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Basal rate testing

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Agree not immediate to get readings like these, and could never achieve personally if I was still on mdi. Life yourself now pumping. Has took a while to get basal rates fine tuned.

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I would not agree with starting at 6 and thinking it ok to be 4.5 after testing... i would not accept a drop of 1.5 on my bassl testing at any time of day. I would be liwering my basals slightly. Especially if this happened overnight. I try to like last night go to bed at 5.4 at 10pm, 1am 5.0 and 3am 5.4... That I accept.... It takes patience and I now been on pump 3years so it is not immediate to get levels like this...
 
After the test had ended my blood glucose levels had dropped from 10 to 4 and i was feeling very ill! so therefore my basal rate is too high and needs to come down? this is all very confusing!
 
NicolaAnne1994 said:
After the test had ended my blood glucose levels had dropped from 10 to 4 and i was feeling very ill! so therefore my basal rate is too high and needs to come down? this is all very confusing!
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As an initial observation, yes it needs reduced. BUT, remember to be aware of external factors. If you were more active/less active or more/less stressed that would alter the readings. As a general rule my nurse says the same thing needs to be noted 3 times for it to be a pattern. Easy for over night testing, less so for day time when you're starving and desperate to eat lol
 
yes that's true, so do you think I should do another basal rate test before Friday when I see my nurse again?
 
Sabantha said:
I can't wait for readings like these guys!!! Nice and tight, well done! Bring in the pump :-)


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Hi

For an insulin pump to control bg levels tightly, it unfortunately calls for bg testing to be done every 2 or so hours to determine whether or not the basal rate settings need to be adjusted or whether the carb ratio needs to be altered. No 2 days are really going to be the same (if only). Ive lost count of the times when Ive needed to get out of bed and stay up because my bg levels have gone a bit too high and I need to deliver a correction and then to make sure that the correction is actually lowering my bg levels, I stay up and keep testing to give me some peace of mind.

Pumps are very life changing........ sometimes Im fairly happy with using one and sometimes I get really fed up with it all as at times it can become an never ending game of challenge with a lot of anxiety chucked in so anyone who thinks that a pump is going to make their life great, be aware of the need to keep bg testing to determine the control and appreciate why cgm is becoming a must have.
 
NicolaAnne1994 said:
yes that's true, so do you think I should do another basal rate test before Friday when I see my nurse again?
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Personally I would do a 2nd test. Can't hurt to be sure! Then you can discuss the results with the nurse and she can advise how to alter your basal :)
 
The ideal time to start basal rate testing is most likely to be sometime in the middle of the night when bg levels are only going to be controlled by the basal rate and not be influenced by the bolus as well. If basal testing is done in the night, then its important not to drink anything with milk in it like tea and coffee as the milk will change bg levels and people don't drink cups of tea and coffee when they are fast asleep. I don't think Mr G.S of TLAP mentions this but its worth remembering. I tend to do bg testing every hour but do so on the half hour and not on the hour - like 1.30, 2.30,3.30 etc and then change the basal rate if need be on the hour and then that allows for 90mins for the basal rate adjustment to get its effect. Where basal rate testing is done during the day, if you normally drink cups of tea and coffee with milk in them throughout the day, then it makes sense to include these in the basal rate test otherwise you will end up needing to bolus all the time.
 
NicolaAnne1994 said:
what time of the day do you reckon I should test? :)
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Erm Brett feel free to tag in around now ;)

I'm not on a pump, so I've only done overnight testing. As you are on the pump you can adjust your basal rate dependant on the time of day. So you (over the coming weeks and month) should be doing multiple tests at various times of day. I think! Since you did the last test based on "starting" at about midday I would do the same this next time. Once you've got the basal rate for that time period sorted you can move on to the next time slot, say from 4pm onwards etc.

I hope that's right. As I'm not on the pump and only diagnosed 6 months I'm certainly not a guru on this!
 
but wont that leave you feeling tired the next day? I did a 3am test like my nurse told me to and it was 14 but then I corrected it which she said was fine but then woke up at 7am at 3 since reducing the insulin through the night though it has been better!
 
Oh okay I may just wait to see my nurse on Friday and see what she says as I really don't want to be feeling how I did yesterday! haha
 
NicolaAnne1994 said:
but wont that leave you feeling tired the next day? I did a 3am test like my nurse told me to and it was 14 but then I corrected it which she said was fine but then woke up at 7am at 3 since reducing the insulin through the night though it has been better!
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The best time to do basal rate testing is when you haven't got to get up early the next day. Ideally, Friday night and Sat night. I think I started basal testing from 4am in the morning when my bg levels were on 5mmol until 4pm in the afternoon. I was going to stop at lunchtime but thought no, carry on and then with any luck I wont have to repeat the procedure again which wasn't the case as I still needed to tweak the basals . You can get by with eating some lettuce, celery as that for most people doesn't really need to be counted but other than that, make up loads of sugarfree jelly and eat that to curb appetite.

Its really difficult to know what to tell you to do regarding the change in your bg levels but it does sound as though some of your hourly basals are not correct but then again it might be that your correction factor is too high and is making you drop too much. You will learn it all as you go along as a lot of pump adjustment is down to trial and error but testing bg levels every hour will tell you what is going on.
 
I would test on Friday night but my appointment is Friday ha! and I don't really like salad only cucumber :/ but the jelly is an idea haha! and yes it is rather frustrating I think I maybe miscalculating somewhere because my blood was 7 this morning had breakfast and gave my normal dosage but then I got to work and I was 3.1!
 
NicolaAnne1994 said:
I would test on Friday night but my appointment is Friday ha! and I don't really like salad only cucumber :/ but the jelly is an idea haha! and yes it is rather frustrating I think I maybe miscalculating somewhere because my blood was 7 this morning had breakfast and gave my normal dosage but then I got to work and I was 3.1!
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You've answered your own problem here. If you are dropping from 7 to 3.1 within 2.5hrs and you haven't done a load of walking etc, then the carb ratio needs to be adjusted so that you don't get so much insulin. Adjusting the carb bolus though is quick short fix because if the hourly basal rates are too low some hours and then too high on others, then that will mess things up. Peoples need for basal insulin differs for some from hour to hour. From midnight until 3am my basal need is very low and then it starts to alter from about 4am onwards and then drops like a stone mid afternoon and then rises again and carries on rising in the evening until midnight. Its only by using trial and error and basal rate testing that has allowed me to see exactly what goes on and why I am like I am.

You will get there in the end but you've got to do it all yourself as no one else can do it for you.
 
But I have never had this problem before I always have 35-40g of breakfast and had the same amount and I walk to work everyday! just so confusing but yes I will get there thank you!
 
NicolaAnne1994 said:
But I have never had this problem before I always have 35-40g of breakfast and had the same amount and I walk to work everyday! just so confusing but yes I will get there thank you!
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Using a pump to control bg levels is mind boggling complicated at times. Its common for the need for basal rates to be adjusted even though basal testing has been done. Sometimes there's a good reason for causing the changes in bg, but sometimes, there isn't and you just have to deal with the time that the change has come. You may find that in 2 or 3 days time, your bg levels might decide to change again so it wil then be time to undo the changes you've made on the pump and go back to how they were. Always write everything down so that you know what to do.

What pump are you using by the way? Is there a chance that you could get your dsn to hook you up to a 7 day cgm sensor to determine the changes in your bg levels?
 
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