Having a really hard time getting my Basal Rates set right. The early morning time is being impossible to figure out. I started out with a 0.400 setting and in the course of a week have gone up to 0.650 setting. As I keep going up on my basal rate every morning my numbers keep going higher.This morning I went from 140 192 160 174 137 then back to normal. Strange thing is before I started going up on the basal rate BG was only going up to around 140. Since I am new to pumping I was wondering if anyone else has experienced a similar problem?
I sometimes experience similar problems. Do you have a strong dawn phenomena during the night? My DP seems to change every few weeks by either getting more aggressive or smaller for reasons I can not figure out. On top of that if my DP is extra strong at night (BGs up higher than target) then when I wake I may see a small spike in my BG and breakfast really makes my BG spike, I believe this is all from insulin resistance from the DP. It can be very frustrating and I understand your pain.
I think you are going about it in the right way. I have a CGM that really helps me get my basals where they should be, or lets me see when things are not working well. Here is how I would recomend changing your basals: If your BG is spiking at 8 am then up your basals 2 hours prior (or peak insulin activity time) and keep it elevated for the period of issue. “Pumping Insulin” recomends a 5% change for basals that are slightly off and a 10% change for basals that are really off. In my experience, I would bump up the basal rate only one notch and wait a few days to get a bit of data and see if you need to fine tune further. Also, I would eat the same breakfast everyday as to try to eliminate food as a variable.
Hope this helps. If your DP is like mine, then you may have to back off the basal rates before then end of the month so be cautious if it is overnight.
Uniboy, do you get up at the same time every day? I vary when I get up, but whenever it is I go 20-30 points higher. It’s not DP with me, just getting out of bed. Happens if I nap too. I’ve learned to just shoot a unit as I’m getting up.
What time are you changing your setting? Do you have a CGM?
I ask because it looks like either typical dawn phenomenon, or, you are going LOW and rebounding. If the latter, continuing could be dangerous.
So, I’d get up at ? 3 am? and do a blood test. I know this is a PITA, but I think it’s very important and you MUST do it.
So, give us some more information - what time is your basal changing, and what time are your BGs being taken?
I do not have a CGM and I don’t know if i am dawn phenonemon are not. I do not normally get up this early I have only been doing this trying to get my basal rate straight. Hope this helps you understand.
"I do not have a CGM and I don’t know if i am dawn phenonemon are not. I do not normally get up this early I have only been doing this trying to get my basal rate straight. Hope this helps you understand."
yeah, you are as anal about this as the rest of us, LOL! These are nice and interesting and still lead to a similar thought as my initial one based solely on your first couple of lines:
0942pm 88 Basal Rate 0.375
1201am 76 0.450
0202am 98 0.450
What might be happening is sometime around midnight-2 am you are going low. When this happens, your liver will dump glucose to try and combat that low. In a non-diabetic this works great, in a T1, this results in highs a few hours later.
I’m not saying this is happening, I’m saying you need to beware of it happening. If it is, then increasing your basal is the wrong thing to do.
If it’s dawn phenomenon, on the other hand, I’d suggest 0.7 starting at about 3 am.
I have terrible Dawn Phenomenon, so just so you can compare, this is what my basal looks like:
midnight: 0.55
5:00 am: 1.35 - more than double!, I get up about 6 am.
9 am: 0.7
3 pm: 0.55
the other thing that affects my dawn phenomenon a lot is dinner. I absolutely cannot eat within 3 hr of bedtime, or my morning BG is 10-50% higher than it would otherwise be. If I eat a high fat dinner, I’ll increase my basal to 0.65 all night long (Italian food, for example).
One thing that is suggested is to fast for a day, or 12 hr at a time if a day is hard on you - don’t eat from 4 pm to 8 am at all and see what that does to your BG. That is a way to test that you basals are covering the basic, non food-related, needs.
That is a surprising increase in a matter of a few days, almost 50% increase for overnight hours. I have two thoughts after looking at this increase:
Troubleshooting: Are you getting sick, kinked cannula, pump malfunction, gaining weight, taking addiitional drugs (steriods), infusion set problems, insulin absorption problems, scar tissue, changed infusion set as needed? Please take care and review these options and others I may have forgotten. I would hate for you to up all your basals to change your set or stop taking a sterioed and come crashing down, especially at night.
My other thought is that your insulin needs are just changing and the important part is to take the appropriate amount of insulin to maintain as normal of BGs as possible. This summer my body required almost a 10% increase in TDD out of the blue in less than a week, is your TDD increasing as well? If I had these numbers (11/7/11) I would increase my basals one tick from 3 or 3:30 am to 5 am. I would be concerned of crashing from 8-10 am with the basal increase as well and consider lowing that basal rate as well (6-8 am basals). Good luck and test often for saftey if you are increasing basals. I think you are doing everything right and unfortunately you may have to do an after-the-fact reactive strategy for the time being.
@TS come to think of it I ate and went to bed 2 hours later last night. What lead to me doing all this testing was after the nurse for Animus told me my basal rates looked good so I decided to do a 24 hour test. Well I was dropping low at night so I lowered my basal then in the morning I started going high.
@Capin101 I just changed my inset last night and first thought it was bad then my numbers came down so I think I can rule that out. Nothing else that I can think of out of the norm. Every time I go to put in an inset I try to make sure I’m not close to any of scar tissue from past surgeries.
I think I’m going to eat normal for a couple of days and see what happens. Maybe I’ll do another 24 hour test on Friday. Think I’ll start this one after breakfast and see what happens.
I’m glad you all responded because I thought I was the only one with problems like this.
Uniboy, don’t forget that if you want to have lower BS at 1am, you’ll need to increase the basal at approximately midnight to cover the 1am highs. The hour is not set in stone, but a good starting point.
Are you downloading your data? The insights available from the Diasend software are incredibly useful. Look for a pattern over the course of at least a few days, or a week. The modal day chart is great for this.
