Urgent question re overnight basal testing

[SilentAssassin1642]

Thanks for that Ellie - I have come across Gary Scheiner's site a few times and it seems to be one of those excellent guides, a bit like Jennifer's advice for the Type 2s 🙂 I'm trying to take in all I am reading about the ups and downs of pumps, should I ever get the chance of one. Reading the other posts about the pros and cons is really starting to sway my opinion, but it's useful to read of the problems that do occur and how best to deal with them (although obviously I would wish that people weren't having problems!). I'll put the link into our Newbies 'Useful Links' and also the Links section.

Sam, I hope that you get settled with the pump soon, it must be very frustrating.

frustrating indeed. Theres a nice body of water just around the corner that I'm tempted to introduce Florence to it :/

 

[Northerner]

frustrating indeed. Theres a nice body of water just around the corner that I'm tempted to introduce Florence to it :/

Aw! Don't take it out on poor Florence! It's the diabetes that isn't cooperating and she doesn't know yet how she can help you! 🙂

 

[SilentAssassin1642]

Aw! Don't take it out on poor Florence! It's the diabetes that isn't cooperating and she doesn't know yet how she can help you! 🙂

ooooh, she needs to be educated quick sharp or I'm sure I can find some form of medieval torture to make her cooperate 😛

oooh hurrah my new sig works! ITS ALL PINK

 

[Adrienne]

Hiya

I've heard Gary Schneider talk and will do again at Friends for Life at the end of October. He comes over here with the USA CWD contingent. Interesting chap.

 

[Adrienne]

Sam, all is not lost. You actually did test something and I would say it works very well. The sensitivity factor, ie the correction ratio. You corrected at the 14 odd and bingo you were ok all night so it obviously works just fine.

If you want to test tonight then test at midnight and 3 am. That's it.

Tomorrow if you want to test, then do it at 11 pm and 2 am

Just a couple of tests.
🙂

 

[Sugarbum]

OMG! The penny just dropped- is he the "think like a pancreas" guy?

I would love to hear a talk by him.

Great link Ellie. Im super impressed how you have 3 basal rates for work. Im also holding my head in shame that I dont! Im feeling enough shame I should do something about it....😉

 

[Ellie Jones]

Didn't think that you would🙂

Some of your problems is actually trying to create one basal that fits all, adjust it to suit a day off it doesn't fit early shift, and well afternoons leaves you a sniffling wreck.. Can you see what I'm saying? If I tried to work in either of the kennels using my hone profile, I be decked within an hour... If I forget to change back to my home profile, I be high as a kite by brekkie... Making sense now?

Your home/day off will be your lead profile so you use the setting from this to set up your two other profile as a starting point... I would at the moment concertrate on getting this home profile settled first (while at work manage with TBR's, correction dosage as best as possible in the intrim) then when it is, then sort out just one of you work profiles.. How I achieved mine, was setting a TBR using an educated guess.. Noted down what it delivered every hour (for each hour) and tested frequently to see what the effect was, using this information I tweak my settings, then see what happened, tried another tactic based on this new profile, perhaps a tweak eariler, or a TBR at certain points until I got results I wanted...

I also keep the data for each profile written down, only combining it all when I'm using the computer software, lot easier to see patterns..

It's time consuming I must admit, but it's worth it just think poor ickle florance won't get tortured nor drowned and she become your very best pal..

Never say never to duck, as once you've got the basal sorted, you can then work on your tactic to sort out the duck, I know that with some high fatty foods I eat, not only do I use a dual-wave but combine it with a subtle TBR basal as well to sort out the very extended tail end it creates..

 

[SilentAssassin1642]

Sam, all is not lost. You actually did test something and I would say it works very well. The sensitivity factor, ie the correction ratio. You corrected at the 14 odd and bingo you were ok all night so it obviously works just fine.

If you want to test tonight then test at midnight and 3 am. That's it.

Tomorrow if you want to test, then do it at 11 pm and 2 am

Just a couple of tests.
🙂

I like that idea 🙂 just a couple of tests. I'll do the 12 and 3 tonight, 11 and 2 tomorrow. Will leave me less tired

as for the changes re shifts, i amn still mega confused :/

 

[Adrienne]

I like that idea 🙂 just a couple of tests. I'll do the 12 and 3 tonight, 11 and 2 tomorrow. Will leave me less tired

as for the changes re shifts, i amn still mega confused :/

Just get your nightime sorted Sam, then worry about the shifts. Too much too soon.

Lots of school kids have a weekend profile and then a school day one. On the Medtronic pump they are called patterns. You get three. The main one is called Standard and then you have A and B.

Jessica however has just one which suits her for school and weekend. Not everyone has different ones. You may find you need to eventually due to your shifts but get your night sorted first, at least you can sleep then.

 

[Ellie Jones]

Not quite sure which aspect of the basal profile the notion of working with or setting the actual profile in the pump part?

But this is my profile settings for part of my day,

Home 5am 0.3 6am 0.4 7am 0.5 8am 0.6 9am 0.6 10am 0.6

Work 1 5am 0.3 6am 0.2 7am 0.2 8am 0.2 9am 0.1 10am 0.1

Work 2 5am 0.3 6am 0.3 7am 0.3 8am 0.3 9am 0.3 10 am 0.3

Using these keeps my levels steady, I can flick from one profile to another miminising the adjustments/corrections at any one time...

So in your case you would create one profile to use on your day off that gives best control, then work out what your basal is up to when on an early shift to create your second, and then your late shift, then all you need to do is flick to what ever profile suits what you'll up too..

Can you see from looking at what I've done, how confusing and poor the out-come would be if I tried to cover all by using one profile... Because the adjustment or data I collected for being up home, would cause an hypo but if I used the data from a work day, I be high as a kite on a day off..

The easist way of achieving some clarity, get the basal setting for you day off sorted, by using only information collected/tested on that day.. if you have a hypo or high in work don't use this to make any adjustments to you basal.. (that will come later) then when you settled on your day off (you will have to ignore the frustrations work control might give you)

Then you tackle the most problematic shift first, you load all you settings from you home profile (main) into profile no 2, on your pump..

Now look at your past BG readings, from just before you go to work any in work, and try to see either a pattern or danger points of high or hypo's... This will give you some idea at what points you may need to make adjustments to the basal on this profile...

When doing this, I don't make any changes to start with, but use the TBR to see what sort of adjustment to make then review my data to see if it worked, then make the changes to the acutal no 2, profile...

To help keep it all as clear as possible when sorting it all out I keep all the data in separate record books, other wise one day tends to merge into another, and it isn't easy to see if the 22nd was a day off or the 23rd was either early or late shift....

If you still confused, let me know exactly which bit you are finding confusing..

 

[bev]

Not quite sure which aspect of the basal profile the notion of working with or setting the actual profile in the pump part?

But this is my profile settings for part of my day,

Home 5am 0.3 6am 0.4 7am 0.5 8am 0.6 9am 0.6 10am 0.6

Work 1 5am 0.3 6am 0.2 7am 0.2 8am 0.2 9am 0.1 10am 0.1

Work 2 5am 0.3 6am 0.3 7am 0.3 8am 0.3 9am 0.3 10 am 0.3

Using these keeps my levels steady, I can flick from one profile to another miminising the adjustments/corrections at any one time...

So in your case you would create one profile to use on your day off that gives best control, then work out what your basal is up to when on an early shift to create your second, and then your late shift, then all you need to do is flick to what ever profile suits what you'll up too..

Can you see from looking at what I've done, how confusing and poor the out-come would be if I tried to cover all by using one profile... Because the adjustment or data I collected for being up home, would cause an hypo but if I used the data from a work day, I be high as a kite on a day off..

The easist way of achieving some clarity, get the basal setting for you day off sorted, by using only information collected/tested on that day.. if you have a hypo or high in work don't use this to make any adjustments to you basal.. (that will come later) then when you settled on your day off (you will have to ignore the frustrations work control might give you)

Then you tackle the most problematic shift first, you load all you settings from you home profile (main) into profile no 2, on your pump..

Now look at your past BG readings, from just before you go to work any in work, and try to see either a pattern or danger points of high or hypo's... This will give you some idea at what points you may need to make adjustments to the basal on this profile...

When doing this, I don't make any changes to start with, but use the TBR to see what sort of adjustment to make then review my data to see if it worked, then make the changes to the acutal no 2, profile...

To help keep it all as clear as possible when sorting it all out I keep all the data in separate record books, other wise one day tends to merge into another, and it isn't easy to see if the 22nd was a day off or the 23rd was either early or late shift....

If you still confused, let me know exactly which bit you are finding confusing..

Hi Ellie,
Sorry to butt in - but just wanted to to say - great advice and its amazing how different your home and work basals are isnt it - although it should be different - but one is a huge amount.

We have been pumping for 1 year now and still trying out new basals and ideas and it seems to change after a couple of months but I think thats probably due to growth hormones and puberty starting - something that you probably dont suffer from anymore luckily.

Out of interest what is your hba1c and how long have you been on your pump for.🙂Bev

 

[bigpurpleduck]

Sam,

Just wanted to say I really feel for you. I'm struggling at the moment too and can't be bothered with it anymore.

Well done for continuing with the basal tests regardless of being totally fed up. Hope you get better BG results as a reward!

 

[SilentAssassin1642]

Sam,

Just wanted to say I really feel for you. I'm struggling at the moment too and can't be bothered with it anymore.

Well done for continuing with the basal tests regardless of being totally fed up. Hope you get better BG results as a reward!

thanks hun 🙂 the thing is, I know if I don't keep at it i'll go back to the way i was before...and i don't really want that :/

 

[Ellie Jones]

Hi bev

I've been using my pump now for almost 3 years, I had to battle 3 year battle to get my pump, which involved building my own medical case, of all the aspects of my diabetes that MDI couldn't control, and how pump therapy worked and would have over-come situations.. with I could have avoid that hypo as I could have done this with a pump, or if I had the pump available that high caused by stress wouldn't have happened if I could have turned my pump up etc...

My last HbA1c's was 6.7% slightly higher than I had hoped for, but sadly did go off kilter a little after losing my dad... I'm due for another very soon, and by my reckoning this one should be around the 6% mark...

Nope no growth spurts for me, just (not) looking forward to the menopause which is not that far around the corner😱

 

[Sugarbum]

Impressive HbA1c Ellie, well done! Great to read of your sucesses, but the hard work you have put into it has paid off also. 🙂

 

[Ellie Jones]

I'm chuffed with my results, more so has I've got the spirt pump which doesn't come with the bells, whistle and wizards of the newer pumps nor the ability to deliver a very fine dosage as the other pumps can do..

So it's been a challange at times to over come some of the pumps failings, with how to get around the glitch of needing a 0.05 incredment, and the pump can only do a 0.5u incredment, means thinking out the box to achieve..

I do wonder what I could do if I the advanage of wizards?

 

[tracey w]

I'm chuffed with my results, more so has I've got the spirt pump which doesn't come with the bells, whistle and wizards of the newer pumps nor the ability to deliver a very fine dosage as the other pumps can do..

So it's been a challange at times to over come some of the pumps failings, with how to get around the glitch of needing a 0.05 incredment, and the pump can only do a 0.5u incredment, means thinking out the box to achieve..

I do wonder what I could do if I the advanage of wizards?

I have the combo which indeed dpoes th 0.05 increments, dont know where id be if i could only do 0.5, that seems a lot 😱 youo have done remarkably well and much take much effort.

You have inspired me today I have set a seperate pattern for my days off, I was using only the one. I want to really fine tune things as much as possible now.

 

[bev]

I'm chuffed with my results, more so has I've got the spirt pump which doesn't come with the bells, whistle and wizards of the newer pumps nor the ability to deliver a very fine dosage as the other pumps can do..

So it's been a challange at times to over come some of the pumps failings, with how to get around the glitch of needing a 0.05 incredment, and the pump can only do a 0.5u incredment, means thinking out the box to achieve..

I do wonder what I could do if I the advanage of wizards?

Great hba1c Ellie.🙂
I cant believe your pump only does 0.5 - you have done really well. Alex's pump goes down to 0.025 of a unit - we need this as he is insulin sensitive.

You must be due a new pump in a year - I bet you will be amazed with all the new gadgets that will be available when you get it.🙂Bev

 

[Ellie Jones]

😱 yes it was a typo error and the mim delivery is 0.1u

yes another year before I get a replacement I did and in many do still like the Animas 2020 which had just come out, but it was the case of the spirit or nothing without having to battle for my right to choose my pump... But battling for 3 years for funding was enough, so excepted what was on offer...

The wizards were there when I first started to research insulin pump, and the Animas 2020 had just come out, this was the one I really wanted, but alas it was spirit or nothing, and after 3 years of battling for funding I really didn't have it in me to battle for my right of choice...

I've looked at the different wizards on the pumps, and to be honest I can't actually say whether I would or wouldn't benefit from using them... But I do intend to have a word with my consultant when I'm in clinic in January, to see if they will up-grade my pump early just to find out..