How many different basal rates you have and use in your pump?


#1

How many different basal rates you have and use in your pump?

  • 1
  • 2
  • 3 or more

0 voters

Why and when you switch from on to another?


#2

It all depends on the basal program we are using. Usually is 2, but some days up to 3.

Basal programs we do have 3, one for the week, one for the weekends and one for growth spurts.


#3

I have four programmed. Early a.m. one is to compensate for Dawn Phenom, then a mid-morning one for when that effect wears off, then a late-afternoon/early-evening one because I apparently still produce a bit of endogenous insulin and that seems to be when it pretty reliably decides to kick in, then another for bedtime to avoid overnight lows.

BTW, it should be noted that this poll won’t apply to people using automode on a Medtronic 670G, because with microbolusing there are no set basal rates as such.


#4

Most of my pump life I have had more than 3, but I will also mention that now basal rates are a thing of the past for me (or at least they are no longer something I focus on or attempt to tweak) because I use a closed loop system (in my case, the 670G & Guardian 3 with Auto Mode). I think that in less than 10 years this will be true for most pump & sensor users as well. This is not to say that basal rates are not important, because they are used when there is a problem with the CGM or for people that do not use CGM. And like I said, it will probably be a little while before everyone uses a closed loop system anyway.


#5

That could be a great next poll; What insulin pump you use?


#6

I’m a little unclear on what this question means. I answered 3 or more because I have 5 programmed basal patterns. My hormones shift around, so I go from Basal 1 (TDD about 11 units) to Basal 5 (TDD about 16 units). Within each of those basal patterns, there used to be several different levels of basal insulin (changing up or down five times: 4am, 10:30am, 3pm, 6pm, and 11pm), but that changes every few months (perimenopause is a major pain), and right now my basal pattern only changes twice: 12 midnight and 10:30am.


#7

I have 7 different basal rates. My endo is amazed it works for me. My last A1C was 5.7


#8

I need about 10 profiles. So I use all 6 on the pump and then cover the high and low end with long term temp basals like 120% etc.

I don’t just adjust basals either. If my basals go high my bolus doses have to go up in proportion so I have insulin and carb factors set for each basal. Lucky for me the extremes tend to be at night so these don’t matter when on a Temp Basal.

As to when I change I use my cgm. For mornings it is simple. I have each setting about 10% from the next. If my fasting glucose on waking is 75 I’ll drop about 2 levels on the pump to try to get it to my 95 set point. (ie experimentally I found a 10% change adjusted my fasting glucose about 10 pts.)

If I get fast changes in the daytime I can often not tell what my fasting level is due to meals but if it looks like I need more insulin for a meal than I took and I am eating a meal I know carbs fairly accurately for, I can use that as a sign to bump the profile up a notch.

I used to be very stable for weeks at a time but now I can change from max to min doses in a 24 hour period which is one reason why I had to go to a pump instead of MDI.

A lot of my adjustments are at night and I keep my CGMS alarms set to 70 and 120 to wake me up for an adjustment. I found it much easier to stay on top of things than to let it get bad and then try to correct.

I just started using the tslim X2 with IQ so I now mostly have to worry about the high glucose alarms only.


#9

I’m curious why you attend to one-time food-related highs with the basal rather than a correction bolus or carb ratio. Or am I misunderstanding?


#10

I do a bolus correction first. However when I change the profile my
basal and my carb factor change too. This gets me more ready for the
next meal and closer to the current basal needs.

This is how I can tell my insulin needs have changed during times I am
not at a fasting level to just read the glucose.
I often have to adjust rates and carb factors during the day and not
just in the mornings.

Typically I need more insulin for bolus and for basal in the evenings vs
mornings. Often they are 20% different. I have 4 built in basal
shifts during the day but this sets a min variation. I often need
more changes but can’t pre-program because it varies from day to day.