Basal Setting Advice Needed, Please

BOLUSED! Keeps changing the spelling.

Well it has now been 10 days. Saturday went well and it broke down with high bgs overnight. Time change probably didn’t help either.

Been talking to my pcp. Am going in tomorrow for tests for other infections, as Buck had mentioned. More and more, wondering if I have low key strep.

Gotta fix this.

Great discussion and lots of comments. I am going to add my 2 cents worth :blush: 
 First of all, I do not make changes to my settings (been pumping for over 13 years). I visit my CDE every 10-12 weeks. They have access to my data via Carelink and if I am ever experiencing issues, they’ll immediately look into it and help me out. I also use the MiniMed Connect, so data is automatically uploaded for their access.

I have had endos in the past that were useless to me - I fired them! The one I visit now works very well for my health. You could try and find someone that better suits your needs?

A note of caution 
 When changing your pump settings on your own, you should try to run with your changes for a few days, minimum. At least a week is best. And as you mention, the slightest changes can have HUGE affects on us, particularly if you do not take a lot of insulin.

Best of luck and congrats on your great A1C number !

1 Like

I can’t find a good endo, and Lord knows, I have tried. Everyone wants my A1C at 7 or above. I refuse. The CDEs I have seen have either been company connected, and fantastic for 3 days, or independent and look at my Carelink numbers and say, you don’t need us.

Sorry to hear that :(. My A1C as of last week was 5.8. My CDE always makes (minor) changes whenever I see him. People change - our needs change alongside. Keep looking?

I had a lot of help at the beginning (when I first did a trial of the Asante Snap, my first pump). After that, I make all my changes on my own. My endo is happy with my A1c in the 5’s, so long as I don’t have a lot of hypos.
I went to a pump primarily because I was having regular hypos
I now have 5 basal settings on my pump. For me, there was (is) a very short overnight window - not all that dissimilar from yours - where my BG would drop, after which it would start to climb somewhat rapidly - regardless of what I did the night before. Somewhere between 3:30am and 4am, my BG starts to drop. At around 5am it starts to rise, and, if not stopped, continues to do so throughout the morning.

As a result of this, my pump drops my basal rate starting at midnight (for me, it seems to work best if I do that in two stages - a little at 12:00, and a bit more at 1:30am). Because of the small window between the fall and rise, and even though the reduced rate since midnight prevents a hypo at 4am, I hesitate to increase my basal until 5am to compensate for the rapid rise. As result, I have a bit of a bigger “step up” at 5am which lasts until 9:30am, when I dial back a bit. With the programming I have, I frequently see nearly straight lines on my Dexcom overnight, and generally wake up ±10 points from where I was at bedtime.

Hi Sue27,

I’m not sure if you mentioned what kind of pump you have but it sounds like it would be in your best interest to meet with a representative in your area for your brand of pump. I have a medtronic pump and my local rep is awesome. She will look at my online CGM profile and give me feedback for changes that need to be made. Sounds like meeting with a local rep would be better for you since your endo is useless. Wow, what a piece of work. I would fire her but if there isn’t a better alternative that might not be the best choice either. What about traveling a little farther to see an endo way better?
The one thing I have learned about my pump, is what the others have said, it takes 2 hours for the insulin to take effect. You need to or the rep needs to look at your online CGM graphs to see where your highs are consistently. Then make a basal setting accordingly. The insulin used in your pump is short acting, not long acting insulin so it won’t last most of the day. You will need to add basal settings and make small adjustments at a time. You might also need your carb ratio adjusted at certain points in the day and sensitivity ratio adjusted for certain points in the day.
I wish you the best!
Busybee

1 Like