Help With Basal Rates Please....

Hello folks,

Haven't posted for some time and really need some asssitance as I cannot get any support from my Hospital Clinic!!

I started pumpin early this year and have had a few ups n downs along the way. My last and very first pumpin Hba1c was 50mmol (by the new system) which I was pleased with. Hypos plagued my day and left me with a low Hba1c when on MDI. I have autonomic neuropathy/retinopathy/peripheral and used to have nephropathy. Pain and tiredness fill my days too much but you just have to get on with it! Been type 1 since 1 yr and now 40. I have so much trouble with infusion sites good enough to work well.

My help needed is with basal rate testing!! Because every infusion site varies absorption and with the added neuropathies I cannot get Basal rate testing done. Is their anyone that has or had the same problem?

I would be extremely grateful to hear your thoughts, opinions and any advice.

Thank you very much,
Tux

ebony321 said:

Hi,

I see your post has been unanswered, maybe missed so bumping you up again.

I know you say your unable to get support from your diabetes clinic, but sounds like a few days with a continuous glucose monitor on loan from your hospital may help with your basal testing, enough maybe for you to tweak it a little to help you get them right.

How often do you test a day normally? i know your neuropathy can cause you more pain by testing more but it may seem the only other way is to stick at it with a basal fasting test. It may be more worthwhile in the end as more stable BG's will maybe ease some of your tiredness.

You could also do some research into alternative site testing so you could spread out your BG's tests along more areas to help with any discomfort.

Sorry i can't be of more help, the only few suggestions i can think of, maybe none will help but just thought i'd try, hopefully someone with more experience in your situation can offer better advice.

all the best

Click to expand...

Hello Ebony321

Thanks for your post advice. Umm, I really don't know where I'm at with my Hopital CLinic - letter emails/text messages and phone messages are all unanswered. My GP directs me back to them for answers yet no-one is answering!!!!! Been sometime now and Its so frustrating being ignored I have my GP clinic soon so I am going to leave it with them to sort out what is going on with the Hospital.

I do a BM before every meal and about 3hrs after and in between most days plus before bed and in the night a few times as I wake all the time. Previously my PDSN told me to cut back on my testing as she thought it was too much (it really was!) so the above testing amounts to min 8 but more like 12+ a day. I have really struggled with Basal fasting mainly due to poor absorption sites I have. I cannot use my legs or abdomen due to severe burns when I was a child (a fight with a chip pan - I lost!) so I use areas on my abdomen sides as advised by my PDSN and as I live alone I cannot get at my back although I have had a **** good contortion to try!

The lack of usable sites and good absorption = failed basal tesing! I sometimes wonder if being on a pump is the right thing. I used to have 11 + hypos a day on multiple daily pen injections and a low hba1c as a result of them and I was overweight with memory issues too but since starting the pump I have lost many kg's, memory improved and my first pump hba1c was 50mmol by the new system I think with a handful of 3.9mmol. My meter seems to read my mean of blood tests at 6mmol but by my record book I can see I need changes and when I do change my basal rate, the infusion site change is due and its all messed up again. My autonomic neuropathy really messes with my 2hr post meal BM but is nearly always back to what it should be after 4 hours. I am sure my insulin to carb ratio is slighlty out but then when using a good absorbtion site, its fine and the basal rate too.

I was carb counting prior to switching to the pump for 4 years and insulin pen (Novorapid+Lantus) dose combined amounted to about 76 to 80u a day. On the pump my Novorapid total daily dose is between 45 and 56 units max.

Any advice I am very grateful to get.

All the best
Tux