Comments please on my basal test results - morning basal test

[mum2westiesGill]

7:53am waking 5.8
9:27am before breakfast and start of basal test 7.2
9:55am 6.7
10:55am 8.4
12:03pm 7.5
13:06pm 7.9

My thoughts are that they've held steady and no changes are needed.
Problem areas are other parts of the day when I test from meal to meal and go hypo - so I'm unsure what to do

I would appreciate other people's thoughts

 

[rebrascora]

That is looking pretty good Gill for that morning portion of the day.
I think it is important to note that you had 2 rich tea biscuits at bedtime, so that it isn't assumed that your levels held steady through the night without any carbs. I know this is a morning basal test but it is easy to look at those results and assume that it covered the night time period as well..... otherwise why include those readings.

 

[mum2westiesGill]

That is looking pretty good Gill for that morning portion of the day.
I think it is important to note that you had 2 rich tea biscuits at bedtime, so that it isn't assumed that your levels held steady through the night without any carbs. I know this is a morning basal test but it is easy to look at those results and assume that it covered the night time period as well..... otherwise why include those readings.

I've removed the before tea and bedtime readings because this was for a morning/breakfast test.

 

[mum2westiesGill]

If my lunchtime level is within target range I will do the lunchtime basal test tomorrow.

This will be where the problems start because if my levels are steady for the morning portion of the day but not for the other portions what would I need to do then?

 

[Kaylz]

As you know Tresiba isn't the easiest basal to be on as it isn't adjustable so it may be a case of leaving the basal where it is but altering the ratio for the time block xx

 

[rebrascora]

If my lunchtime level is within target range I will do the lunchtime basal test tomorrow.

This will be where the problems start because if my levels are steady for the morning portion of the day but not for the other portions what would I need to do then?

You could either eat a couple of biscuits in the afternoon in the same way that you do at bedtime, or reduce your Tresiba by another unit and look at decreasing your breakfast bolus ratio (ie have more bolus insulin) to help keep your levels from going too high in the morning.

 

[mum2westiesGill]

As you know Tresiba isn't the easiest basal to be on as it isn't adjustable so it may be a case of leaving the basal where it is but altering the ratio for the time block xx

Thanks @Kaylz it's so hard knowing what to do. If it was you what would you do?

 

[mum2westiesGill]

You could either eat a couple of biscuits in the afternoon in the same way that you do at bedtime, or reduce your Tresiba by another unit and look at decreasing your breakfast bolus ratio (ie have more bolus insulin) to help keep your levels from going too high in the morning.

The biscuits sound like a good plan - would you have them mid afternoon and do a test before?

Do you mean increase or decrease the breakfast bolus ratio?

 

[rebrascora]

Do you mean increase or decrease the breakfast bolus ratio?

I mean change the ratio, so that you have more insulin for your usual breakfast than you currently do, it depends how you look at it as to whether that is increasing or decreasing the ratio. So if you currently have 1:8 ie I unit of insulin to 8g of carbs, then change it to 1:7 or 1:6 ie 1 unit of insulin for every 7 or 6g of carbs. That is an example. I am not sure of your current ratio.

But first you need to see how your afternoon basal test goes. Try not to cross bridges until you get to them. Wait until you have all the data first and then decide upon a strategy. Your afternoon basal testing should give you an idea of when you might need to eat biscuits if that was your strategy. Of course, if you are prone to putting on weight then eating more biscuits (or a piece of fruit or other carbs) would probably not be a good strategy and reducing the Tresiba and changing the breakfast ratio would perhaps be a better option, but I think you have said before that your weight is fine.

 

[mum2westiesGill]

I mean change the ratio, so that you have more insulin for your usual breakfast than you currently do, it depends how you look at it as to whether that is increasing or decreasing the ratio. So if you currently have 1:8 ie I unit of insulin to 8g of carbs, then change it to 1:7 or 1:6 ie 1 unit of insulin for every 7 or 6g of carbs. That is an example. I am not sure of your current ratio.

From 8:30am - 11:30am my current breakfast ratio is 1:8

But first you need to see how your afternoon basal test goes. Try not to cross bridges until you get to them. Wait until you have all the data first and then decide upon a strategy. Your afternoon basal testing should give you an idea of when you might need to eat biscuits if that was your strategy. Of course, if you are prone to putting on weight then eating more biscuits (or a piece of fruit or other carbs) would probably not be a good strategy and reducing the Tresiba and changing the breakfast ratio would perhaps be a better option, but I think you have said before that your weight is fine.

Yes I will wait until I've done my afternoon test to decide which strategy to take.

If anything gets in the way of doing the afternoon test tomorrow such as not being in my target range or if I have to stop it because my levels have dropped by 1 - 2mmols what would I do then?

 

[rebrascora]

If you are not in target range at lunchtime then do the test another day.
If you start in range at lunchtime and levels drop into a hypo or very close to one, then obviously stop the test and make a note of the time when it dropped. That tells you that you have too much basal insulin at that time of day and if you opt for the afternoon biscuit or piece of fruit strategy, then you would eat them before that time to keep levels from dropping.

 

[everydayupsanddowns]

If anything gets in the way of doing the afternoon test tomorrow such as not being in my target range or if I have to stop it because my levels have dropped by 1 - 2mmols what would I do then?

Unless you are having hypos, I would try to rerun the test. Where did you get 1-2mmols from? When I check basal I am happy for it to rise or fall by 1-2, but if it rises more than that, or if I go hypo then I would stop the test.

 

[mum2westiesGill]

If you are not in target range at lunchtime then do the test another day.

So if not in my target range tomorrow (Monday) do it on Tuesday and so on until I get to a day where I am in my target range?

If you start in range at lunchtime and levels drop into a hypo or very close to one, then obviously stop the test and make a note of the time when it dropped. That tells you that you have too much basal insulin at that time of day and if you opt for the afternoon biscuit or piece of fruit strategy, then you would eat them before that time to keep levels from dropping.

Before deciding on this though do I need to wait until I can do an evening skipping tea test?

 

[mum2westiesGill]

Unless you are having hypos, I would try to rerun the test.

Which test would you try to re run?

Where did you get 1-2mmols from?

I got it from the MySugr basal test link which @Lucyr sent me so not quite 1-2mmols
'After the test (and after you get some food!) take a look at your data. Any unusual movements in your blood sugar? Anything more than 30-40 mg/dl (1.6-2.2mmol/l) of movement may be something to address.'

When I check basal I am happy for it to rise or fall by 1-2, but if it rises more than that, or if I go hypo then I would stop the test.

 

[everydayupsanddowns]

If anything gets in the way of doing the afternoon test tomorrow such as not being in my target range or if I have to stop it because my levels have dropped by 1 - 2mmols what would I do then?

I got it from the MySugr basal test link which @Lucyr sent me

Ah OK, so not necessarily that 2mmols means stop the test, but more that more than 2mmols during the test suggests your basal might need adjusting. That’s what I would do too 🙂

Which test would you try to re run?

I would rerun the test you had to stop, or that something got in the way of (so that you didn‘t get clear results)

 

[Lucyr]

I would do the same as @everydayupsanddowns and redo the same test as the one I had to stop because of a hypo, since that is clearly a problematic time of day