Help with overnight/morning basal rates

[donnellysdogs]

I am only going by my own needs though....and my own experience.. I would advise that you still test though tonight at times-lol

 

[Spiker]

Part of the problem in suggesting the size of the adjustments is we don't know your correction ratio. It's no use us suggesting adjustments based on our own correction ratios. From your first post it looks like either your glucose:BG or your BG:insulin (correction) ratio is wrong, maybe both.

Maybe test your correction ratio next time you get a high blood sugar. Take a correction shot, measure BG every hour, eat nothing for 3-5 hours. You get a good approximation of your correction ratio even if you're not a 100% confident your basal is perfect.

 

[Janelle123]

I would not be changing 5am. (Unless you have figures for 7.30 or 8.30 ish am!!!)

7:18am = 5.7
7:55am = 6.0
8:27am = 6.2

 

[Janelle123]

Part of the problem in suggesting the size of the adjustments is we don't know your correction ratio. It's no use us suggesting adjustments based on our own correction ratios. From your first post it looks like either your glucose:BG or your BG:insulin (correction) ratio is wrong, maybe both.

Maybe test your correction ratio next time you get a high blood sugar. Take a correction shot, measure BG every hour, eat nothing for 3-5 hours. You get a good approximation of your correction ratio even if you're not a 100% confident your basal is perfect.

SInce my initial post I have changed my night time ratio to 1:1.5 which seems to be working. My day time ratio is 1:3 which has always worked well.

 

[iHs]

Janelle what pump do you have?

 

[Janelle123]

Janelle what pump do you have?

Animas Vibe

 

[donnellysdogs]

Your other bg's are excellent for after the hypo you must have taken just the right amount of hypostopper.
Well done on that.....

With my levels being at 90 to 1.27 because of DP I would be making the changes suggested.

When I helped another person on here that person was running at over 2 units per hour and the changes that had to be made were 0.30 at times to get her levels stabilised...

I think you do actually know the increases you need to make size wise but its the timing and thinking of the detail such as changing the hour.

You are doing very well and I congratulate you.

 

[Spiker]

7:18am = 5.7
7:55am = 6.0
8:27am = 6.2

Debatable whether that's a slow rise, or just normal variation on the meter. If your meter is accurate it's probably a slow rise.

 

[Spiker]

You are doing very well and I congratulate you.

I agree!

 

[Janelle123]

Debatable whether that's a slow rise, or just normal variation on the meter. If your meter is accurate it's probably a slow rise.

I probably should've mentioned that I had a coffee at about 7:30am worth 6g carb which I bolused for so that's probably what has caused the slow rise. My current level is *does test* 4.8! Argh! That's probably because I only got through half my coffee before I had to start work...

(Edited for bad language )

 

[iHs]

Ahhhh thought so..... each basal rate has a jump of about 0.200 for each button press and will make bg change.
When I first stsrted with the Vibe, I entered 12 two hourly bssal rate time slots and although some of the slots had the same basal rate, that didnt matter as I knew that I could adjust them if I needed to, so redo the time slots again like 0.00am, 2.00am, 4.00am etc and then youll be able to fine tune them to suit how yr bg is behaving. Remember to write down the old settings first before you re do them

 

[donnellysdogs]

Debatable whether that's a slow rise, or just normal variation on the meter. If your meter is accurate it's probably a slow rise.

Yes could well be. Also as the 3am and 4am lowering of the basal may still impact at 7-8am as well but personally I would see how much the lowering the 3am and 4am impacts still at 7 and 8am before changing anything else. Then Janelle will have the full picture to see how long insulin lasts and will see if they still impact further on for 4 or 5 hours etc.

When I raise or lower doses I always consider the impact on the rest of my rates afterwards for 4-5 hours. Then I would just check the impact before changing these.

 

[donnellysdogs]

Ahhhh thought so..... each basal rate has a jump of about 0.200 for each button press and will make bg change.

0.200 is far different from 0.025????

 

[iHs]

One of my basals is 0.275. If I increase by 1 button click, its 0.300, if I reduce by 1 button click, its 0.250

Its confusing and different from the Combo but appears to be less hassle

 

[donnellysdogs]

But thats not 0.200 change
As you typed above...

 

[iHs]

No ur right....slap wrist....its a difference of 0.025 approx

 

[donnellysdogs]

Although being on an Insight pump the principles of basal and bolus's are the same Janelle.

I stand by what Insaid earlier to change the 3am to 5am down to 1.05 per hour.

 

[Janelle123]

Although being on an Insight pump the principles of basal and bolus's are the same Janelle.

I stand by what Insaid earlier to change the 3am to 5am down to 1.05 per hour.

Thanks for your help

 

[donnellysdogs]

Let us know how you get on. Its good to see that you are in control and with lower rates. It shows how much you have figured out your own doses and your own body.
Well done Janelle. Its a great achievement. It maybe well be that you need another little tweak but you are doing so fantastically well.

 

[Janelle123]

Let us know how you get on. Its good to see that you are in control and with lower rates. It shows how much you have figured out your own doses and your own body.
Well done Janelle. Its a great achievement. It maybe well be that you need another little tweak but you are doing so fantastically well.

Thank you. It makes me happy that someone can appreciate the hard work I am putting into keeping my blood sugars at near normal levels. At my pump course I got the impression that the diabetes team and the other diabetics thought I was crazy that my goal was to not have any readings over 8.

Warning - I'm about to go on a rant:
1. I was horrified when they told us to not take any lantus before bed the first night and that we would start on the pump the following morning. I told them I was not comfortable having no background insulin. After many arguments they agreed that they would set me up on the pump after everyone else had left. The next morning, everybody was 20-30mmol/l (not suprising!) with the exception of one who was at 16mmol/l since she usually took lantus in the morning. As I had been using the pump all night I was the only one with my blood sugar in range.
2. It was my understanding that to gain approval for the pump we had to be competent in carb counting. We then spent the whole morning being taught how to count carbs...
3. When they were teaching us about insulin on board (which I thought as a diabetic, whether on the pump or MDI, people should already know) the nurse told us to only take into account IOB when doing a correction and not with food - correct, BUT then she went on to an example where she did the complete opposite! The example was of someone who had a BG of 17 and because of IOB they took no insulin with their snack!. I interrupted with "1. He should not even be eating with a reading that high! 2. This example is showing the opposite of what I would do/what you just said" She ummed and ahhed for about a minute before continuing on with the example!
4. When telling us how to check that our basal rates are correct they told us to eat a carb free meal like bacon and eggs or some vegetables etc. I said "1. vegetables have carbs. 2. the fat/protein in bacon and eggs will still increase your blood sugar" They agreed with me but bascially said not to make this any more complicated than it needs to me.
5. My last HbA1c was 44 (hoping to be in the 30's next time) and the closest anyone else had to me was 70 something. I felt like I couldn't relate to anyone because they were there for the opposite reason to me. They have gone on the pump to lower their HbA1c and I have gone on the pump to hopefully avoid any more severe hypos (seems to be working so far since I've only had 2 readings under 3 since going on the pump!)

It was such a frustrating week having to listen to their incorrect information - hence asking for advice here and not contacting my DSN.