Basal Testing Question

[Rokaab]

Hiya,
Sorry if this has been answered before (it probably has) - but the search on these forums isn't the best so I couldn't find what I was looking for.

So having recently changed to Tresiba from Lantus I thought it might be wise to do some proper basal testing, especially since I think I've finally got rid of this stinking cold.
Anyways the questions:
1. I often get dawn phenomenon (about 90% of the time - starting at 3am), how can I basal test in the morning if this has happened cos I'll need my Fiasp as soon as I wake up? (if I'm lucky it only goes up by 3-4 mmol/l by the time I wake up, if not lucky it can be 10-12)
2. It says no food for the relevant time span, does this include stuff with no carbs (eggs, cheese, bacon) - I'm one of those people that is always hungry - making it through a long time span without any food will most likely lead to me not completing the testing or being very very irritable and grumpy (I think this is learned behaviour (that my body still hasn't unlearned) from when I was suffering from malnutrition caused by my undiagnosed coeliac over a number of years)

 

[slip]

Point 1, I have no idea - sorry

Point 2, it is best to steer clear of eating anything, a meal of Eggs, Bacon and Cheese is high in fat and protein which the body will break down in to glucose in the absence of any carbs and will therefore affect your BG, may be warn your work colleagues that you're likely to be irritable and grumpy that morning.

I take it you are going to do a 'section' a day/over 3 days.

 

[Rokaab]

I take it you are going to do a 'section' a day/over 3 days.

Yeah over 3 days, more than likely not consecutive days - for a start its pub lunch day on friday lunchtime, 2 vodka and diet cokes without food would make for an interesting afternoon and watching the others eat would be a nightmare.

 

[Juicyj]

Hi @Rokaab

Good switch - I wasn't disappointed with tresiba once i'd got the dose adjusted which did take a while.

1. With DP i'd set the alarm and do a bolus shot at around 3am when the rise starts, as long as your fast acting is out of your system 4 hours before the test starts, then count your morning test from 7am onwards, ideally aim to be below 10 otherwise you will have to stop and take a bolus correction. Do a test first with this to see where your waking reading is though before doing the actual test.

2. No food means no food, even 0 carb food will raise your BG levels due to gluconeogenesis and converting protein to sugar which will raise your levels and affect the test results.

Split the test so do 7am to 12, 12-6, 6-12 and 12 to 7am.

Do the test a couple of times to be sure and see a pattern.

 

[WuTwo]

If I'm basal testing I restrict myself to black coffee with no sweetener or tea - no milk or sugar.

No drinks with carbs in of any sort, and not a crumb of food. It's no fun but if you need to basal test, it's the only way to do it.

 

[Rokaab]

1. With DP i'd set the alarm and do a bolus shot at around 3am when the rise starts, as long as your fast acting is out of your system 4 hours before the test starts, then count your morning test from 7am onwards, ideally aim to be below 10 otherwise you will have to stop and take a bolus correction. Do a test first with this to see where your waking reading is though before doing the actual test.

I may end up doing the tests for all the times except this timeframe then, my DP is too unpredictable to take a bolus at 3am as it starts about then if its going to (doesn't always), but sometimes it's a lot worse than others so I wouldn't really be able to tell til about 4 to 4:30ish as to how much basal I'd need, at which point couldn't start the test til 8:30 at which point I've already been fasting for over 12 hours (I tend to have dinner at about 6pm - so I know all the basal should be gone before I go to bed) and will be starting off hungry. And sugar-free orange squash or diet coke isn't very filling.

2. No food means no food, even 0 carb food will raise your BG levels due to gluconeogenesis and converting protein to sugar which will raise your levels and affect the test results.

Well that's a shame

Will see if i can do one of the time periods over the weekend - probably better to do on a weekend rather than whilst at work.

 

[porl69]

@Rokaab do you use the Libre??? I found that invaluable when setting up the basal patterns on my pump

 

[Juicyj]

Hi @Rokaab

Sorry it's a pain, no food...

The idea behind basal fasting tests is to do it when you are in your regular rhythm so it's best to do it during the week, as activity levels change at the weekend and can affect the test results, so on a day with no exercise or alcohol the previous day.

You can still do the morning test as long as you wake in range and not above 10, if above 10 then of course you can't but no need to omit this time period if BG levels look ok.

 

[endocrinegremlin]

I have always basal tested with carb free meals so that my body doesn't produce ketones. It also helps keep my emotions more balanced as I test so that they don't interfere. I, and apparently my hospital, tend to be the odd one out around here though so you may want to take me with a pinch of salt.