Basal testing question

[ArtemisBow]

Hello all, I've got my libre back on for the festive period because I've had a lot of things to go to in London by myself, and it gives me a lot more confidence that I can test quickly wherever I am. But as I had it on already, I've been having a look at some overnight data - and found I was getting a really big drop that was causing hypos in the night. I reduced my Lantus a bit a few days ago, I'm still getting a drop but not as severe:



My question is, I haven't been fasting, I just saw the big drop and thought I should do something. Is there any value in looking at overnight data when you aren't fasting properly? I should point out that my last Novorapid was about 7pm, so it should have been done by 11pm, but I think to do proper fasting tests you need to only have water and I had a cup of tea about 9pm. I just thought if I could get my Lantus in the right ballpark to start with, then a fasting test could be more of an evaluation rather than starting from scratch - but I don't know if this is right.

Any thoughts welcome, and merry Christmas to all on this wonderful forum for your continued support!

 

[noblehead]

The cup of tea wouldn't have effected the results so don't worry about that, you had fasted from 7pm after your tea so the results still stand.

Provided you didn't do anything out of the ordinary last night like going for a 5m run then you do need to adjust your basal dose again to prevent the drop in bg, ideally your bg shouldn't fluctuate by much more than 1.6mmol when your basal dose is right, although nearer 1mmol is ideal. However never adjust your insulin going from one nights reading, do some basal checks tonight and if the same happens again then cut back as from tomorrow.

Good luck and Merry Christmas to you ArtemisBow.

 

[tim2000s]

Given what we have discovered of Novorapid longevity from the use of the Libre (it seems to kick in later and have a much more variable life than we have been led to believe), I'd be tempted to try and have an earlier evening meal so that you can take the Novorapid earlier, or do something that doesn't require it. That way you can remove any impact that might be had from the early part of the night.

 

[iHs]

From looking at the graft, as long as the Libre data is correct with bg testing, it does look as though bg is dropping a bit too low from around midnight. I think I would suggest lowering the basal by 1u but alter the bolus in the carb ratio for eve meal so that bg is about 8mmol and not 9 or 10mmol. That should hopefully alter yr bg readings over night but try to get up during the night and bg test just to make sure.

 

[iHs]

Novorapid 's action is about 4.5 to 5hrs so it does make sense to allow about 5hrs after doing a bolus for its action to finish its affect on food

 

[ArtemisBow]

Thanks all - I had reduced my basal already by 1u a few days ago because I had seen the recurring nighttime hypos last week (several nights in a row, not just a one off), so I won't reduce it again just yet because I know it takes a bit of time to adjust. But if in a few days it remains the same consistently then I'll knock another unit off. As you have already noted iHS I am not on top of my evening meal bolus just yet, but until the basal is sorted it's going to be difficult to get that right!

 

[iHs]

It should only take no more than 48hrs for a change to basal to have its effect, so if you made the change a few days ago and its still not having the right effect, then its time to change a bit more or carry on with the low bg levels and get up in the night to bg test and eat some jellybabies andvthenget up again to see if bg is still low or ok.

 

[himtoo]

with the main drop looking to have occurred between midnight and 1am i would suggest that possibly your fast acting to carb ratio might need a tweak as after it hit about 3 it did not continue to drop on the basal you are on .
also allowing 5 hours for the fast acting to be finished working is important.