Basal adjustments

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Hanmillmum

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Hi, me again 😱

Just to clarify, to adjust basal you look at 2 hrs before the change, if I saw a rise from 2-3pm would I adjust from 12noon or at 11am inclusive of the hour?

I can never get this :confused:
 
I would go for 12pm..

Some suggest even earlier than that at 4 hours before hand, but I would go for 12 see if it give's the desired... As we all can have a slightly different adjustment time..

Me I would need to adjust an hour before hand... But that's me though, next person along it could be different
 
John Walsh would suggest that you work out the amount you need to drop the basal by and then spread that over a number of hours so that you end up with a very slow/steady changes.

eg if you think you need to add 0.1u onto total daily basal* and the rise is 2-3pm you might add 0.025u for the 4 hours between 10am - 2pm

I worked that way initially, but have had to modify that approach more recently with slightly more rapid changes in rate as my BGs seemed to change more abruptly and my basal rises and falls started to overlap!

* say for a 3.3mmol/L rise on 20u TDD
 
everydayupsanddowns said:
John Walsh would suggest that you work out the amount you need to drop the basal by and then spread that over a number of hours so that you end up with a very slow/steady changes.

eg if you think you need to add 0.1u onto total daily basal* and the rise is 2-3pm you might add 0.025u for the 4 hours between 10am - 2pm

I worked that way initially, but have had to modify that approach more recently with slightly more rapid changes in rate as my BGs seemed to change more abruptly and my basal rises and falls started to overlap!

* say for a 3.3mmol/L rise on 20u TDD
Click to expand...

Thanks, been trying to make sense of Walsh:

Her rise is averaging 3mmols just between 2-3pm and a further 2mmols up to 4pm, so around an average of 5mmols. As per Walsh the adjustment then would be roughly + 0.2u but divided by 5 as her total daily basal is only 3.9u ? So nearest basal would be 0.050 ? this would only be able to go in over 2 hrs then.

lol, maths is not my thing :D
 
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Not sure tbh. The way I read it it is the total change that counts, and his tables seem to suggest total alterations to basal, based on TDD (lower TDD smaller changes...)

So...

Looking to correct a 5mmol/L rise between 2 and 4pm

Smallest TDD in the table I have is 20u a day (guessing yours will be lower than that)

20u TDD and 6mmol/L rise = total change of 0.3u

The difference between 30u TDD and 20u TDD values is significant, so if you are dealing with, say 10u TDD or thereabouts it might be that you are only talking about 0.15u total basal change.

So I guess you could spread that 0.15u over a few hours, say an extra 0.05u/h between 12-1pm, 1-2pm and 2-3pm?

Bit of a head-scratcher innit!
 
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TDD is 3.9u

The lowest example in book is against the TDD of 20u hence I thought of dividing the 0.3 by 5 (rounding the 3.9 up to 4) to get an approx for Millie - which is 0.060.


My head hurts 🙄

Oh dear, will see what tea time brings - lol
 
TDD 'total daily dose' would refer to the sum of both basal and bolus (rather than total basal...) as far as I understand it. eg JW uses TDD as a basis to recommend basal (usually 50% TDD)
 
I suspect you would have to start again wholesale (and then tweak from there). Lots of people who start on a pump have to re-think what they thought they knew about how their D works on MDI.

Having said that, mine has settled back to not dissimilar proportions as on MDI with a slight overall reduction to TDD.

Your apparent pancreatic trickle has 'pump' written all over it Northie. You could spread that 1u in 0.025u increments 🙂
 
everydayupsanddowns said:
TDD 'total daily dose' would refer to the sum of both basal and bolus (rather than total basal...) as far as I understand it. eg JW uses TDD as a basis to recommend basal (usually 50% TDD)
Click to expand...

(Got delayed internet was down)

Ha, finally got there re: TDD, D'oh, thanks for your patience - bet you were rapidly losing will to live!! :D Millie's TDD is usually 10-11u.

Well my plan didn't work too well, was 9.7mmols at 2pm and 5.2mmols at 4pm, nice reading pre meal but still a drop of 4+, whch doesn't leave much scope if a slightly lower mid afternoon.
I increased basal by 0.025 from 11am-1pm.
Now I should probably knock one of those hours back out 🙄
 
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Hmmm so from +5 to -4... Looks like taking out half of the adjustment hours (or halving the adjustment over the same no of hours) could be about right. Always tricky knowing when to change adjustments I find. I never want to carry on if it looks wrong, but constantly tweaking every day can leave you chasing your tail 🙄
 
I know !

I've got a good run at trying to get it sorted as on annual leave from work, I don't expect it to be perfect as too many variables on a daily basis with her age but we'll see.

Thanks for your help 🙂
 
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