Basal trend

[AJB_81]

Hi pumpers. My wife has had T1D since 4 yo. She's been on a pump for 7 years and been through 2 pregnancies - she is amazing! We have been DAFNE carb counters since she attended the course 8 years ago. Recently she's lost weight through following slimming world diet, 2 stone! She feels great but her BGs are now all over the place. I suspect the weight loss has reduced her TDD and hence basal should be tweaked back, I also wonder if her insulin to carb ratio may now be slightly different. Starting point we know is fasting to check basal, although it is tough to find a period that is steady enough to even start fasting!

My question, for anyone willing to share, is what does your basal insulin trend look like through a normal day? My wife's kicks up in he AM for dawn and reduced sensitivity but I'm wondering how extreme other users peaks and troughs are through the day. I know everyone's different but I'm just interested to see if hers looks to extreme. 2 x toast this morning - exactly 44g carbs, insulin dosed at 4.4 units caused hypo 2 hours later!

Any help/others experiences would be really appreciated!

Kind Regards,

Devoted husband of an amazing lady

 

[noblehead]

Hi @andybraith

I need slightly more basal in the early hours of a morning (between 4-8am) and less as the day goes on, but that's the beauty of pump where you can adjust your basal rates to match your body's needs

Definitely start with the basics and do some basal testing, once you get that sorted she can then look at her I:C ratio's. Losing weight does effect basal needs, in his book Think like a Pancreas Gary Scheiner mentions that weight effects basal needs, usually heavier people require more and slimmer people less.

 

[Snapsy]

Hi @andybraith , what a lovely story. Like your wife I'm very fortunate to have great support from my other half.

My basal rate lies between 0.55u/h and 0.70u/h.

It's at its lowest from bedtime to midnight, then I've got it climbing slowly overnight to its highest in the morning, then in the middle of the day it reduces again. It's quite a gentle curve.

Although this isn't the case for me, I know of some who have different profiles for workdays vs weekends. I quite often set temporary basal rates for exercise (or indeed indolence!) and I also do this if I notice my sugars are dropping. It's such a useful tweakable tool!

 

[Okulu]

Hello.

My basal rates are as follows:

00.00-04:00 - 0.90
04.00-08.00 - 0.95
08.00-12.00 - 0.70
12.00-20.00 - 0.75
20.00-00.00 - 0.25

I:C ratio is 7g to 1u all day.

However, my basal rates change during my monthly cycle. I am currently most sensitive to insulin, but in ~2 weeks time, my basal rates will probably change to the following (although how much it changes varies on a monthly basis):

00.00-04:00 - 0.95
04.00-08.00 - 1.00
08.00-12.00 - 0.90
12.00-20.00 - 0.85
20.00-00.00 - 0.45

I:C ratio is then 6g to 1u for breakfast and lunch, and 7g to 1u at dinner.

If your wife is not menopausal (god knows what happens then!), she will probably have found that she has changing sensitivities to insulin during the monthly cycle too (i.e. more sensitive whilst on her period, and then increasingly more resistant for approx 10-14 days before her period starts), but everyone's different!

I did find that when I lost weight, I needed less insulin, and vice versa...

Hope this helps!

Happy to answer any questions if you have any...

 

[AJB_81]

Hello.

My basal rates are as follows:

00.00-04:00 - 0.90
04.00-08.00 - 0.95
08.00-12.00 - 0.70
12.00-20.00 - 0.75
20.00-00.00 - 0.25

I:C ratio is 7g to 1u all day.

However, my basal rates change during my monthly cycle. I am currently most sensitive to insulin, but in ~2 weeks time, my basal rates will probably change to the following (although how much it changes varies on a monthly basis):

00.00-04:00 - 0.95
04.00-08.00 - 1.00
08.00-12.00 - 0.90
12.00-20.00 - 0.85
20.00-00.00 - 0.45

I:C ratio is then 6g to 1u for breakfast and lunch, and 7g to 1u at dinner.

If your wife is not menopausal (god knows what happens then!), she will probably have found that she has changing sensitivities to insulin during the monthly cycle too (i.e. more sensitive whilst on her period, and then increasingly more resistant for approx 10-14 days before her period starts), but everyone's different!

I did find that when I lost weight, I needed less insulin, and vice versa...

Hope this helps!

Happy to answer any questions if you have any...

Thank you!

 

[AJB_81]

Hi @andybraith

I need slightly more basal in the early hours of a morning (between 4-8am) and less as the day goes on, but that's the beauty of pump where you can adjust your basal rates to match your body's needs

Definitely start with the basics and do some basal testing, once you get that sorted she can then look at her I:C ratio's. Losing weight does effect basal needs, in his book Think like a Pancreas Gary Scheiner mentions that weight effects basal needs, usually heavier people require more and slimmer people less.

Thank you!

 

[AJB_81]

Hi @andybraith , what a lovely story. Like your wife I'm very fortunate to have great support from my other half.

My basal rate lies between 0.55u/h and 0.70u/h.

It's at its lowest from bedtime to midnight, then I've got it climbing slowly overnight to its highest in the morning, then in the middle of the day it reduces again. It's quite a gentle curve.

Although this isn't the case for me, I know of some who have different profiles for workdays vs weekends. I quite often set temporary basal rates for exercise (or indeed indolence!) and I also do this if I notice my sugars are dropping. It's such a useful tweakable tool!

Thank you!

 

[hboyt]

my basal rates change during my monthly cycle. I am currently most sensitive to insulin, but in ~2 weeks time, my basal rates will probably change to the following (although how much it changes varies on a monthly basis):

That is interesting....i always wondered if i needed to increase mine for monthly cycle! I'm pregnant ant the moment but will def have to look into this later! x

 

[Okulu]

That is interesting....i always wondered if i needed to increase mine for monthly cycle! I'm pregnant ant the moment but will def have to look into this later! x

Yup, it's a complete pain, but it helps having a pretty regular cycle (and using a pump), so can predict it to some extent.... Best of luck with the rest of your pregnancy anyway!

 

[Postleneo]

Hi my basal profile is as follows

00:00-02:00 -0.05
02:00-04:00 - 0.3
04:00-07:00 - 0.350
07:00-10:00 - 0.275
10:00-15:00 - 0.225
15:00 - 20:00 - 0.250
20:00 - 22:00 - 0.2
22:00 - 00:00 - 0.05

This however at times needs a bit if tweaking

 

[Okulu]

Hi my basal profile is as follows

00:00-02:00 -0.05
02:00-04:00 - 0.3
04:00-07:00 - 0.350
07:00-10:00 - 0.275
10:00-15:00 - 0.225
15:00 - 20:00 - 0.250
20:00 - 22:00 - 0.2
22:00 - 00:00 - 0.05

This however at times needs a bit if tweaking

Wow, that's so much lower than mine! Am I really insulin resistant..?!?

 

[AmandaD]

My basal profile is:

00.00-04.00 0.950
04.00-10.00 1.10
10.00-24.00 0.950
total basal/ day 23.7iu

I have lower basal rates for when I have my period as I seem to get super sensitive to insulin and will have a lot of hypos if I don't change it for that week or so
00.00-04.00 0.575
04.00-11.00 1.00
11.00-24.00 0.575
total basal/day 16.775

I also get pretty bad dawn phenonomen hence the higher rate between 4-10.00/11 am.

 

[hboyt]

Wow, that's so much lower than mine! Am I really insulin resistant..?!?

My basal rates before i was pregnant were 1.3 to 1.8..now im on even more! I've always been on a high rate since i was diagnosed at 11 years old. Everyone's requirements are different...or maybe i'm just even more resistant than you!

 

[catsbd]

My basal rates are between 1.125 and 1.350. I tweak them up and down. TDD (basal only is 29u). I just joined Slimming World and my boluses have dropped but not really the basal rates at present. X