Hi all. Just wondering whether anyone has figured out a good method for determining what your overnight basal rates should be. My Dexcom is showing that my overnight sugars are too high so my endo increased my basal but now the past 2 nights I’ve had issues with my sugar going low. Do you all have one rate all night or different rates per hour when sleeping?
I use a somewhat unconventional approach. I set up a combo bolus at bedtime for 7 hrs., using my bG at bedtime and the amount of fat that I've had with dinner to set the units and ratio. It's been trial and error but I've gotten pretty good at figuring out how many units to take, and whether to load the front end or the back end of the boluses.
I’m impressed with that combo approach! I have a couple of different rates to get me through the night, used to have 3 at one time. I did the hard slog of waking myself up hourly to test BGs & work out when my basal rate should be higher or lower than initial setting. Made adjustments by small amounts up or down then more semi-sleepless nights of testing to confirm all ok or further tweak a little. Some people have several different hourly rates during the night (and day), you may very well need more than one yourself. Ought to be easier with cgms to see when you have higher or lower basal rate needs. Good luck!
Hey Melissa,
I have a basal rate check sheet that show you how to check your basal rates. I will scan it and upload it tomorrow so you can have it. Do you want me email it to you are is there a way I can send it through here?
That would be great. Ill friend request you and then if you can’t send through the site I can give you my email. Thanks
Hi,
I find that I need three different rates, 12-2, 2-4, and 4-7:30, but that’s just me. I use the Dexcom data to make slight adjustments up or down to fine tune my basal. I also find that once I find the right pattern, it might work for 6 months and then for some reason it gets thrown off and I have to recalibrate. I would suggest slight modifications, so you don’t over correct. Live with each modification for a couple of days before modifying again. Also, I try to not eat anything the last hour or two before bed, especially something that may take a long time to digest, e.g., dark chocolate.
Hope this helps
I'd like a copy of that basal rate sheet! ;-)
So I have been tracking with my Dexcom and my sugar seems to spike at 12am. Any suggestions on what to do with my basal rate? Should I bump it up starting at like 9pm or just start increasing the 12am rate?
When we started the pump with our 7 YO, we were directed to Smart Pumping. It's a good basic resource and has information on doing basal checks.
He's now 9 YO, and he periodically goes through growth spurts and our prior overnight basal program no longer seems to keep his bg's in check. If we think he needs an adjustment, we'll either make small adustments and watch a couple nights in a row to see if it's working, OR we'll try a more crude approach of applying a Temp Basal for a specific period of time just to get an idea of that's working (I like that approach in case I forget to change the basal program back if it was too much!).
We've been told (and experience has confirmed) to make the basal adjustment a couple hours before you notice the BG increase, since it'll take that long for the increase to take effect. Not sure if that's different from person to person, but it works for us. Hope that helps.
I like the refined combo approach mentioned. Since we are checking him while he's asleep, we can make adjustments on the fly, but since you are solely responsible for yourself, I think the combo approach makes a lot of sense.
I do overnight basal assessments to determine what my ideal rates should be. Technically, a basal is supposed to keep you stable when you are not eating. My CDE has me eat a small meal at 5pm (about 45g) and then not eat or bolus the whole night until the next morning. This eliminates any 'outside factors' like food or insulin that affect your BGs. We are purely looking at what the basal rates are doing, nothing more. Then I test again at 7pm, 9pm, 12am, 3am and when I wake up (usually around 7am). Your BG should not rise or drop more than 2 mmols during the entire test. If they remain within your target range, the basals are correct. If they either get too high or too low during the assessment, you stop the test for that day, correct the BG, adjust your basal covering two hours before the time of the high/low so it doesn't happen again, and try the assessment again the next night.
I am currently doing one right as we speak to send to my CDE asap. It's a pain in the butt, but worth it.