Just wanted to hear everyone's experience with basal testing. I know this is a necessary step in determining appropriate settings but need some advice on what works best. How often do you all perform basal testing? Do you do it in a 24 hour sweep or the 6-8 hour/individual meal method? What are the general rules you've found helpful for completing a successful basal test (i.e. no caffeine, low fat meal before testing, etc.)? If you go low during the test do you treat and start a new test after 4 hours or start again the next day? Sorry for all the questions!
In 12 years I've never performed a successful basal test. I recently (with the help of a CDE) changed my pump settings to the same .75 setting for 24 hours and really need to determine if this works/what needs to be changed. Any tips/advice you can offer would be greatly appreciated!
Honestly, I used to do it, but was never sure what it shows. Good reading at noon, no lunch. test every hour, all looks good. Then the weather changes, I get stressed, etc. and all is haywire. I tend to use ARs method anymore. Sometimes I will eatt and then check hourly to see what is happening.
I tend to 'fast' for 4-6 hours in different time blocks to see if my basal settings are correct. But more often, if I have a time period that I suspect is off, then I will set a temp basal 2 or 3 days in a row, to see if it helps. For example, several months ago, I found myself going low between 4-5pm many days, and ended up lowering by basal at 3pm, which has helped.
I have a MM pump, which has a 'standard' basal pattern, and then optionally an A and B pattern. When I'm tweaking my basals, I would leave the standard, and then set up the A pattern similar, with the adjustments I think were needed. Then I would keep it on Pattern A for a few days to see how it worked. Always make small increments, and wait a few days to decide if it needs more tweaking.
For illness/stress days, I would use my Pattern B with rates slightly higher than my standard, about 10-15%.
Most folks end up with different rates throughout the day, particularly an increase in the early AM to deal with DP. If you think you need more insulin at 7am, you would increase the basal at 5am. There was a discussion here a while ago, where folks reported how many different rates/time blocks they had, and it seemed like 3-5 was average.
The book Pumping Insulin (John Walsh), and also Gary Scheiner's website http://www.integrateddiabetes.com/
also have many good worksheets/suggestions on testing/adjusting basals.
Read "Pumping Insulin" by John Walsh. There are very specific directions for testing basals in his book. I used his methonds for setting mine when I first got my pump.
I use a skip a meal strategy & basal test over several days & not necessarily consecutive days, depending on what's going on. Fasting for different meals gives yields a broader picture, I think. Also helps with your question of treating lows or highs. For the timeframe I'm testing, no caffeine or exercise. Yea, it's a pain!
I don't have a pump, so can't do basal fine tuning with different settings. But, it's helped with doses & timing of two basal injections.
I did my first basal test 6 months ago, and it was extremely helpful. I tested every hour for 2 days. I didn't exercise. At night, I set alarms and woke up every 3 hours to test. I ate mostly lettuce and cheese, which didn't effect my BG much, and small amounts of things I knew I could bolus accurately for. If I got low, I would correct with a single glucose tablet, and keep testing. I made small adjustments, until my BG stopped changing. I was able to establish a very accurate carb ratio and sensitivity level from this as well.
I take .875u/hr during the day and .775u/hr to sleep at night
