inexplicable rise

[Jeanne]

Hi, was thrilled this morning to see my fasting BG was 11.0 - the best it's been since starting the pump on Tuesday last week.
That was at 7.30 - when I tested again at 8.45, I was 14.7! All I had done in between was have a cup of tea (with soya milk, v low carb) and a bit of ironing. Why would it do this?
Have now had 60g carbs (shredded wheat and banana) with a corrective bolus but no doubt I'll be through the roof now
Jeanne.

 

[Phil65]

Hi, was thrilled this morning to see my fasting BG was 11.0 - the best it's been since starting the pump on Tuesday last week.
That was at 7.30 - when I tested again at 8.45, I was 14.7! All I had done in between was have a cup of tea (with soya milk, v low carb) and a bit of ironing. Why would it do this?
Have now had 60g carbs (shredded wheat and banana) with a corrective bolus but no doubt I'll be through the roof now
Jeanne.

Jeanne your hourly basal dose is probably not high enough, you need to go back to your pumping team/DSN for advice. Once you have your basal doses correct you will not have to do corrections with food that often, as long as you have got your insulin carb ratios correct as well. Also getting used to the effect of GIs and multi-waves, TBRs etc,etc ...lots to think about! It has taken 6 months pumping for me to identify I need a number of different basal doses a day and my bolus ratios are also different during the day. For me:

Bolus - Breakfast 2.7 units per 10g carb
Lunch 2 units per 10g carb
Dinner 2.5 units per 10g carb

Basal - 00.00-03.00 1.15u per hour
03.00-05.00 1u per hour
05.00-06.00 2u per hour
06.00-07.00 2.75u per hour
07.00-09.00 3u per hour
09.00-10.00 2.75u per hour
10.00-12.00 1.75u per hour
12.00-14.00 1.75u per hour
14.00-15.00 1.5u per hour
15.00-17.00 1.25u per hour
17.00-23.00 1.5u per hour
23.00-00.00 1.25u per hour

I hope you get yours cracked soon.....just need to test,test and test!

 

[Jeanne]

Thanks Phil, you're obviously really finely tuned, that's great! However did you get it so precise? Did you stick to the same foods each day until you could be sure? Also, what are TBRs please?

 

[Ellie Jones]

The only way to get it percise is fasting testing your basal...

Which is basically testing every hour to see whole reframing eating heree's a guide to basal testing http://www.diatribe.us/issues/13/learning-curve.php He does have a book but I perfer Pumping Insulin by John Walsh, known as the pumpers bible and well worth the investment (under ?20 if I remember rightly)

A couple of tips about basal testing..

Avoid eating any slow adsorbing carbs such as pasta, or high fat foods before basal testing, so if you are doing night-time testing, no pasta for dinner or tea... If you are testing in the morning no pasta, pastry etc for you evening meal... As they could still be impacting on your system when you are testing...

Create another profile which copies your main profile, and make adustments on this profile, when you got the adjustment right, transfer the setting over to your mian profile, this way you main one will always be the best working one and you know where you are too..

When adjusting, one thing at a time, if you make too many adustments in one go, you won't know which of the adjustments worked and which didn't too much haste ends in a pickle..

something quite often forgotten is the female monthy cycle, it can effect basal needs so bare this in mind, and keep notes it's actually a lot easier with the pump to see patterns on this score and it might be an advantage is gained by using a sperate basal profile when Aunty Flow is due to visit!


It does take time to settle into pumping, it's a lot easier and less intensive once you've got your basal pinned, as it's then a case of getting experience under your belt as you build this up it gets easier to decide what tactic suits what situation better, and when you come across a new situation you have more experience/information to make a better judgment how to tackle it with the pump..

I've been pumping now for almost 4 years, and my tactics are a lot different than when I started, more experience under the belt and improving techinques as you go along etc..

 

[Phil65]

Thanks Phil, you're obviously really finely tuned, that's great! However did you get it so precise? Did you stick to the same foods each day until you could be sure? Also, what are TBRs please?

Hi Jeanne,

Basal testing especially at night is important and just regular testing and adjusting really, my control is not perfect, some days it can be good others not so good, I do think my reading first thing in the morning is an important one though. The pump is so flexible compared to MDI you can bolus correct at any time. TBR is Temporary Basal Rate I use it when I exercise or do sport, eg when I play golf I give myself a TBR of 10% for 4 hours, it means I don't have to have sugary drinks as much as I used to have to when on MDI. You can also increase your TBR maybe if you are ill or on an areoplane, I recently was on a plane for 8 hours and increased my TBR to 200% .....worked well for me!🙂

 

[Unicornz]

Hi, was thrilled this morning to see my fasting BG was 11.0 - the best it's been since starting the pump on Tuesday last week.
That was at 7.30 - when I tested again at 8.45, I was 14.7! All I had done in between was have a cup of tea (with soya milk, v low carb) and a bit of ironing. Why would it do this?
Have now had 60g carbs (shredded wheat and banana) with a corrective bolus but no doubt I'll be through the roof now
Jeanne.

As mentioned before, it's likely to be down to a too low basal rate. I was told by my DSN to change a basal rate around 2 hours before the rise (or dip) appears because the basal takes a while to kick in.

Another thing it could be is Dawn Phenomenon, I suffer from this very badly in the morning. Between 5 and 7 I need double the amount of insulin that I need during most of the rest of the day to make sure my BG doesn't rise! I would wake up with a 7 or 8 and then an hour later (after no breakfast and a walk to work) I would be on 15! Annoying liver dumping glucose whenever it feels like... Either way, this basically still is a shortage of background insulin if you look at it so all you need to do (if you are sure it's a recurring thing and not just a one off!) is increasing your basal a little at a time until it's perfect!