I see my endocrinologist in a month and I have been trying to adjust the night basal but I see no pattern happening. I go up during certain times and then other times I stay flat. Does anyone else have this problem? I would like to do a breakfast basal test but I am unable because I bolus for the correction. I need to get that self adjusting pump soon. It is very frustrating.
Yes, it’s different almost every night for me unless I am eating low carb. I’m not sure there is a true basal pattern you can just find for yourself, and if there was looping wouldn’t be a thing. I do notice what I eat generally and for dinner or before bed can greatly affect my overnight insulin needs though. It’s not just a matter of an extended bolus or some insulin a few hours after dinner. If I’ve eaten red meat, dessert or a big meal of any kind really unless 0 carb, I need way more insulin overnight.
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I generally see no pattern at all if my basals are off. I think your starting with enough time to collect data and do adjustments before your appointment…to at least get them as well adjusted as you can since the data is a little tricky. I also always start with the overnights.
If your seeing flatlines overnight, then I would call that a pattern. I would say that you are in the ballpark. How many nights a week can you achieve flatline overnight. When it rises, how many points does it rise overnight?
I can’t remember, are you currently a pumper or MI?
Yes, I am on the medtronic 630g. I use a dexcom g5. I am on the last sensor of the g5 as my transmitter battery will expire in a few days. This sensor is causing me more hardship. For example, my glucometer will say I am 6.3mmol and this sensor will say 4.8mmol. Now I normally will correct if I am 4.8. I was at 8.0 at 2am and then I went up to 9.4 at 3am. My night basal is 12am to 5am .050. I am going to try. 075 tonight. October 28th was the last time I flatlined. I usually rise between 3 or 4 mmol. It’s usually between 2and 4am.
D’Etta Meloche
How high do you allow yourself to go at night before correcting. I have my dexcom at 9.5 at night. I don’t like to stay high for too long.
I know pumping insulin says you can go up to 14.0mmmol but isn’t that excessive?
I eat a fairly consistent supper a little bit of protein consists of pork chop or chicken breast a potato and vegetables, broccoli or green beans. Low fat no added sugar yogurt. I do a dual bolus because ever since I have been on a pump my sugar will rise between 8 and 9pm. I can hardly wait for the closed loop pump. Then I won’t have to deal with this. This is the only thing I dislike about being on the pump.
@Dee_Meloche I have 6 different settings between 12-8 am. Why not try raising the night basal only between 1:30-3:30 am? or between 2-3 am?
My doctor gets mad when I have too many basal rates. So how many should a person have? I kinda took your advice and raised it between 12and 3 am to.075. It was 12am-5am .050. That should take care of 2 and 3am.
@Dee_Meloche 12 might be too early? It will start about an hour before you want the extra boost. So I guess it depends on when you start to go up. But if it’s 2 am, then 12 might be a little on the early side…
For me, it’s whatever works. The proof is in the results? Most of my changes are to cope with night. As much insulin as I can to control any spike without dropping too low. I adjust my time slots as needed if I’ve noticed a 2 week pattern. Or of course right away if it’s causing a low.
Hopefully my dexcom is more accurate through the night. I changed this sensor on Thursday and it has only been accurate a few times. Like when I went up to 14.9 it only read 11.0. IMHO that is way off being accurate. I find the g5 doesn’t catch alot of the spikes. This evening I tested on my meter which said 5.7. Dexcom kept going lower to 4.8. On Monday I will get the g6. I heard it is more reliable.
I was one of those patients that had way too many rates in a 24 hour span! And after reading John Walsh’s Pumping Insulin book, I had to finally realize less was better.
The reality is a rate change needs to happen about 2 hours before we need to change, so if you have too many, they start to overlap and it gets harder and harder to figure which one you need to change. I was told most people can do very well with 2 or 3 different rates. But keep in mind everyone is very different and if you find 5 works, go for it.
I did find my many rates were just to much. I now have a daytime rate and an overnight rate and it works well.
The no pattern issue drives me crazy also. You should never make changes based on one day. You are suppose to try for at least 3 days to see if there is a pattern. I would have the same pattern for 2 days and than the last day, something completely different. So frustrating!
But if your CGM line is holding relatively flat, the basal is correct. Even if it is running higher than you’d like, if it’s flat, it’s good. If it’s higher, that is usually a carb ration rate that might need to be adjusted early in the day.
And the hard thing for many of us, is these numbers never stay the same. I am always amazed when I meet people who haven’t changed their basal rates in years! I feel like it is a constant thing.
Just remember there is no set number a basal rates. We are all very different. But I have realized that less makes my life a lot easier. Good luck!
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I have six basal rates right now but after I basal test I might be able to get it down to 5. I guess 5 basal rates aren’t so bad!
No such thing as good or bad with diabetes! Just what works best for you!
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From pumping insulin book, you should be able to skip any meal and maintain proper bg level. They recommend skipping a meal periodically to validate this. Vary which meal is skipped to check basal for entire day. Also, I’ve found that I need to eat approximately the same number if carbs every day. If I eat more carbs than normal, it takes about 36 hours to get basal balance back on track.
As my voice to those recommending Pumping Insulin by John Walsh. A couple of other things to think about… 1) For the meal before the one you skip, avoid foods that have a long tail, that can keep your bGs high for many hours. Pizza is so notorious for this, it gets the title rights, pizza effect. Mexican food does it for me too.
And 2) if you’ve had a hypo in the previous 24 hours, don’t adjust your basal. Counter-regulatory hormones can keep the bG elevated for a long time and with great variation from one hypo to another. I actually wait 48 hours.
And YMMV. As I like to say, there are almost as may types of diabetes as there are people with diabetes.
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