Basal not working

[gillkin]

Has anyone had a problem with their pump when the basal doesn't seem to work but the bolus does?

I started with a basal dose of 0.4 units per hour last Monday and have increased it to 0.5 per hour but it's as if I'm not taking any at all and my fasting blood sugar rose from 8.8 going to bed last night with no carbohydrate after 7pm to 7.8 at 3am and then 19.7 at 8.30am. The pattern has been similar over the last few days, I can correct with a bolus dose so I don't think it's the insulin or the infusion site/set but can't understand why this is happening ( I corrected with a bolus of 8 units and it's down to 6.8 now 3 1/2 hours later).

Thanks

Gill

 

[pickle76]

Hi,

I notice you've only been on the pump a week and it does take a little while to get basals right. I was started on a varying pattern of basals as the body naturally needs different amounts of basal at different times. For instance I need much more at about 5am than I do earlier in the night, to avoid the dawn phenomenon but also avoid hypos earlier. I expect you were started on flat rates of basal to begin with so that you can see patterns and increase/decrease where necessary. I would speak to your DSN and ask. Everone's different but I find that I need significantly more than 0.5 per hour at certain times of the day and significantly less at others. Hope you can work it out with your team and start to feel better x

 

[iHs]

Unfortunately

This happens to us all. Thank G for blood glucose teststrips!!!! :lol:

If I was left to my own devices I would look in the manual and find out how to create some more basal rate time slots and increase the basal up from 2am onwards but of course keep getting up and testing bg to find out what effect the basal rate changes were having. There's nothing wrong with the pump or infusion set, it's just that DP is happening to you.

If you want to wait for your dsn to advise you then just keep getting up every 2hrs from 2am onwards and correcting those bg levels over 10 or 12mmol.

 

[CarbsRok]

Has anyone had a problem with their pump when the basal doesn't seem to work but the bolus does?

I started with a basal dose of 0.4 units per hour last Monday and have increased it to 0.5 per hour but it's as if I'm not taking any at all and my fasting blood sugar rose from 8.8 going to bed last night with no carbohydrate after 7pm to 7.8 at 3am and then 19.7 at 8.30am. The pattern has been similar over the last few days, I can correct with a bolus dose so I don't think it's the insulin or the infusion site/set but can't understand why this is happening ( I corrected with a bolus of 8 units and it's down to 6.8 now 3 1/2 hours later).

Thanks

Gill

Hi Gill,
in simple terms the pump only delivers what you tell it to.
So if you increase your basal then then your numbers will come down.
Have you not been instructed in the art of basal testing and adjusting your basal?

 

[Cheryl]

If you suffer from DP you may need a huge jump in your basal around an hour before you get up. My basals range from 0.45 at bed time, rising to 0.55 at 2am, the stepping up in stages to 1.4 between 5.30 & 9am (I get up at 6), dropping immediately after that to 0.3. My consultant thinks the sudden drop is too big, but she can't argue with the results of my fasting basal testing showing that this approach keeps my BG steady through the night & morning. I also drop my basal right down to 0.25 in the late afternoon & need approximately 20-25% less basal insulin at weekends.

Don't worry, you'll get it right eventually, but it does take time, lots of skipped meals & lots of testing to identify your unique pattern.

 

[ShaunTheRam]

And patterns can change - so well worth doing the basal test again every 2 or 3 months