I have 5 basal segments 12a-4a.075 4a-9a .175 9a-4p.075 4p-8p .125 8p-12a .05 . Is it bad to have more than 4. My endo thinks I shouldn’t have more than 4. Your opinions?
I have six, that I’ve worked out in coordination with my endo. There’s no rule about how many you “should” have. The only rule is what works. What problem is the endo trying to fix?
My opinion is that your endo is being ridiculous because he/she is not treating you as an individual, but trying to clump you into some arbitrarily defined diabetes standard.
You can tell your endo that a non-diabetic pancreas releases a variable amount of insulin every few minutes, so a non-diabetic has over a hundred basal rates.
Do what works best for you. If you can easily manage many basal rates and it is not confusing or difficult for you, and it works better - do it.
BTW, I have 10 rates right now.
I have five: 12-3 - 1.15 3-6 - 1.45 6-12 - 1.6 12-17 - 0.7 17-0 - 1.1
Tell him to shove it
I have 5 segments too and there’s nothing wrong with that. There is no hard limit to the number of basal rates other than what your pump allows. Your endo is not completely wrong though. People should be cautious with adding basal rates, although it may be tempting. More basal rates means more parameters, which makes the system more complicated and increases the likelihood of errors occurring. At some point you’re overfitting the data. 20 basal rates probably aren’t good for anyone. Our bodies aren’t clockworks like that. Keep in mind that the action profile of insulin doesn’t match the programmed basal profile. Insulin has its peak action after 1-2 hours, so the action profile is much more smoothed out than the basal rates. Tiny differences in basal rate for just 30 minutes or an hour are unlikely to make a significant difference in BG levels.
When I change my rates I do go small amounts and then watch it to see what it does. I pay attention to the total amount of basal when I change it. If it is too big of a difference I reduce it . Dexcom is really handy at seeing how fast I drop.
He might be a little old school. My diabetes educator works in the same clinic as he does and when I see her I tell her most of things that he says. She has told me that anymore there really isn’t any rule of thumb. If your numbers are good then what is there to fix?
Do you have a tslim pump? My medtronic can only change basal rates on the quarter: .025, .050, .075, .100…
I have 10 rates right now. I just did a fasting basal and it kept me nice and flat line all day until late evening where I had to make a small less insulin adjustment. 7 of mine are between 12 am- 12 pm to compensate for normal at night then DP then normal then FOTF lol…all without eating in the am. But it works!
I would love to do an all day fasting but I am only 87 lbs, maybe ninety on a full stomach. I have a small body frame and I am 5ft tall. Going all day without food probably isn’t the best thing for me.
Ahh, sure. I’m Omnipod.
You can certainly eat 1 meal a day and fast 23+ hours every day without affecting your weight. Just need to adjust your diet accordingly.
I have 13! haha. it seems excessive but my BG stays completely flat overnight and without a few different ones it wouldn’t. (they only change by .1-.2 at a time) I feel like the more basal rates you have the more precise you can be. The only time my endo has me delete any is if I have more than one in a row thats the same.
You need as many as you need to keep your sugar stable. Although small, .05 can make a big enough difference to stop a drift up or down. We are currently using 8.
Welcome to TUD @Hillary2!
Last month I had 12, this month I’m trying 10, and like @ashleyx1356 I’ll use as many as I damn well need to keep things relatively flat, and dampen my dawn phenomenon and unrelated Feet to Floor Phenomenon
I’m not sure I could maintain that kind of basal control with injections of Lantus
I have 9. Most of them are between midnight and breakfast, to address my strong dawn phenomenon. I too set my daytime basal during fasting, skipping one meal at a time, with several days gap in between. I also have two profiles, each with 9 basal rates. One for when my CGM is functional, and one a little more relaxed for when my CGM is not behaving. I have no idea why an Endo wouldn’t think you should have as many rates as needed to have a flat line on you BG graph. Apparently, he thinks variability is good??
We generally know what works best for our body more than our docs when it comes to t1d.
Because you may not actually need that many basal rates to maintain a flat line. Though this seems counterintuitive to many, more basal rates doesn’t necessarily mean more precision. Of course it could be that you need that many basal rates, but I do think some people overestimate the number of basal rates they need. Here’s Stephen Ponder’s (T1D and endo, author of ‘Sugar Surfing’) perspective on this: The Basal Rate Parallax