Basal Testing

noblehead

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Had an interesting morning, decided to do a basal check as my bg levels have been dipping into the low 4''s & late 3's pre-lunch over the last week or two, woke to a bg reading of 6.1 after going to bed on 6.4 which was fine, tested 90mins later and my bg levels had gone up to 8.9 then 2 hours after that it had reached 11.2 so all in all my bg went up by 4.8mmol.

I've known for some time that I get a liver dump if I don't eat breakfast soon after waking so always ensure that I have something to eat, but what was surprising by today's results is that I appear to have had not one but two liver dumps which was unexpected, but levels are back down to 10.4 which does prove that my mid-morning basal rate needs reduced slightly.

Does anyone else experience the similar results when they don't eat on a morning?
 
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novorapidboi26

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I also experience a continued dump into the morning if I don't eat......as I am sure everyone does to some degree.......

how did you co nclude there was 2 dumps........?
 
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noblehead

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@novorapidboi26, they were 2 hours apart so it looked that way to me.

@robert72, quite possibly yes, I do get a late DP as when I oversleep on a weekend I wake to higher levels, but since moving to a pump I have a basal rate that deals with this.
 

novorapidboi26

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I would assume your morning basal rates are sufficient for a morning where a breakfast is present........

if not, then your livers output will be completely different due it thinking you have no fuel in the fuel tank........
 
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noblehead

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@novorapidboi26, yes they are fine apart from my bg levels dropping pre-lunch which is why I've done the basal test, but tbh I should of adjusted the basal rate anyway with doing a check as I eat breakfast around 6.30 so my bolus dose is all but exhausted by 10.30, so it could only be the basal.

That said it was a worthwhile test just to see where my levels would be in the absence of food, from past experiences when having a fasting cholesterol check I see a bg rise but don't normally leave it this long before eating something as I always get an early appointment for the blood test. Thanks for the reply.
 
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toby64

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HELLO NOBLEHEAD, yes i have had exactly the same on several occasions, especially when i am not well, my worst was,woke up at 5.1 and within 30 minutes it was 16.6 without eating or drinking, this showed up on my meter and was investigated, turned out to be caused by to many gallstones, and they had reacted some sort of reading to my liver and as you have said dumped glucose into the blood . As a result from this happening more frequently i have been referred to a surgical team to have my gallbladder removed, have you ever had yours checked?.

Best Regards
Toby
 
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smidge

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May be not a dump, but a steady rise?

I would expect this is what it was from my experience with the Libre . When I was on Levemir and waking to double-figure fasting, the diabetes team were adamant that I needed to reduce my basal as I was going low overnight and the liver dump was causing the highs. The very first thing I learnt from the Libre data was that I had a steady BG rise from about 2am - basal needed increasing. I think sometimes too much is put down to the effects of a liver dump when evidence does not bear it out.

Smidge
 
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tim2000s

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@smidge totally agree. I've seen only occasional evidence of a true dump early morning, and a lot more of a gradual rise.

I only really see a proper spike that I think is related to a liver dump when I am doing intense training.
 
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noblehead

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@toby64 @smidge @tim2000s , thanks for the comments and feedback :)

No its almost certainly a liver dump and nothing to do with the basal being too low, my insulin-to-carb ratio for my breakfast is 1:10 and over the last 7 days I've bolused between 4.65 - 5.55u for a 50g breakfast of porridge, that has not changed for a long time and if my basal insulin was too low then I'd expect I'd be bolusing more for my breakfast and even doing correction doses in-between then and lunch.
 
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ono

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Oh dear, never heard of this morning liver dumps in, but this explains some mysterious highs... Thanks noblehead ! :)

BTW : how would you do a basal test avoiding the liver dump?
 

Gaz-M

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I graze on a morning, test bloods, get ready go to work, set the kithchen up and do my injection and nibble, I normally give myself 4-6 units depending on what I,m going to have but its normally a slice of toast and a few fruit items.
 
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donnellysdogs

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Noblehead...
See photo of my DPP for later getting up.. Early getting up is about the same but 5 hours earlier!!
ImageUploadedByDCUK Forum1429916343.957149.jpg


That is just getting up that causes that. Literally from the moment my feet touch the floor. If I stay in bed longer when my hubby say works early shifts and I forget to change my basals over I go low......and yet if I get up at the right time, with the correct basal programme I am perfection.

I don't eat all day until 5-6pm so I know 100% that this is all liver dump and nothing to do with food.
 
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noblehead

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BTW : how would you do a basal test avoiding the liver dump?


There lies the problem............

Yesterday I was going to test after the first bg rise but obviously that went out of the window :rolleyes: Of all the basal checks the morning one has always been the most difficult for this very reason.
 
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iHs

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DD why dont you eat until 5pm? Is this because of driving and keeping yr bg ok or to try to get yr cholesterol down?
 

iHs

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What time of the day do you find you need to tweak your basal the most iHs?
There isnt any real rhyme or reason......but usually if bodyweight has dropped or increased or if weather temp has changed.
A pump will keep you on yr toes with bg testing so get used to it and if a pattern starts to emerge, then its time to change basals or if the pattern is only a temporary thing, then you may be able to cover it using TBR instead.
 
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noblehead

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Thanks @iHs, interesting I have reduced my basal doses since the weather has warmed up (much the same as I had to do on MDI).
 
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smidge

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@noblehead - how about asking your diabetes team to put you on a CGM for a week? Having invested in the pump for you, they might be persuaded to give you a week on a sensor to get the adjustment right and help you use it to its maximum. It really is the only way to know what is truly going on with BG overnight - there can be so many twists an turns that you miss with spot checks.

Smidge
 
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