistency for a renewed test, but suspect I'll end up testing and increasing. Seems like the weather isn't enough to offset the honeymoon period variability maybe

 

[SB2015]

Thanks all for the shared insights. Very helpful fir a relative newbie like me. And just to state the typical diabetes contradiction, I'm actually considering increasing basal

It is ‘great’ the way that Diabetes keeps us all on our toes and we react in such different ways to the same circumstances.

 

[eggyg]

I had my first hypo free day for a week yesterday. Reduced both day and night basal by 1.5 units, bolus ratios I’ve kept the same, on the whole, 1:5 breakfast. 1:10 lunch and depending on my start point, 1:15/20 evening meal. Still like to go to bed no lower than about 7, prefer 7.3 if I can. I’m sticking to my above changes for the time being but it’s forecast for 32 degrees today and whilst the only exercise I’ll get today will be running after a two year old, I’ll be keeping a very close eye on things. Doesn’t look like this weather is going to let up anytime soon.

 

[pawprint91]

Seems like the weather isn't enough to offset the honeymoon period variability maybe

I would agree - when it was very hot last summer I’d just been diagnosed, and the heat didn’t affect me at all. It’s not been drastic, but I’d say I’ve noticed a change this year.

 

[Sally71]

Well I think that worked - much flatter line last night! I shall have to keep an eye on it over the next few days and see whether I need to drop it any more.
Am also considering changing the correction ratio slightly, on the rare occasion she goes a bit high she usually drops low afterwards, pump is so good though that doesn’t happen very often so I haven’t been able to make my mind up! I think I shall do it, after I’ve waited a few days to make sure the basal doesn’t need to be adjusted any further.

 

[Mumpie_olgran]

I would agree - when it was very hot last summer I’d just been diagnosed, and the heat didn’t affect me at all. It’s not been drastic, but I’d say I’ve noticed a change this year.

Having said all that, near carb free meal last night at about 7.30pm (salmon and roast veg) and this line might suggest I could use a downward tweak on basal after all...
(and yes pretty happy with minimal spike too )

 

[SimonP]

I take back my suggestion that perhaps a summer reduction in blood glucose is due to doing more exercise; yesterday and today I've run much lower than usual (despite being standard WFH days with an hour bike ride over lunch as usual) . I've not adjusted my basal (overnight was fine, my day times have not been clear enough to test/I've been hungry), though I will probably look at dialling it back another unit at each end, but I have certainly had to reduce my boluses to something like 50% of the normal dose.

 

[SB2015]

Medtronic‘s system sets basal for you I think - so you have to wait for the system to make the adjustments for you.

This is true, as it makes adjustments every 5 min. Whilst away I found using temp targets to counter the heat when I was more active. That was useful for the first couple of days, whilst Hermione (my pump) caught up with the change in weather. (Thanks @marie11 for that idea) . I need to be a bit more involved during big changes in weather or levels of activity.

 

[SimonP]

Just to throw a proverbial cat amongst the pigeons, I reduced my morning basal by 1U yesterday morning, expecting more of the same (1/2 bolus doses), but my boluses were then back to normal (which meant I was effectively split dosing every meal and snack wondering whether I'd be starting to trend higher after an hour or two - 11 bolus injections in total, ouch) and I then ran high overnight.

It wasn't a particularly abnormal day (I was at work, though I drove rather than riding in as I needed to pick something up, 7k steps & 18 flights of stairs according to Garmin) but the one notable difference between that and the preceding two days was that I didn't have time to get out for a bike ride (I did probably twice as many steps though walking around at work).

The overnight high is probably unrelated and due to protein snacking - over the past couple of days I was able to snack in the evening (which probably points to basal being too high, so related obliquely) but obviously the same wasn't true last night!

I can't believe that the bolus doses going back to normal was the effect of removing a single unit of basal (my basal = 2x9U for 18/24U/hr = 0.75U/hr active insulin. Removing one unit is a difference of 0.0417U/hr. A bolus dose might be 2.5U to 7.5U and have a duration of 5hr giving 0.5U/hr and 1.5U/hr active insulin, respectively.) so I'm going to put my basal back up, keep en eye on the protein snacks and see how the ongoing life experiment reacts 🙂

 

[everydayupsanddowns]

I need to be a bit more involved during big changes in weather or levels of activity.

Fascinating how users of the different systems find little workarounds to improve performance ‘in the real world’ isn’t it?!

 

[everydayupsanddowns]

I can't believe that the bolus doses going back to normal was the effect of removing a single unit of basal (my basal = 2x9U for 18/24U/hr = 0.75U/hr active insulin. Removing one unit is a difference of 0.0417U/hr. A bolus dose might be 2.5U to 7.5U and have a duration of 5hr giving 0.5U/hr and 1.5U/hr active insulin, respectively.) so I'm going to put my basal back up, keep en eye on the protein snacks and see how the ongoing life experiment reacts 🙂

Hehe! I’ve had exactly the same head scratching confusion in the past. How 1u over 24hrs too much or too little can apparently need many many bolus units in corrections, or grams and grams of fast acting carbs.

I had all sorts of fun and games with Lantus in my last years on MDI. That (along with the ever-present overnight hypo risk) was one of the main motivators that prompted me to ask about an insulin pump.

Morning person

Because no two days with type 1 diabetes are the same. Except when they are. The ups and downs of life with T1D.

www.everydayupsanddowns.co.uk

 

[helli]

I have not adjusted my basal ... yet.
Whilst I am not fully closed loop, my CGM/pump combo does auto-suspend when I am getting low.
Yesterday, I spent 8 hours auto-suspended. I think I need to make those hot weather basal tweaks .

 

[Flower]

Sunshine basal has been activated or Basal Pattern 3 as Medtronic prefers to call it.

I’m noticing the effects of warm weather so much more over the last few weeks, I keep heading low. I think it’s because I managed to do a basal test a few months back and the effect it had on my levels was amazing. In range results haven’t got much wriggle room when the sun’s out.

Ah the sheer variety of diabetes! 🙄