howdy pumpers

[Adrienne]

Going off this, I would want the change from 2 am, so i would change midnight to affect 2-3 am, change 1am to affect 3-4 am.

I would be tempted to test at 3am to see if there is a rise maybe first? A 3 am change would usally kick in at 5 am too late, or for some 4am again too late as you have already risen.

I agree. I think Sam has said that when she has tested at 3 am before she is high already so I would guess the rise is starting at 2.30 odd to make her high at 3 am so I would suggest, like you said, putting in a higher temp at 12.30 or 1 am (probably 1 am to see what happens first of all) as not everyone needs the 2 hours before and I am always wary about night times.

Do you agree Tracey? I know you've done all this as well.

 

[tracey w]

I agree. I think Sam has said that when she has tested at 3 am before she is high already so I would guess the rise is starting at 2.30 odd to make her high at 3 am so I would suggest, like you said, putting in a higher temp at 12.30 or 1 am (probably 1 am to see what happens first of all) as not everyone needs the 2 hours before and I am always wary about night times.

Do you agree Tracey? I know you've done all this as well.

Absolutely what i would do, but for me i would start two hours before to get my affect, depends how long Sam needs for the change to affect her, she will know. The spirit combo lets you change on the hour only not half past.

 

[SilentAssassin1642]

here's my current basal rates from midnight

00.00-01.00 - 0.43
0100 - 0200 - 0.43
0200 - 0300- 0.47
0300- 0400 - 0.52

I dunno what to change and I want to do a change tonight.

Help?

 

[SilentAssassin1642]

Absolutely what i would do, but for me i would start two hours before to get my affect, depends how long Sam needs for the change to affect her, she will know. The spirit combo lets you change on the hour only not half past.

I've noticed that even changing an hour before things tend to go upside down...

like for instance if I put a 0% on an hour before I leave work, and then I get home and I'm still hypo.

I'm so confused with all of this at the moment

(and sleep deprived...)

 

[Adrienne]

here's my current basal rates from midnight

00.00-01.00 - 0.43
0100 - 0200 - 0.43
0200 - 0300- 0.47
0300- 0400 - 0.52

I dunno what to change and I want to do a change tonight.

Help?

Gosh a different one each hour. Is it like this throughout the 24 hour period? If so maybe that is why you are getting confused. Did you put these all in yourself?

Do you have the Medtronic (I thought you did but maybe you don't). If you say things take effect only after an hour then maybe you should change the 1am basal be 0.47 so you get an extra hour at the higher rate, ie same as the 2 am basal.

I can't obviously guarantee this will be right but it is a start. Tracey, do you agree? Sam can pull it back to 12.30 if needed or even go forward to 1.30 if it doesn't work (if she has the Medtronic of course which does do the half hour).

 

[SilentAssassin1642]

Gosh a different one each hour. Is it like this throughout the 24 hour period? If so maybe that is why you are getting confused. Did you put these all in yourself?

Do you have the Medtronic (I thought you did but maybe you don't). If you say things take effect only after an hour then maybe you should change the 1am basal be 0.47 so you get an extra hour at the higher rate, ie same as the 2 am basal.

I can't obviously guarantee this will be right but it is a start. Tracey, do you agree? Sam can pull it back to 12.30 if needed or even go forward to 1.30 if it doesn't work (if she has the Medtronic of course which does do the half hour).

not all the time, am on pretty much the same for a few hours at a go in the day...

0500-0700 - 0.60
0700-1200 - 0.55
1200- 1600 0.60
1600-2000- 0.55
2000-000 0.45

then during the night it gets all scewiff...I'm ok til 2am then boom, high at 3-4am. I'm just all like

So, dyu think I should up it to something the same between maybe 12-3?

Also, I'm on the roche spirit combo,not the medtronic...

 

[Adrienne]

not all the time, am on pretty much the same for a few hours at a go in the day...

0500-0700 - 0.60
0700-1200 - 0.55
1200- 1600 0.60
1600-2000- 0.55
2000-000 0.45

then during the night it gets all scewiff...I'm ok til 2am then boom, high at 3-4am. I'm just all like

So, dyu think I should up it to something the same between maybe 12-3?

Also, I'm on the roche spirit combo,not the medtronic...

Oh ok. Where have you come up with the odd numbers ie 0.43 or 0.47, do you not think it would be easier to work with numbers like the rest of the day ie 0.45 and 0.40 and 0.50 etc.

If so then you could change it all a bit.


00.00-01.00 - 0.43
0100 - 0200 - 0.43
0200 - 0300- 0.47
0300- 0400 - 0.52

I would maybe do this :


00.00-01.00 - 0.45
0100 - 0200 - 0.50
0200 - 0300- 0.50
0300- 0400 - 0.50

So you will be looking at :

0000 - 0100 - 0.45
0100 - 0500 - 0.50
0500 - 0700 - 0.60
etc etc

I take it you can't use the half hour like Tracey, is that right?

All I have done is round things up and down and make the 1 am the higher amount so you are getting a bit more for an extra hour. You may find you need to make it 0200 starting at 0.50 if you go hypo at 3 am. It is just trial and error.

I was thinking about your post breakfast spike and once you are waking up ok, you could tweak that 5 am basal a bit higher and see if that counter balances the post breakfast spike. This is where we have to tweak if for Jessica for a 10 am post spike, a full 5 hours before it happens.

 

[SilentAssassin1642]

Oh ok. Where have you come up with the odd numbers ie 0.43 or 0.47, do you not think it would be easier to work with numbers like the rest of the day ie 0.45 and 0.40 and 0.50 etc.

If so then you could change it all a bit.


00.00-01.00 - 0.43
0100 - 0200 - 0.43
0200 - 0300- 0.47
0300- 0400 - 0.52

I would maybe do this :


00.00-01.00 - 0.45
0100 - 0200 - 0.50
0200 - 0300- 0.50
0300- 0400 - 0.50

So you will be looking at :

0000 - 0100 - 0.45
0100 - 0500 - 0.50
0500 - 0700 - 0.60
etc etc

I take it you can't use the half hour like Tracey, is that right?

All I have done is round things up and down and make the 1 am the higher amount so you are getting a bit more for an extra hour. You may find you need to make it 0200 starting at 0.50 if you go hypo at 3 am. It is just trial and error.

I was thinking about your post breakfast spike and once you are waking up ok, you could tweak that 5 am basal a bit higher and see if that counter balances the post breakfast spike. This is where we have to tweak if for Jessica for a 10 am post spike, a full 5 hours before it happens.

you are an angel!

Those random ones were me thinking that tidgy adjustments would work best...they didn't. I failed yet again D:

*is going to favourite this thread*

re breakfast, the only thing i've found to not hugely spike me is sainsburys own instant hot oats. Very odd. But when I get to work I'm either hypo or floating at 8/9 where I stay for the rest of the day and it irritates me no end. But its the post lunch that gets me...anywhere between 13 and 19 most days after lunch, despite eating the same, and doing exactly the same with insulin each day. Very annoying. Just as soon as I'm waking up on decent levels I can start tweaking day time, cuz that needs tackling asap!

 

[tracey w]

Gosh a different one each hour. Is it like this throughout the 24 hour period? If so maybe that is why you are getting confused. Did you put these all in yourself?

Do you have the Medtronic (I thought you did but maybe you don't). If you say things take effect only after an hour then maybe you should change the 1am basal be 0.47 so you get an extra hour at the higher rate, ie same as the 2 am basal.

I can't obviously guarantee this will be right but it is a start. Tracey, do you agree? Sam can pull it back to 12.30 if needed or even go forward to 1.30 if it doesn't work (if she has the Medtronic of course which does do the half hour).

I do agree, i would start at 1am if you see an effect after 1 hour Sam, you can always go back to upping the midnight one if it is not enough. Just checking are you sure its 1 hour not 2, because i would think thats why you hypo after work you are not changing to the zero percent early enough and the basal the hour before the zero is having the effect?

 

[SilentAssassin1642]

I do agree, i would start at 1am if you see an effect after 1 hour Sam, you can always go back to upping the midnight one if it is not enough. Just checking are you sure its 1 hour not 2, because i would think thats why you hypo after work you are not changing to the zero percent early enough and the basal the hour before the zero is having the effect?

mmmhmmm. Could well be...but having 0% on for before the hour before i leave for work...it frightens me a bit. Nurse may have been all like ONLY DO IT AN HOUR BEFORE OR YOU WILL GET SICK or something to that extent.......

maybe an hour and a half before I leave.

So say for instance, I get up at bout 6.30/7 every morning, and leave the house at 8.15. So If i set the TBR for say 6.45am at 0% and leave it going for 2.5 hours? Same for when I leave from work, maybe start it half an hour earlier than usual? Urgh, I dunno. Head about to implode from all the complicated numbers

 

[tracey w]

Sam i only change rates up or down by 0.05 each time, as you have found the tiny amounts will make no difference, think about 0.05 its very small, if its not enough up it again the next day.........you go a long way before this is even 1 unit.

Now think about mdi, huge difference the pump can make eh, dont give up you will get there.

 

[SilentAssassin1642]

Sam i only change rates up or down by 0.05 each time, as you have found the tiny amounts will make no difference, think about 0.05 its very small, if its not enough up it again the next day.........you go a long way before this is even 1 unit.

Now think about mdi, huge difference the pump can make eh, dont give up you will get there.

Thank you tracey - gonna bear that in mind for future 🙂

Hoping Adrienne's suggestions bear some kind of fruit most definitely. Need a night off tonight however, and may have had a glass of rather strong (18 year old...) JD and coke! Oops.

If I wake up with brilliant numbers however tomorrow But I guess like anything it will take a few days to show properly? Or am I still in MDI mindset?

 

[tracey w]

mmmhmmm. Could well be...but having 0% on for before the hour before i leave for work...it frightens me a bit. Nurse may have been all like ONLY DO IT AN HOUR BEFORE OR YOU WILL GET SICK or something to that extent.......

maybe an hour and a half before I leave.

So say for instance, I get up at bout 6.30/7 every morning, and leave the house at 8.15. So If i set the TBR for say 6.45am at 0% and leave it going for 2.5 hours? Same for when I leave from work, maybe start it half an hour earlier than usual? Urgh, I dunno. Head about to implode from all the complicated numbers

I didnt want to get too in depth i know you are tackling a lot! But i used to do zero and disconnections for exercise, but my consultant is not happy with disconnections or no insulin for long periods. My lowest now is 0.05, i exercise on full amount and TBR for a few hours after, better to have small snack than no insulin, it just messes you up later on.

If you are exercising (walking to work), i would not do zero basal, i would give less breakfast insulin as you are exercising.

I would not do zero at all now especially not 2.5 hours, this could be why you rise much higher later Sam, just a thought.

 

[SilentAssassin1642]

I didnt want to get too in depth i know you are tackling a lot! But i used to do zero and disconnections for exercise, but my consultant is not happy with disconnections or no insulin for long periods. My lowest now is 0.05, i exercise on full amount and TBR for a few hours after, better to have small snack than no insulin, it just messes you up later on.

If you are exercising (walking to work), i would not do zero basal, i would give less breakfast insulin as you are exercising.

I would not do zero at all now especially not 2.5 hours, this could be why you rise much higher later Sam, just a thought.

now that's an idea...maybe if I stick myself on a 10/20%? And slash my breakfast insulin by a bit?

Whoa very confusing...

p.s. you can do a 0.05 TBR????

 

[tracey w]

Thank you tracey - gonna bear that in mind for future 🙂

Hoping Adrienne's suggestions bear some kind of fruit most definitely. Need a night off tonight however, and may have had a glass of rather strong (18 year old...) JD and coke! Oops.

If I wake up with brilliant numbers however tomorrow But I guess like anything it will take a few days to show properly? Or am I still in MDI mindset?

yep thats mdi forget it!

 

[SilentAssassin1642]

so plan, I'm gonna try and stick myself on a 20% TBR for 2.5 hours pre leaving tomorrow, so from 6.45 instead of 7.15 (or whatever time I leave). Also, have put myself to a 1:8 ratio at bfast instead of a 1:7 - just to play around with it.

And will do the same pre leaving work.

Now, I am off for a bath and bed 🙂

 

[Adrienne]

now that's an idea...maybe if I stick myself on a 10/20%? And slash my breakfast insulin by a bit?

Whoa very confusing...

p.s. you can do a 0.05 TBR????

Tracey is right. For exercise for a half hour swimming lesson, an hour before we put on a 50% temp basal for four hours !!! Within that four hours though there is an hour where the pump is off and she is getting changed so there is three hours of 50%.

You could try a 20% tbr for a few hours putting it on an hour beforehand. Or an hour and a half before hand. Then start tweaking that up as needed.

The rule of thumb for exercise is to eat your body weight in free carbs. So for example Jessica is 42 kilos and so should eat 40 free carbs. This is just a starting point and may be too much or in come cases not enough. You could start by 20 free carbs and see what that does and take it from there. ie only bolus for part of breakfast making 20 carbs of it free !

Good luck, I think you are finally getting there and understanding it, which is fab. xx

 

[tracey w]

so plan, I'm gonna try and stick myself on a 20% TBR for 2.5 hours pre leaving tomorrow, so from 6.45 instead of 7.15 (or whatever time I leave). Also, have put myself to a 1:8 ratio at bfast instead of a 1:7 - just to play around with it.

And will do the same pre leaving work.

Now, I am off for a bath and bed 🙂

good luck worth a try, least you will have no zero insulin as thats not a great idea really. 🙂

 

[tracey w]

now that's an idea...maybe if I stick myself on a 10/20%? And slash my breakfast insulin by a bit?

Whoa very confusing...

p.s. you can do a 0.05 TBR????

hmmm, yes but you would need to see what ratio you are on for that hour if it makes sense, eg. if its 0.10 and you do 50% decrease that would be 0.05............dont ask me work out anything harder this late but you get the picture.

 

[SilentAssassin1642]

Tracey is right. For exercise for a half hour swimming lesson, an hour before we put on a 50% temp basal for four hours !!! Within that four hours though there is an hour where the pump is off and she is getting changed so there is three hours of 50%.

You could try a 20% tbr for a few hours putting it on an hour beforehand. Or an hour and a half before hand. Then start tweaking that up as needed.

The rule of thumb for exercise is to eat your body weight in free carbs. So for example Jessica is 42 kilos and so should eat 40 free carbs. This is just a starting point and may be too much or in come cases not enough. You could start by 20 free carbs and see what that does and take it from there. ie only bolus for part of breakfast making 20 carbs of it free !

Good luck, I think you are finally getting there and understanding it, which is fab. xx

😱 this is so complicated. My 40g bowl of borridge is 33g carbs...so erm...that would mean bolusing for just 10g of that 😱 whoa, this is making my head hurt unless...unless I have a large bowl of breakfast, bolus as normal?

Blimey, this is all too complicated for nearly 11pm. I'm off to beddy byes - thankfully tomorrow is just a 5 hour shift so fingers crossed I can get something working hehe.

Have changed those settings and praying praying praying that something a bit more friendly happens tonight. I might shedule a 3am test or a 4am, just because I'm curious 🙂