Only Two Basal Rates - what do you think?

[Jan B]

I would love some opinions. My trainer is helping, but . . .

First issue: dawn phenom correction

TDD: 19-22, carb factor 1:16, correction factor: 54
Current Basal rates (just 2):

12:00am - basal .6
6:00am - basal .65 (Supposed to begin .65 at 4am tomorrow per trainer) Maybe this will help enough?

If I get out of bed at 6 or 8am, bg is great: 88 or so.
Without eating, in 2 hours I'm up 50 from waking bg; 3 hours, I'm up 90-100 from waking bg.

I began with just one basal rate of .65, but was having a lot of night lows (repetitive 40-60 readings).

Second issue: eating snack(s) when I don't want to!!

To prevent going low at approx 4pm, I have to have a 15 carb snack at about 3pm with no bolus. I don't want to have to eat! I won't complain about my bedtime snack to prevent a night low; I enjoy that snack of 15 carbs (with no bolus).

I want my basals where I am never forced to eat. I have been reading Pumping Insulin, but find it easier to recognize someone elses habits than see my own bad trends!

Thanks for any thoughts and help!

[Jan B]

More info: I get up, drink decaf tea and read, get on DF, do home searches, etc. I dont' get physically active until about 10 or 11am. Then it's very busy, dog walks, errands, etc. Plus, I don't eat breakfast until about noon. Then I like to nibble at about 4 or 5pm, then have a grazing dinner from about 7p to 9pm instead of having one big meal. My eating style is throwing things off. That's why I was recently told by the pump trainer to have a snack at 3pm, and have a "regular" dinner at 7pm. I should be getting a cable anyday so I can download numbers and chart.

I'm still hoping to match basals with my style, instead of having to eat like a "regular" person!

[palefacegirl03]

if you want to borrow the cable before yours get here, just let me know.

When i was first pumping, i was having some problems too. My trainer talked about hooking me up to the GCMS for a few days to see what was going on, maybe yours could do that as sort of a trial?

[xMenace]

So you go up about 90 pts in the morning. At 1:16 I:C that's 1.125 units of insulin where 50pts = 10grams of carbs. (90 bgs/50bgs per 10 carbs) * (10 u per carbs/16 u per carbs) The bigger question is the timings. I'd add a bit an hour before you wake and spread it over the next two or three hours. That's .375 per hour. However, I'd start slowly adding only .10 per hour or less and see how that works. For some reason, basals can be more effective than boluses. I don't think my math is wrong. It's just been true for me and others I've seen do this.

Also consider post lunch. You may be currently dropping back to normal ranges. When you do this adjustment, there's a good chance you'll experience worse lows in the afternoons. You definately need to basal test from lunch to dinner. You may have to suck it up and try a few breakfasts while you do.

If your afternoon basals get adjusted properly and you find a bolus level that works, but you still go low, you may have to treat it as a superbolus by cutting those afternoon basals. You don't need to feed the lows.

[Jan B]

Thank you John. That's just what I needed. Simple math spelled out, and logical help. For a few days I will eat breakfast early (ick) and do afternoon and early evening basal testing. I've been stuck on night-time basals.

I had been getting up every couple hours at night checking (used to be always going low), doing a pretty good job of seeing night patterns. Now that I'm not having all the sleeping time lows, it's waking through noon I'm having a hard time with. When I was having consistent night lows, I didn't see this big after-dawn rising bg effect.

Charlotte - If I don't get my cable real soon (by Tuesday), I'll take you up on your offer. I'm going to try to get straightened out a while longer before asking for the continuous monitor, even though my doctor would help me with that I know. Last time I did that, I was on Lantus, and all over the place -- extremely inconsistent.

[xMenace]

Anything you add or subtract to the mornings, do the opposite to your lunch bolus to compensate, so if you add .5 total units in the morning, reduce your lunch bolus by .5. I might seem cautions. I am. But you are already going low. If that send you high, then add it back slowly.

[Lloyd]

I have dawn phenomenon, and 9 basal rates to deal with it. My basal is like a cruve with steps.

[kgm0612]

I have 3 basal rates now. I started out with one, then endo added a 2nd one about 4 weeks into pumping, and a third about a month after that.

Jan........you should be eating breakfast earlier.......it's very important for you! LOL

Karen

[xMenace]

I have 3 basal rates now. I started out with one, then endo added a 2nd one about 4 weeks into pumping, and a third about a month after that.


Isn't this the give them food or teach them to farm argument? Do you know how to adjust them yourself? Shouldn't you?

Jan........you should be eating breakfast earlier.......it's very important for you! LOL

This is what doctors, DE's, and dieticians tell us, but this is also how people successfully managing their weight und up gaining 20lbs before they know what hit them. We see that a lot on here with newly diagnosed. IMO our regimines should be tailored to our lifestyles, not the other way around, regardless of how unhealthy they may be. Go with what works for you not what 'they' say should work for you.

[Jan B]

I have dawn phenomenon, and 9 basal rates to deal with it. My basal is like a cruve with steps.

I figure I need at least 5; in all the years I've had D, I never wrapped my head around this phenom.

I have 3 basal rates now. I started out with one, then endo added a 2nd one about 4 weeks into pumping, and a third about a month after that.

Jan........you should be eating breakfast earlier.......it's very important for you! LOL

Karen

I'm working on that breakfast thing! Old ways die hard. I've been a fanatic about weight control for a long time. The earlier in the day I start eating, the hungrier I am the rest of the day. So . . . my breakfast used to be caffeine. Now it's decaf tea!

The trainer told me yesterday that she now has 9 basal rates, but they were added slowly over more than a year. Since I've been pumping again only a few weeks, I guess I'm not too off, but I am adding a 3rd, and likely 4th today. I'm a little impatient and always looking for "right" and truth. I'll be looking for a long long time!