I’m clearly transitioning…again. (Wah!)
Anybody out there have tips for someone who reeeeeally doesn’t want to do this again???
I’ll just throw out what has worked for me, Laura; though it is more a “copout” on basal testing, than actual basal testing. I think it works as well, but just takes longer? I started insulin in my pump on 1/8 and the Animas staff just suggested one basal rate that was 20% less than my MDI basal dose. I did that for a week or so and had both highs and lows and at that point I began to see patterns of “time zones” where it was too much basal and “time zones” where it was too little. I started inching away at those areas with .025 changes, and it took me awhile to figure out the start and end times and then tweak the numbers to minimize lows and highs. But it was really amazing to me how well it worked! I ended up with 6 time zones and had made 8 changes (I know because they were footnoted A-H). It is now perfect! The only out of range numbers I experience are ones obviously connected to bolus issues and now that my basal is stable (at least for awhile!) I feel it’s easier to hack away at the bolus issues.So it took me a month and 3 weeks but the system worked very well for me. Took longer to get there and I can’t compare the efficacy of methods because this is the only way I do it.
I generally don’t bother doing formal “basal testing”, if I get a number that’s off a few days in a row, I’ll try to measure carbs carefully and, if thatdoesn’t work, I’ll turn my pump up .05 in .05U/ hour increments. I recently adjusted it from .95/1.0U/ hr increments, tried .90, it was ok, tried .85, saw some higher numbers for a few days so I went back to .90 and it seems hunky dory. I have a few things to work out, lows in the AM and some DP that I hit with adjustments but I don’t bother fasting or anything like that.
I don’t know that basal testing is really effective for us. The times we’ve tried it without eating, my daughter’s blood sugar has increased anyway (liver dump? stress from hunger? Lower activity due to hunger?). She is also impacted by fat, so eating a lot of cheese or something similar would still cause spikes for her in spite of being low carb. It’s really hard to get kids put kids through it and for us it wasn’t worth it.
I know it works for some people though. Instead of doing the traditional basal testing I analyze the cgms reports and make changes to basal based on that instead.
Sounds like you both, acidrock and midwestmommy also do more informal tweaking rather than formal basal testing. I think though that what you said, midwest about your daughter’s blood sugar increasing anyway is kind of the point of basal testing, that it’s supposed to stay level without eating when it’s correctly set and if the blood sugar goes up that means the basals (at least for that time period) are too low.I can definitely see why you wouldn’t want to put a kid through the fasting thing.
I’ll be interested to hear if someone who has done both formal testing and the less formal “pattern recognition tweaking” says if they find one or the other method more effective.
Zoe, I didn’t word that very well. Her blood sugar would go up during the basal testing (way beyond the highs that made us seek out basal testing in the first place). But when I increased the inulin rates on her pump she had too many lows – it was clear that the patterns we saw during basal testing were not typical and couldn’t be relied on. I theorize that it could be due to stress from hunger, lower activity due to hunger, etc. The test is great in theory, but for us not so great to actually use to adjust insulin.
Oh, yes midwestmommy, I did misinterpret what you said and sorry if my response was telling you something you obviously already know. (It’s the teacher in me…lol). Yes, that would certainly make the basal testing pretty useless AND difficult for a child, so why bother! I have always sort of felt I was supposed to do it, but besides seeming like a pain, something about it always sounded a bit too formulaic. I love books like Using Insulin but more for the general principals and information. The formulas always seem too “one size fits all” to me.
Basal testing the ‘formal’ way works for me – I guess I’m just loathe to do it. The girls pretty much knock the starch out of me during the day…but they sleep reeeeeeally well. they’re down for a solid 10 hours. That means I sleep a good 8 hours a night, which means I can function the next day. Given that nailing down the overnight comes first, sets you up for tweaking the rest of the day’s rates, it means waking up several times at night (and for me for more than one night), which is so disruptive to sleep it’s just like not sleeping at all. And some people do okay, but I don’t function well at all without sleep. I really (really really really really) need it to get through the day…
I guess there’s probably no great secret anybody in cyber-diabetes-land can offer me.
I just have to suck it up and do it. ???
The only other great secret is a CGM. I just realized that’s why I go “oh, look, a hump that wasn’t there yesterday, I’d better fix it…” and just try a different number? I probably didn’t notice that stuff as much before I had the CGM. I am a total slacker about keeping records. I think that I likely just took longer to make a decision about changing something? Like weeks or months of correcting off numbers instead of a 3-5 days that I do these days.
Yes! CGM is awesome. Would you believe my insurance company won’t cover my sensors anymore? I know I should fight them on this…but I don’t know if I have it in me.
I appreciate all your responses! In retrospect I think I was just feeling a little frustrated and whiny and vented it here.
Sigh. (Still whiny today.)