Some basal results - can anyone look over for me please?

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lauraw1983

lauraw1983

Well-Known Member
Relationship to Diabetes
Type 1
So, still trying to nail these basal rates, morning first! I would really appreciate it if some of you seasoned pumpers could take a look over these and give me your thoughts? After making some changes my basal profile is this:

I had eaten nothing since 6pm the night before. BG was 11 at 11pm, corrected down.

00:00 - 06.00u
01:00 - 0.600u
02:00 - 0.600u
03:00 - 0.600u - BG 6.3
04:00 - 0.600u
05:00 - 0.700u
06:00 - 0.700u
07:00 - 0.850u - BG 4.3
08:00 - 0.900u - BG 4.2
09:00 - 0.925u - BG 4.2
10:00 - 0.925u - BG 4.4
11:00 - 0.925u - BG 4.3
12:00 - 0.600u
13:00 - 0.600u

So obviously a little too much of a drop from 6.3 to 4.3 @ 7am. But staying very steady!

I was going to change my 05:00 and 06:00 rate to 0.650 - would you agree?

Still have the 12:00 and 13:00 to do obviously, will update with those when I can.

Does anyone else find it hard to have these perfect situations to do basal testing? I've forced myself this morning to stay fairly "resting" to try to nail these rates, I work a desk job but don't work a Friday so normally much busier (with temp reduced basals running!) but tomorrow and Sunday being the weekend my routine is pretty different again! How many of you have a different "pattern" set up for weekends?

Thanks in advance for reading & any help appreciated!
 
I am NOT making these as suggestions for what you should do - but here's what I would be thinking if these were mine...

I had eaten nothing since 6pm the night before. BG was 11 at 11pm, corrected down.

00:00 - 06.00u Correction still working
01:00 - 0.600u Correction still working
02:00 - 0.600u Correction still working
03:00 - 0.600u - BG 6.3 Assuming 4h insulin duration correction is now finished, perfectly in range so correction factor looks good
04:00 - 0.600u
05:00 - 0.700u
06:00 - 0.700u
07:00 - 0.850u - BG 4.3 OK We have dropped 2mmol/L here. Not disastrous, but not ideal. Without extra info I would assume general dip from 3am onwards. Basal changes take an hour or two to kick in, so we need to lose some insulin from maybe 3-4am onwards until just before waking
08:00 - 0.900u - BG 4.2 All holding steady from here on in - really ridiculously good!
09:00 - 0.925u - BG 4.2
10:00 - 0.925u - BG 4.4
11:00 - 0.925u - BG 4.3
12:00 - 0.600u
13:00 - 0.600u

Possible changes:
02:00 - 0.600u becomes 0.575u - begin to back off basal v slightly before the dip began??
03:00 - 0.600u becomes 0.575u
04:00 - 0.600u becomes 0.575u
05:00 - 0.700u becomes 0.650u
06:00 - 0.700u keep this as-is to counter any possible DP from rising onwards
​
Then retest on another night to see what happened - ideally filling in the blanks a bit by testing at midnight, 2am, 4am, 6am rather than just 3am. It may be that the blocks aren't right and you need a slightly different 'shape' with some rates lasting longer and others shorter. Hope that aids your thinking.
 
Thank you so much - it really helps having others input into this! I had planned to test at 5am but would appear I slept through that alarm - lots of nights of testing to get my overnight correct have left me knackered! Oops. I will revisit that in a few days just to check it.

I can see what you mean about backing it off slightly earlier too in the early hours.

Thinking of setting my alarm tomorrow and getting up as though it is a work day, to see what happens when I eat. And then may fast over lunch time tomorrow if I have a fairly quiet afternoon - would you say that's a good plan?

Hmmm just to confuse things, my 12 noon test is 8.3!! A rise of 4mmol. o_O That suggests my 10am basal rate needs tweaked too?
 
Difficult to say for sure on just one basal test - especially a morning one. My liver can get a bit twitchy after all those hours of fasting when I skip breakfast and has been known to do it's own unpredictable thing, releasing some stored glucose. Sometimes you can keep it quite with a chunk of cheese or something so it realises you are not starving.

On the other hand it might be that you DO need more basal late morning, and this boost is partly showing in your post-breakfast spikes.

Fun and games eh?!
 
Hmm I see what you mean re; liver. Ok I will disregard that reading just now, not act on it.

13:00 I was 7.4....

Scoffed some lunch now, was sooooo hungry! 😛

Curious what my 2 hour test will be, and 4 hour. I hope I am back in range.....fingers crossed!

Fun and games...grumble grumble......🙄

My plan tomorrow or Sunday is to fast over lunch period. Although that relies on my carb ratio at breakfast being correct, and I have a sneaking suspicion it isn't, I think I possibly need 1u:8g rather than 10g? I suppose tomorrow morning is my test for that, see what my bloods do when I have food and from there can decide how to proceed - sensible??

Thank you again so much 🙂
 
Sounds like a plan!

Did you leave any delay between lunch bolus and eating? And (if it does spike and you feel able to ride it out) check what the reading is 4-5 hours after lunch dose. Then compare that with fasting test over the same period to see if some of the BG movement might be basal, or ratio ,or a bit of both.
 
I left about 10 mins, I know not quite the recommended 15-20 mins but was after school run, had to eat, then back out to my daughters dancing! I will do a 2 & 4 hour test, and possibly a 5 depending on the results! Would you correct at the 2 and 4 hour marks if recommended?

Just reminded myself, must phone the pharmacy to reorder test strips....gone through many more than usual!
 
Not sure - would depend how I felt. Sometimes if numbers not too errant I take a couple of days with fewer corrections because all that overlapping insulin makes it much harder to see what's going on and the before/after of different doses.

Tricky call though, and def correct if numbers really running amok!
 
So 2 hour test @ 3pm - 11.0

Hmmmm. Didn't advise a correction as 'correct' amount still on board. Will check again at 5pm....
 
5pm - 6.8

So right back in target range at 4 hours - I want a nice 2 hour post meal reading!
 
If back near range at 5-6pm then I would suspect timing rather than dose/basal is behind the 11.
 
Oops! Posted as you were writing that.

Seems to me that shows that the dose is 'right' but the food is hitting too fast or the insulin is acting too slow.

Try waiting 20 mins to see if any difference, then 30 mins or 40 mins or whatever if not. Either that or look at the meal composition and mix it up a bit to see if you can find something that hits your BG slower.
 
It's just annoying having to think about taking a bolus way before I have food - I don't always know and can't always wait to eat! Because I have stuff to do, not cos I am greedy. 😛 Am I alone with that feeling!? I do know what you mean though. And I will trial it as I am curious what the difference will be once the basal part is correct....

6pm test - 3.8 - doh! 3 jelly babies then my dinner, only 18g carbs.....

8.30pm - 11.7 (!!)

Lunchtime meal was a pretty even split of carbs, fat and protein btw.
 
Firstly I agree entirely with Mike's suggested adjustments - I NEVER change any dose by more than 5% at a time if I can help it. It's amazing how much difference altering 0.50u/hr to 0.51 or 0.49, can make !
 
Thank you. Yeah my clinic have always said a 0.25 or 0.50 change at most each time and adjust gradually.

Went to bed on 6.8. Woke this morning to a 4.9 and 2 hours after breakfast - 8.8.

Curious what it'll be at 4 hours, just praying for no hypo so I can do the basal testing as planned this afternoon - got the other half taking the kids out so I can focus on it today...hopefully! Afternoon a film or 2 for me! If it goes belly up, I will just go swimming with them! Lol.
 
Sorry wrote that earlier but hadn't posted it - doh!
 
Ok.....here we go with today's fasting results!


07:15 - Woke on 4.9 (yay!)
Ate breakfast about 07:45 - 52g carb - 5.2u given
09:45 - 2 hour post breakfast - 8.8
11:45 - 4 hour post breakfast - 7.7

07:00 - 0.850
08:00 - 0.900
09:00 - 0.925
10:00 - 0.925
11:00 - 0.925

Started fasting:

12:00 - 0.600 - 7.7
13:00 - 0.600 - 5.7
14:00 - 0.550 - 6.4
15:00 - 0.550 - 4.8
16:00 - 0.475 - 4.7
17:00 - 0.475 - 6.7
18:00 - 0.650 - 7.8

Ate dinner about 6.15pm. 69g carb - 6.9u plus 0.2u correction given. Will do 1, 2 & 4 hour tests post meal tonight.

Changes? The 1pm to 0.575 and 2pm to 0.525? And the 4pm to 0.525?

A quick question too - if doing 2 hour post meal tests, but it's a meal you want to pre-bolus by 15-30 mins for, do you test from the time you took your insulin or the time you started eating? Sorry if that's a really daft question!

If anyone has time to tell me what you would do/change if these were your results, I would again be forever grateful! I am slowly beginning to see the wood from the trees a little with it all...!
 
Oh and what about the 4 hour post breakfast reading being from 4.9 to 7.7 ??? o_O The day before the 4mmol jump I had was at the same time....so possibly more basal than bolus? Increase just the 10am one slightly?
 
52g is quite a big brekkie isn't it? Do you regularly have that much? - and Yes - it looks like a bolus issue to me mid/late morning rather than basal.

Moving to the afternoon of course, if you increased the 11am one to eg 0.95 - you might not have to do another thing, because your 1pm BG would not be that high neither would the 2pm. Then, that means the 13.00 base rate would probably need to go DOWN - but try the 11am one first, and see what happens.

It can take ages, this - but just get it about right then live with it a bit and have a flippin rest I should !

Laura - it's never perfect every single day - never! But if that's what you think you are gonna get - then you will be constantly disappointed I'm afraid.
 
Not always that much no, but knew I would be fasting too - I am also doing slimming world so trying to stick to the 'rules' of that! It was a protein pot Arla yoghurt thing (13g carb), all bran crunch topping (35g of it, 19g carb) and an apple which was 20g carb. Nothing horrendous....I sometimes have similar and sometimes have much less, it depends how I split my day up really!

I am not looking for perfection, I am well past thinking that can be achieved 😱, just looking to work as best I can on the results I have to smooth things over - my levels before were rather up and down! Alongside my anxiety as I knew it had to be tackled - just trying to do my best.
 
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