My Battle with Basals: Day 3 - How NOT to do a Basal Test!

After failing to do my 4pm-midnight basal test the previous day due to all the craziness that ensued (and my high sugar reading at the start of the test) I decided to go all the way and fast for almost 24 hours to get my 8am-midnight readings in one shot. I was determined!

The night before, having no need to fast I made sure to stuff my face in preparation for the day-long fasting torture the next day. I even set my alarm for 3am in case my sugar needed adjustment, as I needed it to be good for the start of my test at 8am. When the alarm went off the common sense I usually rely on seem to abandon me at this witching hour, and I decided that in addition to correcting my sugar (it was too high), it was a good idea to eat some more food, since I wasn't planning on eating again until midnight (that's 21 hours!) and figured I still had time for my sugar to get back to normal by 8am. I made sure to take some extra insulin (hoping it wouldn't be too much) to meet that goal. I woke up at 7am with a blood sugar reading of 150. Now if you've read my previous posts you would know that this reading would only go up due to the Dawn Phenomenon I experience, if I was not going to bolus. And of course I couldn't do that. I decided the reading wasn't too terrible so I would indeed proceed with the test come 8am, providing my sugar at that time didn't rise too much.

Crossing my fingers I checked my sugar an hour later - it was 189. A bit too high but I wanted to do this basal test more than anything at this point so I took my log and entered the number for my starting time of 8am, then prayed I would be able to get through it without any major spikes.

Well, The Man Upstairs must have been busy that morning because my prayers were not answered. After dropping off my laundry and picking up some medications at a pharmacy I walked my usual mile to work and got there at 9am. I promptly checked my sugar, continuing my basal test. It now read 214. "Ok" - I thought - "not good but not too terrible. I can work with that".

So I continued to "work with it" while I did my job. It was a much less crazy day, with fewer urgent issues, no family member's appointments, no box chasing, tube changing or broken insulin bottles. That's a pretty good day for me. But at 10am when I checked my sugar again and found it was 272 I was infuriated! I considered stopping the test as I could foresee the next 14 hours to be utter torture, not to mention definitely not good for my health, but I convinced myself to give it more time and hope my sugar would go down on its own (which wouldn't be good either as that would indicate major basal rate adjustments were needed). What also kept me going was the fact that having my sugar so high didn't make me feel hungry, (plus I was still stuffed from the 3am feeding frenzy!), so I figured - why not give it a try.

Hunger crept in around 11am as everyone gathered for lunch. I normally don't eat the Indian food that's delivered to my department (a bit too spicy and oily for me) but today - it smelled good! I checked my sugar - it was 261. Not good! Not good at all! Still, I didn't stop the test.

This would be a good spot for a disclaimer: DO NOT DO WHAT I DID! DO AS I SAY - NOT AS I DO! (And what I say, at least in my book, is: stop the test when your sugar is too far out of range! After all, having your sugar be high all day does permanent damage to your organs. That's p-e-r-m-a-n-e-n-t! It means forever! But did I listen to myself? No! I hope you all are a lot smarter than me!)

By noon I didn't expect much of a change. My sugar dropped down to 245. I was happy to see it lower but it wasn't low enough. At this point I was drinking water and peeing like crazy. I felt a bit sick to my stomach, and although I couldn't taste the toxic ketones yet on the back of my tongue (or smell them on my breath) I was feeling sluggish and heavy, but at the same time lightheaded. I was pretty much feeling like crap. As I was still doing ok hunger-wise, however, I decided to continue my test.

At 1pm my sugar dropped a whopping 2mg to 243. Normally having little change from hour to hour in your sugar when checking your basals is a good thing. It means your basal insulin is keeping your blood sugar steady. But in this case I was hoping to see a lower number so I could feel better. Still, I continued with the test.

By 2pm my sugar dropped a bit more. It was now at 229. Still a long way off from feeling comfortable (at least 100mg off!) I was now used to the weird floaty feeling so I continued to "work through it" telling myself I will definitely stop the test if my sugar rises at any point. Or if I get so hungry I consider going postal.

My meter showed a reading of 214 when I checked again at 3pm. At least it was dropping. I may actually get away with this! If only I wasn't so hungry now! I read somewhere that hunger clears your head, makes you more alert, more enlightened ( though alertness and enlightenment may not exactly go hand in hand). I was wondering at what point in the fast does that take place? I'm guessing not at the 12 hour mark. I certainly was not feeling alert, and the only enlightening thought was: "I really shouldn't have eaten at 3am, nor continued the test once it reached heights of over 200!"

Food was now consuming my thoughts: "It's been 12 hours since I last ate. That includes 8 hours of being awake and not eating. I know I'll be fine. People don't die from fasting for 12 hours.... (Do they?) I can't even take Advil for the headache that's been plaguing me for the last hour or so. If I take it without food my stomach will get upset...and so will I! I very much doubt I'll be able to pull this off for another 9 hours. But I'll hold on for as long as I can. Is that oatmeal I smell? People can be so cruel here!"

I checked my sugar at 4pm while walking home from work. It was 223. Not a significant change but enough to keep me feeling uncomfortable. Oddly enough the hunger now mostly went away. So again, I chose to continue.

By 5pm there wasn't much change. My sugar was now 227. I just got home and was putting away laundry, sending my boyfriend to the kitchen to eat - just in case I couldn't deal with the smell or sight of food. He was more than happy to oblige with his burgers and iphone in tow to keep him full and entertained.

At 6pm, as we were comfortably lounging and watching tv, my sugar crept up to 256. At that point I decided to give it just one more hour and finish the test another day. It wasn't the hunger as much as it was exhaustion from having a blood sugar reading of over 200 for nearly 10 hours now that finally made me realize it was time to stop. It wasn't worth any more aggravation. My boyfriend kindly offered to make me scrambled eggs with bacon and I took him up on it - you bet! He started cooking a little before 7 and I hovered over him excitedly like that dog in the Beggin' Strips bacon bits commercial "IT'S BACOOOOOON!!"

At 7pm my sugar was 229 and I was DONE! I bolused (it felt sooooo goooooooood!!) and dove into the scrambled eggs (and BACOOOOON!!) plus some carbs on the side I won't mention that are definitely not good for me, and I was in heaven!

My 8am -7pm sugar readings showed me the following:

- they ranged from 189 at the start of the test (8am) to 272 just two hours later at 10am.

- the biggest rise was between 9-10am when my sugar crept up by 58mg! It then took five hours (from 10am to 3pm) for it to drop by the same amount. It then gradually rose again from 3-6pm (by a whopping 42mg) and came down by 27mg an hour later.

- oddly enough when comparing this test to one I did a while back (and which I published in my book) I discovered that on both occasions my sugar went up by exactly 58mg between 9am and 10am. And in both cases the sugar dropped again gradually by 3pm by the same amount (a difference of 1mg. In the previous test it dropped by 59mg). It's strange because I adjusted my basal rates to counteract this problem before, yet here I am two years later having the same issue. At least my body seems to be consistent, despite my insulin adjustments. I am determined to win this battle, however, and ultimately - the war!

So I managed to do a fasting test from 8am to 7pm. That was quite an accomplishment for me, though technically I shouldn't have continued it when my sugar was over 200. It really wasn't a smart thing to do. And I still have to check my basals from 7pm - midnight, which means fasting from 3 or 4pm (which at this point seems like a walk in the park!). Once that's done I can start tweaking my basal rates, then checking my bolus ratios as well. This should give me a good idea of what my current insulin needs are. Now whether or not my body will comply is yet to be seen. Stay tuned as My Battle with Basals continues...

Thanks for sharing your details. What a frustrating experience !
One explanation of your drop from 272 (over several hours) to low 200's could be the loss of glucose through your urine, not from your basal insulin. This is one reason why testing basals when your BG is high is not recommended.
I would suggest focusing on your morning basal rate. I suspect you may need more basal in the morning, as many of us do. Or the stress of anticipating a 20 hr fast could also cause the rise in BG.
I tend to test basal in 6-8 hour blocks, and do this 2-3 days in a row to find a pattern, rather than making changes based on 1 test. I pick one meal to skip, and test basal for that time period (start = once the bolus insulin/food is 'done' from the prior meal -> up to the time of the next meal).

Thanks for your comment. I completely agree with you as to losing the glucose through the urine, and not doing the test when your BG is high, which is why I warned against doing what I did ;) I wanted to be fair and honest and share my true experience (even if I did what I shouldn't have) so I blogged about it. I usually do exatly what you do - fast over several days and skip one meal at a time. That's what I've always done. I was just getting frustrated lately when things would get in the way of my basal tests so I decided to do as much as I could in one shot. I'm not changing anything until I finish the test. Will blog about that tomorrow :)

I'm curious why you attempted a 24 basal test in the first place ? Obviously you learned it was 'what not to do'. If things would 'get in the way' of 6-8 hour tests, why would a 24 hour test be any easier ?

Good luck !

Oh no I just wanted to get it done faster as things kept getting in the way of me doing the basal tests - that’s all.

I mean things were getting in the way of me starting the test so once I did I just wanted to continue. I do make sure to say that it’s not the best thing to do and I illustrated that :slight_smile: I don’t advise that in my book either. It’s a case of “do as I say, not as I do” :slight_smile: