Question about validity of basal testing

"The manual" would say your basal and bolus should be 50/50, although the Francine Kaufman book that I think I cited somewhere (free copy giveaway prize!) mentions that people using a lower carb approach may end up skewed a bit towards basal, like 55-60/45-40 rather than the 70/30 like yours? I still think there's too much basal. If the tailing off in your BG is at 11:00 PM, which according to the initial scenario is @ dinner time, the only solution would be less basal or more carbs. I can't exclude the possibility that the "Levimir Stack" might go the other way too. The large dose bubble that Dr. Bernstein cites could work that way with the evening Levimir deploying more slowly w/ a 7U shot. If that shot has a 24 hour (maybe even more, sorry I don't have better info...), it again could "stack". Not to mention your ferocious exercise schedule. I also find that when I mix up exercising (say biking, pushups, running instead of just running...) it seems to make the insulin "zippier."

To get higher BG at that time, if everything else is consistent, would mean either less basal (before you eat...) or changing a carb ratio before the low numbers, to make it a shade higher, which may not be possible if the pens only shoot whole units? Sorry I don't recall all the details if I'm "off" but I am pretty disinclined to consider endogenous insulin.

I discount a lot of the "usual suspects" metabolically like homegrown insulin, liver dumps (although perhaps I drink regularly enough to stop those?), insulin resistance, etc. I'm as inclined to blame anomalies on astrology as on any metabolic phenomenon.

The other thing that occurred to me with formal fasting basal testing would be that once you do that, you still have to do the next step of testing the new rate to which you'd adjust it under "normal" conditions. To me, that's another reason why it is less bothersome to just test it under normal conditions and skip the fasting. I know a lot of people like basal testing but theoretically, it doesn't make a lot of sense to me.

In my view, basal testing should establish a normal baseline for your insulin needs during times of fasting. If you have a pump, then you can adjust up or down with a temporary rate to handle exercise. But on MDI, you take a fixed dose and you cannot make these sorts of transient adjustments, let alone predict ahead of time whether or not your exercise will happen. So you should try to establish your basal to match you routine as close as possible, while remaining safe. If you cycle every day, then that is your routine. But if you only cycle some days, then you have difficulty.

The days that you don't cycle, your body will usually need more insulin and there is a delay in these affects since the effect of exercise is felt for up to 48 hours afterwards. So if you exercise Mon-Fri, but take Sat-Sun off, you might be fine Sat, since you are still feeling the benefit of exercise all week, but Sun and Mon, your couch potato weekend results in more insulin needs. And what you may think is a strange high on Mon is actually just the delayed effect.

I don't do formal basal testing. I use key indicators to adjust our basal. My two key indicators are my waking blood sugar and my before meal numbers which generally reflect a fast of at least 5 hours. If I find that I have been correcting before meals for highs, I know I need to increase my basal. I make a change by trying to look at what happens on average over a week. Every days is different, so I never make basal changes just based on a single day.

omg, head is spinning now. ahhh! i wish i had a pump!

If you had a pump, you'd have a lot more motivation to basal test. The fine tuning you can do to your basal rates is amazing but to get the most out of it, you need to know your entire 24 hour basal profile. I'm very active as well but I used my rest days to basal test and broke the 24 hours into blocks of 12 hours over a three day holiday weekend.

If you have a consistent routine, your basal rates are not going to change that much over a one or two day period of complete rest. The transient effect of exercise over even a couple of hours a day, or even just a very active day over a few hours, will show up in a decrease in basal rate, but the remaining hours of relative inactivity really won't change that much. I've seen research showing that the lingering effects of exercise can last up to ten days past the last bout of increased physical activity.

So, even if you exercised over, say, a five day period then decided to take two days off, the basal rate of the time you were not exercising really shouldn't change all that much over the two days of rest versus the 5 days of exercise. You would definitely see less of a need for insulin due to the exercise itself, but that's about it.

Of course, the only way to find out how you personally respond is to basal test then see how exercise affects insulin requirements relative to inactive fasting. As Brian suggested, that's a difficult thing to delineate while on MDI.

At the same time, whether you're pumping or shooting, you'll still have a sort of Goldilocks' choice, more, less or ***just right*** until you find ***just right***. I've always found it sort of easy to skate along pumping extra as it makes my BG run really tight but then I gain 5 lbs and go "hmm, why am I eating all this extra food?" and figure it out and stop.

That's sort of the point of basal testing, to help determine "just right" without having to jump from bed to bed or eat a gazillion bowls of porridge. Of course it's never "just right", really.

As a general rule, I also opt for slightly more basal, then correct with carbs rather than opting for slightly less basal then correcting with insulin boluses. That's more of a choice not to adjust my basal rate than it is not knowing that my basal rate needs to be adjusted though and a decision based on the fact that it's difficult for me to maintain lean mass.

If you've never basal tested while you've been on the pump though acid, it really is worthwhile to go through the experience at least once.

its really interesting to read what you more seasoned people have to say. thank you for all the responses here. i think im just gonna drop a unit in the am and see what happens tomorrow.

i had a unit of novo and 30 carbs at breakfast at 830am and 2 units of levemir at 930am. i ate 7 estra carbs before going on a run/walk for an hour at like 1130. got back and at lunch i was at 68. had low carb lunch and no insulin. cycled to work at like 2pm (about 25 min away). i teach and while im not active, i never sit down while teaching. at 6pm im at 107, eat some fat and about 14 grams carbs. at finish at 10pm i have 2 grams carbs cuz im at 115 and need to cycle 25 min home. how do 14 carbs only get me to 107 from 115? the numbers really point to too much bolus but how can that be? i get home at 87. does this sound like lowering a unit would be good?

im gonna bite the bullet and shave off a unit and see if i dont go high with just a unit of levimir in the day. still 7 at night. it would be so cool if D was just going away....dont worry, i know its not, but its nice to dream!

you think my liver doesnt produce enough glucose?