Changing basal rate

I was doing a supper basal test. My 4 pm blood sugar fell more than 1.7mmol. I moved my 3pm basal .075to 4pm .075 even though my drop was at 4pm. If I were to change it at 2pm my basal rate would be choppy. What do others think?

Depending on what insulin you use, you want to make the change anywhere from 30 minutes to 2 hours before the low.

That should work. What I have on mine is 10 different settings. So depending when my drop started I might put in a slightly lower number at 2:00 or 2:30 and then more of a drop at 3:00.

I just did a 24 hour fasting basal test yesterday. I had only a slightly too high setting in the late evening. That was better than I expected!

Doing a true fasting period is nice to truly gauge how well your basals truly work for you.
On the other hand, looking at an hourly for the past two weeks is usually my go to tool for seeing when I need to change my basals.
Now that I am on Control-IQ, I haven’t really messed with it. Mainly because I was initially messing with the settings, but now because I really don’t need to as much.
But, having spent the time initially to fine tune my basals was a big change for me and getting myself under better control and to stop, or at least slow down the roller coaster I was previously on.

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I look at my dexcom clarity and do about 4 days. I tap on statistics and hourly. I make a change if the hour is more than 60% high. I still have 8 more months to go before I am eligible for a new pump. I am sooo anxious!!!

My endo doesn’t like it when I have more than four different basals. My basal rate is 12am-5am .075 5am-9am.175 9am -400pm .075 4-10pm.125
10pm-12am 0.50. Gary Schreiner says to make changes on the hour and that there will always be one peak and one valley. If there are too many of these the basal rate is probably not set correctly.

I am doing well on my own so I don’t think my endo would try to comment and it’s doubtful I would listen.

I have done a bunch of changing over the last few months, so I was curious when I had flipped back to my low DP setting one how accurate it would be.

But here’s the 24 hours graph, so my 10 settings is working well! The gray area is a 80-130 range. I never went over 107 and never below 80.


PS 7 of those settings are before 12 pm to combat a small increase in DP and a FOTF increase.


I am down to 4 different rates. I have an issue with high BP before bed until about 3-4 am. My FOTF actually DROPS my BG.
But I will say Control-IQ is responsible for this.
Before Basal-IQ I was 6 or 7 different time/rates.

@Marie20 I WISH I was doing that well. I found my OLD prescription list that I used to carry with me in my purse from Jan 2019 tonight - in said old purse. I ended up losing my insurance coverage in like April of 2019 and because I wasn’t aware of any help to keep my pump and insulin supplies going I came off of ALL of my medications. I JUST started taking insulin in April and put back on my Medtronic 630G in May with a Dexcom G6. After remembering why I HATED my pump (being tethered), I got in touch with OmniPod and my Dr. prescribed it for me. We were still titrating my dosages when she made the current Rx out for 150u daily in pump. I am finding that I’m going through 200u every 24 hours with boluses and everything. The original prescription is for me to change pods every two days. I think we’re going to have to change it to changing my pods every day (not a big deal to me - I’d rather do that than be back on Medtronic). I THINK if we can get my basal right (to where I don’t have to bolus for anything but meals) then maybe I’ll be sitting where you are. We just increased me to 4.4u/hr today…but in Jan 2019 I was doing MDIs and taking 90U twice a day of Lantus and 15u of Humalog at every meal. Due to not being on the G6 or any CGM for that matter I have no idea how my graph would look but I don’t remember ever having a low.

@EGreen76 I ended up on less than half my insulin dose on a pump because I ended up getting insulin when I actually needed it. I notoriously would also give a bigger dose to cover a snack and meal and then have to eat to what insulin I had taken. The 15 units of Humalog at every meal sounds like you might be doing the same thing.

A pump also makes it easier with a CGM to give those smaller correction doses.

But I would suggest considering the Humalog U 200. You would at least just have to change the pod every 2 days. Plus not so much volume of insulin at one time which will help your absorption better. I hesitate to recommend the Humalog U 500 as I’ve heard it doesn’t work as well. Much slower acting. But the Humalog U 200 some have said it is even better at absorption. I like it.

If I remember correctly you are going through your pcp to get your supplies and they might be a little more hesitant to prescribe something that hasn’t been “approved” for use. But my last endo used to recommend it to people all the time. The programming is just trickier at first, but easier once you’ve gotten used to it.

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@Marie20 Yes I am going through my PCP for Rx at this time. I see my new Endo on July 7th. The reason we did it this way was because the Omnipod rep was familiar with my Endo and she very rarely referred anyone for Omnipod. She’s a big fan of Medtronic - and I refused to stay tethered any longer than I had to. Humalog is not on the “formulary” for my current insurance. That being said I’m not sure my PCP would do U 200 in the pump. I could ask, however my trainer is not allowed to discuss anything that is “off label” in terms of helping me with programming, etc. And with my PCP not being familiar with pumps that may not be an option currently.

Yea, it is a little trickier at the beginning. A good call to get it before you saw the endo too. :wink: