Basal Change?

I posted a couple of weeks ago about my BG problems on vacation. My high BG problems continue, but are now morning focused. Woke up this morning (6am) at 81. Decided to basal test this mornng. At 7am I am 128. At 8am, I am 163. I correct, stop truly testing and continue to record true BGs. At 9am I am 165. Then it goes down, but I only go to124 by noon (my goal is 100.) Once I start to rise that fast, I know I need to correct at a higher level then my normal 1 unit brings me down 65 points.

My estimations of the dramatic rise are from 6am to 9am. If I add the correction dose to my normal basal at that time, I go from .60 to(for 6 to 9) to add the normal correction, it would raise my basal to 1.2 per hour. I have never had a basal in 8 years of pumping over .60 Scares me and my wonderful husband

Suggestions? You always have great ones! THANKS!

Here is an article on diaTribe written by Gary Scheiner. He suggests changing the basal rate for adults 2 hours before your BS actually starts to go up. If your increase starts at 6 AM, you would change your basal setting at 4 AM. You should also make the changes in small increments. If your current basal is .60, per Gary Scheiner’s chart, you should only add .2 units to the basal (that is for a large jump). You would make that change for 4 AM, not 6 AM when it goes up. I would try that and give it a few days to see what happens before making another change. Funny you did basal testing this AM, I did also! Mine did not go good either.

http://www.diatribe.us/issues/26/thinking-like-a-pancreas.php

Whenever I adjust basals: I make the adjustment 2 hours (peak insulin activity timimg) before the BG rise. So if your BG is high from 6 to 9, I would make basal adjustments from 4 to 7. I would also suggest a more conservative increase in your basal rates. I just tick my basal rates up/down one tick (0.05 U/hr on my pump) and see how it works for a day or 2 and then adjust from there. I believe “Pumping Insulin” recomends a 5% (5% of 0.6 U/hr is a 0.03 U/hr increase) change for small adjustments and a 10% change when things are really out of whack.

Hope this helps.

I think these are great recommendations. And it is important to see how the changes affect you over 2-3 days.

Good suggestions. I woke at 114 at 6:00 and was 152 at 7:00 at which time I corrected with 1 unit. At 10:30 it is 124.

If I set the rise at 4 AM, how many hours at the higher rate. The thing I am worried about is that it is taking at least 1 unit to bring me down into an acceptable range. So, if I raise it .03 at 4, it would take 33 hours to pump in the extra unit, and that seems a little off.

Won’t try until Sunday, as I am having major dental work tomorrow–another pump problem, as it will be with sedation.

I can’t seem to catch a break lately…

I am printing the Diatribe article. That is SO cool! I have never had those explanations ever! I feel fairly normal now. Thanks, Kelly!

You are welcome! Unfortunately, I don’t think most of us have ever had those explanations. That is what I love about this site - 21000 people reading different articles and one will find a good one.

I think you’re mixing in two things, T1 - your correction factor and the amount of basal to keep you from going high to begin with. Once you are actually high it takes a bit to get down. It takes less to keep you level in the first place.

Is it possible you are getting too low overnight and your body is responding to the low?

My daughter’s endo has explained to me that if you go too low overnight your body responds by releasing other hormones to raise your blood sugar thus causing a high in response to the low.

You could try testing every two hours overnight to see if you are getting low without realizing it.

Overnight has been great (I have a CGM) and I have been hovering around 80-90 until about 4. The it goes up a bit and I usually wake up around 100. I have noticed that it does begin its very slow ascent earlier than the huge spike at 6 to 7.

I agree. I never thought about thedifference between basal and correction. It is a great thought. Thanks, ZOE! I should have thought about that.