Basal Testing

[notme]

I have heard several people talk about doing basal testing here and decided that this is something I need to do. My basal was set years ago by sort of a haphazard method. My blood sugar tends to be good first thing in the morning and then rise to an alarming rate whether or not I eat anything.

I heard there was instructions on basal testing on the MiniMed site, but I can't find it. Does anyone know where this is on their website? Or....can someone just tell me how the heck you do this. I did a search hear for instructions here and couldn't find the thread that explains it.

Better late than never....... I need to get this done. :o

[xMenace]

Integrated Diabetes Services - Diabetes Management (http://www.integrateddiabetes.com/pump_bt.shtml)

Getting Down to Basals :: Diabetes Self-Management (http://www.diabetesselfmanagement.com/articles/Insulin/Getting_Down_to_Basals)

HOWTO profile your Basal Rates. (http://www.insulin-pumpers.org/howto/baslr.html)

Index of Diabetes Technology pages: Insulin Pumps, Insulin Pump Comparison, Blood Sugar Meters, continuous glucose monitoring devices, noninvasive monitoring, diabetes software. (http://www.diabetesnet.com/diabetes_technology/dia.php)

These links are in my order of preference. The 4th might make you say "huh?" but you have to have a firm understanding how your insulin works - what are the impacts of making a dosage chance? Or "when should I adjust to treat that rise or fall?"

My simple rules:
-be in range at the start
-don't eat or bolus for 4, preferably 6 hours prior.
-test hourly
-re-test every two hours to validate readings, you are making important decisions on readings with a potential 20% variance.
-stop and treat if you too far go out of range
-test for 6 hours
-make conservative adjustments
-re-test to validate the next day or soon after.
-expect inconsistencies in behavior and treatment

[notme]

Thanks John. Just what I needed. :)

[Jan B]

I'm glad John wrote before I made my feeble attempts!! Yeah, what John said! The charting is very helpful. Nancy, I'm struggling with morning highs also. I got my night lows under control, now it's that wicked dawn phenomenon. I'm following my trainers advice for one more day -- she wants me to continue to go high after getting up in the morning, so she can see just how much to increase my basal! (I've got John's ideas/plan ready to go!)

It doesn't matter if I get up at 6 or 8 am, I'm about 80-90, but then go to almost 200 in 3 hours while eating nothing. This also happens if I eat early. I obviously need to increase after-waking basal. The more I ask around, the more I find people using eight or more basal rates.

[xMenace]

Keep in mind you are in an artificial equilibrium. If your numbers are stable and your basals are off, then your boluses have to be off too. For any adjustments you make to basals, you should make teh opposite adjustment to boluses. So if you add a half unit in the mornings over say four hours, reduce your breakfast bolus by this much. Once your basals are good, then you can fine tune to boluses. It's just a cautious approach to prevent those nasty unexpected hypos. Changing routines generally does this.

Another less precise way of testing basals is to vary your meal sizes. For example, if you eat a big breakfast but your BGs drop then your basal is too low and your I:C too high. With enough testing you can figure out an adjustment, but timing can not be refined easily.

[notme]

I going to give this a shot tonight. One day at a time and I will see where it goes. Thanks John. This is exactly what I needed. So many of the sites I found were very unclear in the instructions. I am a "stay between the lines" kinda girl. I needed exact instructions.

What would I do without this website???? :confused:

[xMenace]

I going to give this a shot tonight. One day at a time and I will see where it goes. Thanks John. This is exactly what I needed. So many of the sites I found were very unclear in the instructions. I am a "stay between the lines" kinda girl. I needed exact instructions.

What would I do without this website???? :confused:

I know exactly what you mean. It took me weeks to find this stuff out and the sites I gave. It wasn't till I stumbled through the process myself that it all came together. I'm amazed that the pump companies and DE's don't push a structured protocol. I sense both a CYA attitutude and a certain level of ignornance on their parts. My DE doesn't know anything about it nor cares to learn as it's not part of the prescribed treatments. Pffft! Our diabetic support systems can be downright dangerous sometimes..

[Eddy]

I'm amazed that the pump companies and DE's don't push a structured protocol. I sense both a CYA attitutude and a certain level of ignornance on their parts. [...] Our diabetic support systems can be downright dangerous sometimes


Indeed. Prior to finding this site, I took what the hospital gave me, then researched and experimented on my own. It's time-consuming and expensive... but it's better than "official" information that is offbeat or outright wrong.

I found this site while looking for others with whom to swap experiences. An excellent find, to be sure. :)

[notme]

That is exactly what I did Eddy.

Thanks for doing all of the leg work John. I am going to bookmark these sites and refer to them often. The past few days I have had so many lows from stacking insulin (and a lot of strenous exercise in the yard). It is high time I got my act together. :stupido:

[kgm0612]

Hey John..........thanks for the info you posted. I'm in need of basal testing myself and am thinking I should do it before my next endo appointment on March 3.

Karen

[xMenace]

I'm in need of some re-testing myself in the evenings and afternoons.

I'm still happy with my mornings. I got up early on Sat. at 4am and tested at 4.9, at 8am at 5.4, and slept in until noon where ai was 5.5.

I've been thinking that arranging some some where we can chat might be interesting. We could motivate each other and discuss our results. But it can also muddy the water with extraneous comments. We're not always free at the same times or for the duration. But if you are testing, maybe hang out in chat if you can.

[Jan B]

I'm in need of some re-testing myself in the evenings and afternoons.

I'm still happy with my mornings. I got up early on Sat. at 4am and tested at 4.9, at 8am at 5.4, and slept in until noon where ai was 5.5.

I've been thinking that arranging some some where we can chat might be interesting. We could motivate each other and discuss our results. But it can also muddy the water with extraneous comments. We're not always free at the same times or for the duration. But if you are testing, maybe hang out in chat if you can.

If I go to the chat room, I promise I won't muddy the water with extraneous comments. I just tested being in there -- never have participated.

[notme]

I am sure there are a lot of us that are due to basal test. I definitely think it helps to have others who are doing the same testing discussing their results and helping out. Chat sounds great.

[xMenace]

If I go to the chat room, I promise I won't muddy the water with extraneous comments. I just tested being in there -- never have participated.

Ummm, you get Jedi' 2High, Rikki, Peter, and a few other jabbers in there, and it can get fun in a hurry. :eek: ;)

[Subby]

Great thread, definitely helps to think others are doing the same thing.

I know there are all those great pages to read and go by, but I wanted to ask about people's experience with doing night basal testing. Anyone stayed up later than normal, to do say 11 - 3am testing? Do you find it is accurate/usable, or is being awake during the time makes it too far from normality?

[xMenace]

Great thread, definitely helps to think others are doing the same thing.

I know there are all those great pages to read and go by, but I wanted to ask about people's experience with doing night basal testing. Anyone stayed up later than normal, to do say 11 - 3am testing? Do you find it is accurate/usable, or is being awake during the time makes it too far from normality?


I've had the same question. Someone else on here was up and testing all night and made a comment it didn't make any difference. I stayed up all night once in November and tested every half hour. I sorted out my nighttime drops and haven't hypoed since. Other times I've gotten up at 3am or 4am, and I often stay up till 2am or 3am. So far I've had pretty consistent behavior.

I've concluded that once or even twice in a row will have little to no impact.

[notme]

I wonder if the stress of just staying up will have an impact on your blood sugars. It is stressful to be that tired. I think when I do this testing, I will set an alarm. I have not done my basal test yet. I have had a stomach issue for about three days that will mess up my test. I also feel like I am coming down with something. :(

[pegasus]

Thanks much; I too am much in need of these refs and this thread/site. As I wrote in another thread, my DE was impatient; my doc wants a month's results.

I saw John's recommendation on bolus changes, but I haven't seen reference to bolus wizards here. Doesn't the MM wizard use basals to help calculate bolus?

[Subby]

I don't think so. The MM wizard on my 722 calculates bolus using three elements:
- carb input (using carb ratio)
- current blood sugar (using sensitivity setting)
- current Insulin On Board (from previous boluses)

It does not take basals into account in any way when calculating the bolus. Nor should it, the two are best treated as seperately as possible to maximise flexibility and stability.

I am, as always, happy to be corrected if I've overlooked something.

[ant hill]

Other times I've gotten up at 3am or 4am, and I often stay up till 2am or 3am. So far I've had pretty consistent behavior.

John, Do you think that your body has a difference from staying up apposed to sleep as your heart beats more slowly if you sleep so the insulin that you use overnight may differ?

I wonder if the stress of just staying up will have an impact on your blood sugars.

I think that there is a difference Nancy. ;)

[pegasus]

Subby,
Of course you're right--I'm still "internalizing" the equations, and am badly in need of absorbing the tech info in that 4th site recommendation John gave.
Thanks.

[Subby]

Hey, I wrote a reply partly to test myself on this stuff. Takes a while for it to break its' way into my brain.

You'll get there, pegusus, keep asking questions and we will answer what we can. I expect no less of everyone when I ask mine :)

Are you talking about the 4th link, about insulin action time setting? Because I notice it gets flaky at the end, talking about a 2nd table that doesn't appear, and only seems to give the recommendations for the cozmo. Shame. Anyone shed some light there for the mm?

[pegasus]

Thanks. I've never actually had other diabetics to talk to (or been able to), so this is extraordinary for me.

Yes, that's the link (the 3rd one about profiling looks good too), but I didn't have any trouble loading 2nd table. I haven't read any of them through; just skimmed, so I appreciate the forewarning.

[Subby]

Hehe, yes I know, it is like finding another of your alien species out there that speak your alien language. The few type ones I have bumped into in real life over the years often seem another species too - either they just have it so much easier that my issues made no sense to them, or they spend their time covering or compensating or denying it or, something or other. Or maybe we just didn't get along as people. Dunno! But often not much conversation to be had.

Maybe John can explain what occurs at the end of that article, perhaps I am just not reading it right and the info is there.