I am struggling to make a decision and your opinion would be very helpful to me.
I am type 1 and an insulin pump user. The past week I have seen a pattern occurring. My BG before going to bed is usually around 85-100, and during the night I go low… The other day I was 85 before going to bed and I set a temporary basal (as an emergency strategy) from 0,85 to 0,70 units for the next 5 hours and it worked because I woke up with 120.
Now I am confused about which basal should I decrease? Lets say I usually go to bed around 11pm…
Thank You, I appreciate your help!
Fabi
Your body will change and basals will need to be adjusted. It is scary. I had some recent problems similar to yours. I had two posts. Got some fantastic advice. You will need to cut and paste these, as I am not really sure how to add the link correctly.)
I would suggest repeating the temporary basal routine for a week or so to make sure that the change gets you to where you want to be consistently. A one off is just not enough data.
It looks like .70 or .75 might be the winner? I notice w/ a CGM that my bump, where my BG will spike sort of naturally from DP is currently around 3:00 AM so I set the pump up accordingly.
Basal changes give max effect only after insulin max duration: if you change your basal starting at 00 you have max effect from 3:00AM forward so keep this in mind when you correct your profile.
If you get low at 3AM start lowering hours before
It’s due to the sum of all the drops of insulin your pump gives over time: a graphic would be simpler to explain this …
Thank You!! It is hard to find the ideal basal but I will read each information you gave me carefully. I guess I will need to reset all my basal as well… Its alot of work but as you are saying, its worth it
I have a MiniMed Paradigm CGM and like it a lot, although everyone says that the Dexcom is vastly supierior it seems to work ok and some of my interests are not interested in the extra Dexcom gizmo that I’ve understood I would have to lug around if I were to switch.
I mean you should start lowering basal at 00 - 01 am, certainly not at 2 or 3 am.
At 3 am you have the sum of effects of drops of insulin released from that time backwards till the duration of effect insulin has on your body.
So if insulin for you as effects for 4 hours, at 3am you have the tail of basal insulin infused at 11pm plus all the following.
If insulin peaks for you at 2 hours, basal rate infused at 1am is peaking at 3am while insulin released at 2am has not yet hit with max strength, so it’s not responsible for your low at 3am (but keeps you low for the following hours)
This study indicates that it takes 2.5–4 h until a considerable change in basal infusion rate (0.5–1.0 units/h) leads to a new steady-state level in the induced metabolic effect even if a rapid-acting insulin analog is infused.
