Basal question

[gillrogers]

So really now starting to come round to needing to somehow find time for basal testing. How though I’m not sure. Anyway something I’ve noticed over the last couple of days is that over 5 hours since my breakfast and last boils Im dropping half a unit every 15 mins . That’s suggesting to me that my basal is too high but it’s right for breakfast. I’m thinking then that I need to drop my basal by one unit and up my breakfast bolus to compensate? And probably up my evening meal basal too. ? That could have been part of my problem with my cream teas lol.

 

[rebrascora]

I guess you options are to do that or to adjust your lunchtime bolus ratio, if you have lunch.

 

[Inka]

I wouldn’t change anything without doing a basal test of some kind @gillrogers If you really can’t do a basal test, then try dropping the basal one unit as you suggest but leave your breakfast bolus alone for now and see how things go.

 

[Bloden]

I wouldn’t make so many changes in one go either. One thing at a time! 🙂

 

[Lucyr]

You don’t really need to find time to basal test, just do your normal day but skip a meal. It doesn’t take any extra time in your day but can be useful results.

 

[helli]

I have to plan to miss a meal as I can get very hungry (and hangry) if I go for more than about 4 hours without food. Whilst it takes no time, It is most certainly not easy and I could not do it on a stressful work day.
You also have to avoid exercise (and stress). Again that needs to be planned for

 

[gillrogers]

You don’t really need to find time to basal test, just do your normal day but skip a meal. It doesn’t take any extra time in your day but can be useful results.

Ooh can I still do a physical job though?

 

[gillrogers]

I have to plan to miss a meal as I can get very hungry (and hangry) if I go for more than about 4 hours without food. Whilst it takes no time, It is most certainly not easy and I could not do it on a stressful work day.
You also have to avoid exercise (and stress). Again that needs to be planned for

Thats what I thought. My job is physical and has a bit of a routine but depending on how much ness has been left by hirers it can be either not to physical or very physical. I don’t know until I’m there to see. Planning just goes straight out of the window.

 

[SB2015]

Hi @gillrogers your basal test needs to be for your normal activity, so if you do a physical job you need your basal to match that. I was using a pump so had a basal profile for work days and another for weekends as my needs were very different. If on MDI I was not able to fine tune it in the same way, so sorted out the split basal and then made adjustmenus with additional carbs as necessary.

I find the basal tests took forever. I split it up and tried to make the gaps as big as I could between the meals, but this was difficult when working. They frequently got interrupted by hypos and hypers. I found it could take me about two weeks to get the full 24 hours covered.

 

[SB2015]

Us hats what I thought. My job is physical and has a bit of a routine but depending on how much ness has been left by hirers it can be either not to physical or very physical. I don’t know until I’m there to see. Planning just goes straight out of the window.

This makes it sound like you would have a good argument for asking for a pump, which would allow you more flexibility and the facility to make adjustments on a daily basis Using temporary basal rates which can be set for any number of hours. Just a thought

 

[gillrogers]

Hi @gillrogers your basal test needs to be for your normal activity, so if you do a physical job you need your basal to match that. I was using a pump so had a basal profile for work days and another for weekends as my needs were very different. If on MDI I was not able to fine tune it in the same way, so sorted out the split basal and then made adjustmenus with additional carbs as necessary.

I find the basal tests took forever. I split it up and tried to make the gaps as big as I could between the meals, but this was difficult when working. They frequently got interrupted by hypos and hypers. I found it could take me about two weeks to get the full 24 hours covered.

Wow. My job has no normality to it. It’s sporadic and unpredictable. Sometimes I’ll go to it expecting not to have much to do so no change in basal or meal insulin then I can go and find a hell of a mess that should require me to have dropped my basal and meal time by 30 percent and I’ve tried eating but I’ve got to give 15 mins to half hour sat doing nothing before I can start, which I don’t have plus I can’t work out how much I need to eat. Everything is an experiment that I can’t keep up with. I’m not getting anything sorted again as too much needs changing again and it’s getting me so down again.

 

[gillrogers]

This makes it sound like you would have a good argument for asking for a pump, which would allow you more flexibility and the facility to make adjustments on a daily basis Using temporary basal rates which can be set for any number of hours. Just a thought

That has been going through my mind but I’m worried I don’t know and understand enough yet. I’ve only been a type one for about 18 months .

 

[gillrogers]

I wouldn’t make so many changes in one go either. One thing at a time! 🙂

Oh I know. Just got so many pickles with it all again. And I’m sure it’s because my job is to sporadic.

 

[Inka]

and I’ve tried eating but I’ve got to give 15 mins to half hour sat doing nothing before I can start, which I don’t have plus I can’t work out how much I need to eat.

When your routine is unpredictable, you just have to improvise as you go along, I’ve found. You don’t have to get things perfect, just keep going along ok. There is no magic sequence of things that will ensure perfect results every time. So, for example, if you start work with a blood sugar of 6.5 and think that will be fine as you’re going to have a quiet, unenergetic day, then that all changes and you have to be active, just top up with glucose and/or carbs as needed without a bolus. You don’t have to sit for half an hour as you wouldn’t be bolusing @gillrogers

 

[gillrogers]

and I’ve tried eating but I’ve got to give 15 mins to half hour sat doing nothing before I can start, which I don’t have plus I can’t work out how much I need to eat.

When your routine is unpredictable, you just have to improvise as you go along, I’ve found. You don’t have to get things perfect, just keep going along ok. There is no magic sequence of things that will ensure perfect results every time. So, for example, if you start work with a blood sugar of 6.5 and think that will be fine as you’re going to have a quiet, unenergetic day, then that all changes and you have to be active, just top up with glucose and/or carbs as needed without a bolus. You don’t have to sit for half an hour as you wouldn’t be bolusing @gillrogers

That’s very true. But I can’t find the middle ground and end up 2 high. I think a lot of this anxiety I have is from my early days when after lock down I was able to go back to work and suddenly I’m finding my self heading to a hypo so fast that the libre couldn’t keep up with so didn’t set off the alarm . I had to have 2 bottles of glucose juice until it started coming back up. Clutz here did realise or twig that cleaning and pushing a hoover around amounted to excercise and being physical. I was on my own in the village hall and absolutely terrified. And even though I now understand about dropping basal and bolus insulin I’m aware that my basal could drop on the day that happens again.

 

[Inka]

Never feel bad about being scared of hypos @gillrogers I am - and, like you, I sometimes overcompensate and eat too much. I do find the Libre helps that though as I can scan often to reassure myself. I tend to eat a certain amount, check I’m at an ok number but keep extra glucose/food by me so I can top up again if necessary.

I agree the Libre low alarm is a bit behind, but I sometimes set it higher so it sounds and reminds me to check my blood sugar. I then look at the arrow and see how things are going.

If you can work out what’s sending you down fast - ie insulin or activity - then that helps. Another thing to say is that I pre-load with glucose/carbs before an activity rather than wait till I’m dropping.

 

[gillrogers]

Never feel bad about being scared of hypos @gillrogers I am - and, like you, I sometimes overcompensate and eat too much. I do find the Libre helps that though as I can scan often to reassure myself. I tend to eat a certain amount, check I’m at an ok number but keep extra glucose/food by me so I can top up again if necessary.

I agree the Libre low alarm is a bit behind, but I sometimes set it higher so it sounds and reminds me to check my blood sugar. I then look at the arrow and see how things are going.

If you can work out what’s sending you down fast - ie insulin or activity - then that helps. Another thing to say is that I pre-load with glucose/carbs before an activity rather than wait till I’m dropping.

I have mine set at 5.6 but still misses it . I keep getting told it’s insulin that’s dropping it but I’m sure that’s not always the case. Perhaps preloading before I do my activity may be the way to go . That would solve the problem of planning and finding out I’ve planned wrong when I’ve got there.

 

[trophywench]

I have a friend who manages a village hall in rural Worcestershire and some hirers there don't seem to be able to a) tell the time anyway or b) realise that should they overstay their booking - she's going to invoice them for the extra time. Comes as a very nasty surprise apparently. Short of employing bouncers (in the old fashioned sense of the word) I'm not sure what you can do about that - just know I'm empathetic !

 

[SB2015]

That has been going through my mind but I’m worried I don’t know and understand enough yet. I’ve only been a type one for about 18 months .

With the variation in each day for you I think you might find that a pump would help.
You need to be carb counting and have done some sort of education course around here.
The initial phase with a pump is a lot to get used to but well worth it And your already 18 months in.
It could be worth talking to your team, as it may take a while to get to having one after you get agreement.

The new NICE Guidelines certainly support all T1s having access to the tech (in theory, so it does not always follow that the CCG go along with this)

 

[gillrogers]

I have a friend who manages a village hall in rural Worcestershire and some hirers there don't seem to be able to a) tell the time anyway or b) realise that should they overstay their booking - she's going to invoice them for the extra time. Comes as a very nasty surprise apparently. Short of employing bouncers (in the old fashioned sense of the word) I'm not sure what you can do about that - just know I'm empathetic !

Thanks Jenny, I’m glad I’m not the only one lol. We have a particular group at the moment who can’t tell the time, can’t follow instructions on how to use the dishwasher, can’t even organise themselves then use our car park afterwards while the go to the pub over the road for lunch! Never mind that we have other users in afterwards. Ooh they do my swede in! Lol