Basal testing - STUPID question

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imtrying

imtrying

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Relationship to Diabetes
Type 1
Ok, I'm going to sound really, really thick here, but what is basal testing?

This is the first place I've heard anything about it so am very confused :confused: is it something I should be doing? (I'm on Novorapid and Lantus if that makes any difference?)

Thanks all 🙂
 
Hi Katie, basal testing is a method of making sure that you have the correct dose of slow-acting insulin (e.g. lantus or levemir) if on injections, or the correct amount of insulin trickling in on a pump, to 'mop' up the glucose that the liver produces throughout the day and night and prevent your levels from going too high or too low. To test, you need to go without eating carbs (so you don't need to inject/bolus) for a long period and test your levels. If they stay steady, then your basal insulin is covering the liver's glucose properly. If they drop low, you have too much basal, and if they climb high then you have too little basal.

This article explains in more detail:

http://www.diabetesselfmanagement.com/Articles/Insulin/getting_down_to_basals/
 
Northerner said:
Hi Katie, basal testing is a method of making sure that you have the correct dose of slow-acting insulin (e.g. lantus or levemir) if on injections, or the correct amount of insulin trickling in on a pump, to 'mop' up the glucose that the liver produces throughout the day and night and prevent your levels from going too high or too low. To test, you need to go without eating carbs (so you don't need to inject/bolus) for a long period and test your levels. If they stay steady, then your basal insulin is covering the liver's glucose properly. If they drop low, you have too much basal, and if they climb high then you have too little basal.

This article explains in more detail:

http://www.diabetesselfmanagement.com/Articles/Insulin/getting_down_to_basals/
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What Northey said :D

No diabetes question is stupid! I hadn't heard of basal testing until I started on my pump.
 
thanks girls....I just can't believe I've heard of so many things on here and they're things that have NEVER been mentioned to me before.

It's making me realise I've probably been getting fobbed off by my diabetes centre as all I've had is annual check ups and an annual blood test and thats it - you can appreciate I'm sure that in that one meeting short of going through my tests (or lack of) that nothing else gets spoken about.

and Northe - you should be writing about diabetes - your explanations of things are so comprehensive. I googled basal testing and was still confused. your explanation has made it really clear.

so do you seriously have to go 24 hours without eating???? the thought of 3 hours without eating scares me lol
 
imtrying said:
so do you seriously have to go 24 hours without eating???? the thought of 3 hours without eating scares me lol
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I've never been advised to go 24 hours without food. My body couldn't take it, for a start. My DSN told me to focus on one period at a time, i.e. skip breakfast and test from 8am to 12pm to check this basal. However, this is in reference to pumping so I'm not sure about basal testing on MDI. Northey...?

I wouldn't advise it because I hear basal testing really does help to get numbers right, but I refuse to do it. My body's been used to regular snacks to keep my BG up for 18 years, and asking it to go without food for more than 3 hours is highly unpleasant for me!
 
imtrying said:
...and Northe - you should be writing about diabetes - your explanations of things are so comprehensive. I googled basal testing and was still confused. your explanation has made it really clear.

so do you seriously have to go 24 hours without eating???? the thought of 3 hours without eating scares me lol
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Thank you Katie! 🙂 No, you don't need to go so long! You test your basal at different times of the day, on different days - so skipping breakfast one day, lunch another day etc. There is some contention over whether you should eat nothing at all whilst testing, or if you are allowed to have a meal with no carbs like bacon and eggs. Many people find that, if they eat nothing, then their liver will respond by putting out extra glucose, which then makes it difficult to decide whether your basal is right. This happens to me - if I skip breakfast then my levels climb higher than if I have a no-carb breakfast.

Unfortunately, diabetes does like to make us jump through hoops!🙄
 
imtrying said:
so do you seriously have to go 24 hours without eating???? the thought of 3 hours without eating scares me lol
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No you don't, first do a basal test over-night first, so have your evening meal and test during the night to establish your bg readings and then eat breakfast as normal. A day or two later repeat the test but do this from your breakfast, so 4 hours after start testing (means fasting and missing lunch) and wait till late afternoon before eating again. Only by fasting in between meals can you determine that you have your basal insulin correct, just remember to only increase or decrease your insulin no more than one or two units at a time when adjusting.

I just switched insulin's 3 weeks ago from lantus to levemir, so I too had to do the fasting test, but believe me its worth it to gain good bg control. Good luck! Toby.
 
Thankfully no you don't have to complete the testing in 24 hours..

You separate it into sectors of the day, overnight, morning upto dinner time, then dinner to supper time..

Your basal shouldn't increase or decrease by more than 2mmol/l if correctly set.. But if your suffer an hypo or get too high you need to correct and abort the fasting test...

You can even cheat on the night time one if you don't fancy getting woken every hour.. And do this over several nights, just test on a couple of hours, i.e 10pm, 3am and 6am on one night, the next night/time test at 11pm, 4am and 7am.. Over several different nights you get all the hours..

When doing this, you need to ensure that your starting BG is similar and routine is simialr (I actually when doing this will eat the same tea etc) gives a better result.. As you should be able to see the pattern of what is happening..

A good book to invest in which explains fasting tests etc are

Think Like a Pancreas by Gary Schadier (sp)
or

Using Insulin by John Walsh..
 
wow, thanks guys.

sounds quite complicated (at the moment) so I think I will wait until I actually have a diabetes centre allocated to me and get an appointment and tell them I am going to do it and sit down and work out a schedule!

I can't believe my one before - that I've had since I was diagnosed 18 years ago - has never mentioned, let alone suggested one! even when I changed to having lantus.

I've got a feeling this site is really going to highlight the downfall of my diabetes centre and my now apparent lack of care.
 
I only came across it in forums this year too.

It is well worth doing though. Pretty much all my recent BG level meltdowns since Feb seem to have been directly related to a unit or two too much or two little Basal: Basal driving me bonkers

Good luck with it, when you give it a go 🙂
M
 
I really hate basal testing, think i should probably do some before my next clinic appointment. The difficulty I find is although I seem to identify where my basal needs alter, I feel limited in how to address them. Basal testing is useful though in seeing if my basal is round about right. It was what helped me identify that lantus wasn't lasting 24 hours for me and prompted me to take a split dose.
 
My problem is this: I know that maybe a split of my lantus would help me if I could give more in the morning than at night, as my levels do tend to creep up in the morning. For example, this morning I had breakfast at 6:30. At 10:30 I was 5.8, at 11:30 I was 7.0 and at 12:30 just before lunch I was 7.8. Overnight though, the amount of lantus keeps me nicely within range. Trouble is - how do you split doses when you only take 3 units? 😱 :confused:
 
Northe

Might be worth asking about Levemir (I'm half tempted to do this myself). Not only does it seem to be more biddable in terms of changing doses, but it's compatible with a different set of pens, so .5 unit ones may well be available.

M
 
everydayupsanddowns said:
Northe

Might be worth asking about Levemir (I'm half tempted to do this myself). Not only does it seem to be more biddable in terms of changing doses, but it's compatible with a different set of pens, so .5 unit ones may well be available.

M
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It's a possibility Mike. Trouble is that my problems really aren't that bad - after all, 7.8 is only just out of range and many people would consider it excellent - so I'm not sure I want to go through the pain of changing. Insulin inertia!
 
everydayupsanddowns said:
Northe

Might be worth asking about Levemir (I'm half tempted to do this myself). Not only does it seem to be more biddable in terms of changing doses, but it's compatible with a different set of pens, so .5 unit ones may well be available.

M
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Mike, I can hardly talk from experience having only changed from lantus to levemir 3 weeks ago, however I have noticed one thing in this time, that is levemir is less prone to cause the high's and low's associated with lantus, don't know if this is due to splitting the dose into 2 injections rather than one big dose as before, but it certainly seems to level things out more even. The split dose has worked to date, and hasn't been as problematic as I first thought (thinking I would forget the morning dose) but I suppose there's time yet. Toby
 
nope levimer doesn't come in a 0.5 pen..

There are curtain things in clinic that does seem to be bit of a 'trade secret' never to be uttered!

At your new clinic one of the first things to ask... Can your name be added to there DAFNE course (hopefully they do this) but if not they will do an alternitive carb counting course.. These cause teach you how to adjust your dose to carbs you eating, how to read your data and use it to make adjustments to your background etc.. And many other aspects of what actually effects our control on a daily aspect...
 
Northerner said:
My problem is this: I know that maybe a split of my lantus would help me if I could give more in the morning than at night, as my levels do tend to creep up in the morning. For example, this morning I had breakfast at 6:30. At 10:30 I was 5.8, at 11:30 I was 7.0 and at 12:30 just before lunch I was 7.8. Overnight though, the amount of lantus keeps me nicely within range. Trouble is - how do you split doses when you only take 3 units? 😱 :confused:
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oh. my. god! you only take 3 units????

should I be worried that I take 32??????????????????
 
imtrying said:
oh. my. god! you only take 3 units????

should I be worried that I take 32??????????????????
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No! That's not unusual, and you take whatever you need to keep your levels steady. Who knows how many 'units' a fully functioning pancreas produces?! When I was first diagnosed I was on 20 units lantus, so I think I am a bit odd in reducing it by 85%!
 
Northerner said:
No! That's not unusual, and you take whatever you need to keep your levels steady. Who knows how many 'units' a fully functioning pancreas produces?! When I was first diagnosed I was on 20 units lantus, so I think I am a bit odd in reducing it by 85%!
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ok, panicking less now :D ...tho I think I need to do something about getting it down a bit....insulin encourages fat and i'm injecting farrrr too much!

oh and I LOVE all your poems! you should publish them - a diabetic book of poems 🙂 or a book of diabetic poems lol I'd buy it!
 
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