Basal trend

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

Okulu said:

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...

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Thank you!

noblehead said:

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.

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Thank you!

Snapsy said:

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!

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Thank you!