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Basal

PG1759

Well-Known Member
Messages
128
Type of diabetes
Type 1
Treatment type
Insulin
Quick question and maybe a stupid one....

My basal (lantus) would appear to be correct as I don't drop when missing meals etc.

My question is - if my basal was too low would my blood levels rise ?

I ask as I can't manage the spikes after meals well and wondering if I need more basal to assist....
 
Depends... Because if you increase your bolus, this bolus can carry on acting for up to 5 hours.... So the extra bolus could then be too much after eating..... Between the 3-5 hour mark....

Are you pretty much running on a 50-50 ratio for bolus n basal?
 
Depends... Because if you increase your bolus, this bolus can carry on acting for up to 5 hours.... So the extra bolus could then be too much after eating..... Between the 3-5 hour mark....

Are you pretty much running on a 50-50 ratio for bolus n basal?
It's not the basal being too low that's affecting your spikes after eating. More than likely the qty of carbs if not consider above post..
 
Just a T2 guessing but...if your fasting/miss a meal basal test is ok..then it's bolus and sounds like you I:C ratio is wrong for the meal or time of day. I've read here than ICR can change from breakfast to supper
i would check with your nurse


There is an online course for background and an idea to it. Free to register

http://www.bdec-e-learning.com/

This set of workbooks are worth reading and practising working examples of carbs and doses and corrections. Don't change dose without nurse approval

Workbook 1

http://www.diabetesinscotland.org.uk/Publications/9225 Carbohydrate Counting.pdf

Workbook 2

http://www.diabetesinscotland.org.uk/Publications/9226 Carbohydrate Counting the Next Steps.pdf

Carb list

http://www.diabetesinscotland.org.uk/Publications/9227 Carbohydrate Tables A6.pdf

Diary

http://www.diabetesinscotland.org.uk/Publications/9228 Free Diary Portrait A4.pdf

Basal testing

http://www.diabetes-support.org.uk/info/?page_id=120

Sick day rules

http://www.diabetes-support.org.uk/info/?page_id=141

http://www.diabetes-healthnet.ac.uk...flet_-_Sick_Day_Rules_for_Type_1_-_Nov_13.pdf

Sick day rules flowchart

http://www.leicestershirediabetes.org.uk/uploads//documents/Type1 Sick_day_rules_InsulinV3.pdf

A workbook with USA numbers and math rules, but it has a good trouble shoot at the end

http://www.bd.com/us/diabetes/download/insulin_adjustment_workbook_complete.pdf


Splitting background insulin recommended

http://www.dafne.uk.com/uploads/223/documents/PU04.009, Version 1 - September 2013 - Insulin statement.pdf
 
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Hi PG1759,
I don't want to hijack your thread but something you wrote really interests me. I go low during the day if I skip meals, does that mean my basal is too high? I never knew that this could be the cause. I thought it was just because I need a steady stream of food and when I go for extended periods this is normal.

Thank you for allowing the quick hijack...
Sandra
 
Hi. If you think your Basal is about right i.e. not causing a BS change when misisng meals etc, then you need to adjust the Bolus ratio to control the spikes or reduce the carbs if you aren't already low-carbing. Why would you wnat to use the Basal to manage meal spikes?
 
My own understanding from my end of this is that is your basel rate is correct that you can go low or high during the course of the day depending on what you are doing but that it shouldn't be that much of a spike over all - as in if your set to be at 5 most of the time then spiking to 7 or hitting 4 over the course of the day is within allowable base range between meals. Base doesn't cover meals it sits in the background at what ever your base number should be at and you need to then correct to base with your bolus amount adjusting for that carbs and protein in the meal.

Example ... pre dinner = 6, correction ratio is 2.65 off of 5 = no correction for pre meal number
carb count = 83 carbs with a correction of 1:10 meaning taking 8 units to cover carbs
protein count = 42 grams with a correction of 1:10 meaning taking 2 units to cover protein
total correction to cover meal would be 10 units of fast acting insulin
post meal = 5.5 so close to target since at the 3 hour mark I did hit 5.

Now this isn't standard and the above is what has been worked out for myself with the help of my endocrinologist and medical team, a lot of people don't cover the protein in a meal because it is a slow spike, but it can and does spike you thus we've learned that it does need to be taken into account for a correction dosage (in my case at least, can't speak for anyone else).

The numbers for me where found though a lot of trial error and money (as in having to go though more test strips in a month to figure out what was going on with my numbers after each meal), but its served me rather well over the years though now we're back to learning things again because I've had to cut a few things out that I was eating on occasion (cutting the gluten has meant a lot of the testing I did needs to be dun again to find the new happy medium, though from my own numbers we're not to far off the ratio, for dinner and breakfast its lunch that is the wild card).
 
if you are not rising on basal alone then the bolus would appear to be the culprit.

my insulin/carb ratio changes during the day being higher earlier in the day than later in the day
2.6 units per 10CHO in the morning and 2.1 units per 10CHO evening
 
Hi PG1759,
I don't want to hijack your thread but something you wrote really interests me. I go low during the day if I skip meals, does that mean my basal is too high? I never knew that this could be the cause. I thought it was just because I need a steady stream of food and when I go for extended periods this is normal.

Thank you for allowing the quick hijack...
Sandra

Well no expert myself but I had the same problem and managed to get the basal to the right level. He most likely cause is basal being too high. In theory you should be able to skip a meal and be within 10% of what you were at the last interval. I suppose technically you could also be dropping if you inject too much bolus with your meal as it works for 5 hours or more on occasions. I would say basal dose is the likely cause...
 
Depends... Because if you increase your bolus, this bolus can carry on acting for up to 5 hours.... So the extra bolus could then be too much after eating..... Between the 3-5 hour mark....

Are you pretty much running on a 50-50 ratio for bolus n basal?

Yes it's around 50 percent of my bolus ratio. I have upped it by a unit today and it seems to have helped without dropping me too badly between meals. Only day one so it may or may not need dropping back down again .... We will see :)
 
Hi PG1759
would agree with your assessment of cherryred going lower even with no food
 
My take on basal was from my illness last week. I ran practically flat all for 24 hours with no food. That's where I think basal should be.
 
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