any help on testing basal rates? … been
on MM pump 10+ yrs; however, need to
improve control- change basal 2-3 hrs before to
correct hi/low???
Not enough information to offer much helpful advice.
Changing your basal rate two - 3 hours before . . . . before what? change basal up or down? Basal rates are not meant to be changed or adjusted frequently. They should be set to match your lifestyle and general level of activity and remain there until it’s clear that your bolusing and physical activities aren’t doing the job.
Correct highs with a bolus. Correct lows by eating some carbs. Change your basal rate to help level out wide swings in highs and lows, assuming you are otherwise bolusing correctly.
Test your basal rate by using the guidelines in John Walsh’s book “Pumping Insulin”, the information at this site Basal Rate Profiling or by calling MM for a brochure on the subject.
Good luck,
Terry
To add, what Terry K stated below ; could be carb ratio’s , that need to be looked at , including sensitivity settings…and active insulin time ( which I have set mine at 3 hours …I use less than 40 u daily …between 1-40 u : 3 hours, between 41-150 u 4 hours , between 150-300 u 5 u etc) .But if you start changing settings take small steps at one time . CGMS available to you ??
Maybe see or contact a CDE / MM pump trainer ?
Be well .
thanks… I’m thin…TDD of about 23u. Don’t want to change carb bolus’s yet cause am re-testing basals. Pump Ins book (3rd Ed) says to correct for rise or fall 3 hrs earlier. And I didn’t know about active ins rules u listed…I use novalog & a 4 hr active INS.
thanks Terry…see my reply below to Lori. MM can’t seem to get me in touch w/CDE…have u had luck w/that? any names??
thanks Alan…LOL @ ur remarks about sensitivity & changing w/DowJones. Me too!!!..which is why I am fasting & testing
Just not sure I can think through the changes, Oh & I’ve already let it drive me nuts
Janny , my total TDD 31 day av. shows 21.91u ( novalog…we call it NovoRapid ) …you and I are close in number. I did not realize, that you are testing basals at this moment …as I said small steps at the time and did not mean to do more than one process at the time .
We had a Medtronic pump session here last Thursday ; the Nurse mentioned about the active insulin rules to the group .
My pump has been set for 3 hours for several years as recommended then by my Pump nurse .
As an on the side, I think 4 th Edition of Pumping Insulin has more info .
Can you refer to the page quote : " Pump Ins book (3rd Ed) says to correct for rise or fall 3 hrs earlier " , please ??
Nel: I’m ordering 4th ed of Pump. INS tonite! Ch 10 (last pg) of 3rd Ed. is the suggestion to change basal 3-6 hrs before bg rise/fall-referring to humulog ( I use novolog) 3rd Ed only refers to regular & humulog. As of now, had to quit eve. test
cause bg 349. ): Wish there were MM sessions close to me. am in Ctl TX
My doc suggested fasting then checking every two hours. Do it over a few days, that way you have a morning, afternoon, evening, and night.
Yes, this is why it is obviously required to test, if you have a BG of 349 .Hang in !!
I checked page 104 , 3 rd ED ( year 2000) .Novolog not as well known then .What I see in 4 th ED page 134 : When to change the basal rate : quote :" basal delivery is far slower than boluses even though the same insulin is being used " : Form 11.3 same page : if a 0.5 u basal reduction is needed , you might lower your basal by 0.1 u/hr for 5 hrs between 2 and 7 hrs. before the low reading occurs … this is getting toooo complex for me .
What I do for basal testing , incl some fasting : I change basal 1-2 hours before the rise or downward trend …for instance : at 11 am if my BG at 3 readings is similar and higher , than I
like , taken all other reasons in consideration why high , then I re-set basal at my 1 pm rate. I hope this answers your question …and test, test, test
Medtronic will do Webinar sessions in Canada www.realglucosecontrol.ca and another website :
http://www.realdiabetescontrol.com/events/index.html instead of group sessions …in some places NO one showed up …we had 12 plus people in my town attending . Maybe something similar in your state ??
THANK U,Nel I ordered 4th Ed from Amazon.com altho,as u say,
sometimes tooo complex & this roller coaster leaves me drained
& depressed. I will definetely ck on webinar
possibilities…& I am the testing queen. I also volunteer for ADA as
u do in Canada…soo glad to add u as a friend!
I just notice a typo in my response …re-set basal at 9 am , when 11 am is too high …not 1 pm as noted.
yes, 2 hrs before…
Alan how long u been using Apidra? Do u find
the faster action better?
I was going to ask Alan similar question …
I do know,that Apidra has not been available in Canada all that long.
Alan : how many units do you use daily on the average ? Does one use less Apidra compared to NovoRapid ?
Buy John Walsh’s book “Pumping Insulin.” He will tell you how to test basals. Basically, we test the four time periods 6am to 12 noon, 12 noon to 6pm (for us, this needs to be broken down where we have a new basal time period 3pm, 5pm and 6pm as she rises more aggessively during this time). 6pm to midnight. Midnight to 2 or 3am and 2 or 3am to 6am. The midnight to 2am and 2am to 6am basals are separate basal time periods for us as well. Basals need to be adjusted either up or down two hours before the higher or lower blood sugar. So high at noon, change basal up at 10am, etc. How much you adjust, .50 or more, depends on your sensitivity to insulin. It has not been our experience that basals remain stable at all. In fact, they change quite frequently, but we have a growing child. Adults probably change less, but I would be surprised if most adults never need basal adjustments. Females probably need more adjustments due to menstruation, menopause, etc. Walsh’s book is great. So is “Think Like a Pancreas” by Gary Scheiner. Scheiner’s book is particularly useful if you exercise or are active. Scheiner’s book is a faster read than Walsh’s so if you need something easy to follow I would start with Scheiner’s book. Walsh’s book is quite comprehensive and a bible of sorts.
Thanks, Alan …we discussed Apidra at the Advanced Medtronic pumping eve. last week ; I had seen Apidra mentioned on the CDA website and mentioned it at this training session ; both Nurses in attendance were aware about availability in Canada …
On the side : one chap ,who does an incredible amount of regular cycling and who still maybe going through the honeymoon stage ??, 5 years after diagnosis will check out 2 things : 1) another c-peptide test 2) Apidra …I will check out Apidra today at the Pharmacy .
And I eat far more carbs than you do …as you said , we are all different .
Alan , how about a C-peptide test for you too ??..I would not be too surprised , if anything is possible .Wowy , you are " sensiitve " , to insulin ( I add 
)
re -Apidra …one of my Pharmacists said ( BC , Canada ) : one requires a prescription from Doc, if one changes insulin brand …I asked him , if he could bend the rule, since I am living with D almost 30 years …No he said .