1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2021 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
  4. Guest, stay home, stay safe, save the NHS. Stay up to date with information about keeping yourself and people around you safe here and GOV.UK: Coronavirus (COVID-19). Think you have symptoms? NHS 111 service is available here.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Basal Changes

Discussion in 'Insulin Pump Forum' started by Hooked, Jul 3, 2014.

  1. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

    Messages:
    2,831
    Likes Received:
    1,857
    Trophy Points:
    178
    with regards to basal adjustments, how is the digestion of food considered in your case?

    the basal delivery deals with the liver......
     
  2. donnellysdogs

    donnellysdogs Type 1 · Master

    Messages:
    13,204
    Likes Received:
    12,464
    Trophy Points:
    298
    Because with the speed that the transit pushes food through my stomach the slowness of release and absorption can make my levels go really high. When nearer to chronic constipation they can rise really significantly... I don't know why the lead up to impaction can give much raised rates.

    However, because I add in more fat now, that too is absorbed differently than carbs - and that too is significant to affecting my bolus times.. Ie when I have my brie at night I do bolus for the qty of it, but I do it over a one hour extended. It is only a small bolus of 0.2 or 0.3 over 1 hour but I need that cheese and the extended.

    Everbody is different. My liver is due for an ultrasound and my sleen in next couple if weeks, so this may be impacting as to why.

    However, the pump does take a full hour to deliver any hourly rate fully in to our bodies and my acting time is also one hour. So if you add those two times up.. Thats why I never adjust the one hour before.

    If I was to do a test at 4 am and 6am for example. And my levels had gone up say from 6 to 7.0 by 6am. I assume that my levels are starting to rise from 4.01am onward. Unless I want to faff around the next night to do a 5am test then I will alter the 3am and 4am.because I do assume that my level has gradually risen over the period of 2 hours.

    Most days I am between 5 and 7.0 with an odd blip sometimes. Even at levels of 5ish they will change probbly by about 0.5 at max in two hours.

    I do not anally examine my levels anymore, I am totally relaxed, rarely even writing them down. I had a cgm and when 1st on pump I was too watchful. I don't actually get up to test at 4am and 6- lol!!

    I also eat small amounts of food and saw much improved stability of levels from having more fat.

    Why? I haven't got a clue, it just works for me.




    Loving life
     
  3. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

    Messages:
    2,831
    Likes Received:
    1,857
    Trophy Points:
    178
    That's interesting................

    It seems you have fine tuned your delivery to suit your special requirements.......

    I was curious to know how you set your basal rates...........when your testing basal, how can you be sure all the food has been digested and left the system...
     
  4. donnellysdogs

    donnellysdogs Type 1 · Master

    Messages:
    13,204
    Likes Received:
    12,464
    Trophy Points:
    298
    Rarely basal test. Go by the rule my consultant told me. If high or low anytime between 2-3 hours after a food bolus, then its the bolus...


    Loving life
     
  5. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

    Messages:
    2,831
    Likes Received:
    1,857
    Trophy Points:
    178
    that's a rule designed specifically for your digestive condition though, you can acknowledge that........

    what are your basal rates then, and how did you decide on what they should be.....?
     
  6. donnellysdogs

    donnellysdogs Type 1 · Master

    Messages:
    13,204
    Likes Received:
    12,464
    Trophy Points:
    298
    They were pretty well set up from start with the great help from another pumper and initially basal testing.

    However the 2-3 hour eating bolus rule advice was not only given to me. It was to everyone. My SLow stomeach started 18 months after.


    Loving life
     
  7. donnellysdogs

    donnellysdogs Type 1 · Master

    Messages:
    13,204
    Likes Received:
    12,464
    Trophy Points:
    298
    The advice by consultants for the bolus was the same advice for altering basals.. 2 and 3 hours...


    Loving life
     
  8. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

    Messages:
    2,831
    Likes Received:
    1,857
    Trophy Points:
    178
    I don't think I understand how they can be the same though........

    thee basal, all be it the same insulin, is delivered differently, every 10 minutes or so............so the two insulin behaviors are not the same.....

    will you ever basal test again.......?

    I understand that high blood sugars within the the 5 hours after a meal mean that the problem could be a bolus one......but that's why you test your basal, to eliminate a deficit with that as the culprit..........

    what is the rule in the words of the consultant.....;)
     
  9. donnellysdogs

    donnellysdogs Type 1 · Master

    Messages:
    13,204
    Likes Received:
    12,464
    Trophy Points:
    298
    The rule my consultant told me: if you are high or low within 2-3 hours of a food bolus and you have carb countrd correctly then it is the bolus. All other times it will be the basal.

    What I meant is that if the same rule of thumb applied to basal then you would change the rate 2-3 hours before the high or low. Not the hour before. Like we have both said the insulin actually takes 1 whole hour from start of delivery to get in you, so why adjust that hour when effectively that insulin would only just have finished its delivery?
    Don't forget that changing your basal one hour ahead will impact on your rates after that one hour according to how long your acting time is.

    I think you are wrong about the 5hour for a eating bolus.

    A correction bolus should bring you back to normal at 5 hours,. If I am back to normal at 2-3 hours I will go low within 5 hours.

    If I'm not hungry, and don't fancy eating then I will just count that as my basal testing. However since going on to berries and full fat yogurt for breakfast it is very rare that I go for a 10hour stretch without eating.

    We are all individual, as with how we are instructed by nhs guidelines for eating.. The advice we get from consultants varies. I know of somebody that was told to change the basal rate at the time of the high or low!!

    Our bodies all have different metabolic rates too, so my insulin acting times and offset times will be different to yours. One size definitely does not fit all with diabetes, let alone pump set ups!!


    Loving life
     
    • Like Like x 2
  10. donnellysdogs

    donnellysdogs Type 1 · Master

    Messages:
    13,204
    Likes Received:
    12,464
    Trophy Points:
    298
    Forgot to answer one of your questions:
    My basal rates are from 0.35 an hour up to 1.10. Every hour is different. This is because I used to get DP, my hourly usage with my body varies, although there is routine. E.g.drive up to an hour to work-so not much energy there, up to 6hrs average gardening, then an hour driveback, then more physical usage with other hobbies. The exercise all day continues to refect into my early evening rates being lower as well.
    The beauty of a pump isn't it? Mdi never gave this flexibility!
    I did get odd blips around certain weeks but have a way round this now too.
    The pump is the worst thing for blipping me. I have had some probs with a particular box of tubes that pushed airbubbles through irregularly when priming.. This actually meant that when in use the tubes weren't delivering the insulin through regularly. When I identified this problem and went to a different batch number then my blips ceased. Odd blips happen. I had to decide what to do about days when I'm not gardening etc and using up different amounts of exercise. I know that the clocks changing will affect me. I'm very aware that July has always been my worst times previously for a severe hypo.
    Everyone is different. We all have different metabolisms, activitys etc.. So it does take some playing around with.


    Loving life
     
    • Like Like x 3
  11. donnellysdogs

    donnellysdogs Type 1 · Master

    Messages:
    13,204
    Likes Received:
    12,464
    Trophy Points:
    298
    Actually, I think I am still quite intense, but only just realised it... Now I have berries and yogurt for breakfast I did actually weigh out the berries and the yogurt to het an exact amount of carbs. I also did this with my salads initially too. Any recipes I make as I now do a lot of home baking always has the ingredients put into my fitness pal to get the carb value as exact as I can. So although I said I'm more relaxed, on certain things like getting my carbs right I am still quite intense.


    Loving life
     
    • Like Like x 2
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook