I switched to a pump 2 weeks ago and I’m struggling finding the right basals. For the time being I have a single basal rate for the day of 0.95 U/H. For the past few days, I have skipped a few meals (mainly breakfast) to figure out if my basal was set correctly. Here are my results starting around midnight till noon so a 12 hours period :
11:00 pm : 117 mg/dl
1:00 am : 113
4:30 am : 110
6:00 am : 93
7:30 am : 110
8:30 am : 127
10:30 am : 126
12:00 am : 87
How can I make my BG more stable? What I’ve read in the book “Pumping insulin” is that a basal change should happen 4 to 8 hours before the rise/drop occurs. However, on various websites, it is claimed that the change should happen 1 to 2 hours before. Based on your experiences, how much time is it required before one can see the effect of a basal change ? What would you advise me to do to correct my readings?
If not, here are some very general guidelines. Please consult your doctor beforehand. I’m just a T1, not a physician! I have several sheets lying around about it and have combined some info, based on what works for me. You can split the segments up differently. I’ve tested as many as 5. Here are three that are good to start with though.
Testing Segment 1: Overnight (skipping breakfast)
Test at 10pm, 12am, 3am, 8am (or waking), 10am, noon. Then eat lunch.
Testing Segment 2: Midday (skipping lunch)
Test 2 hrs after breakfast, noon, 2pm, 4pm, 6pm. Then eat dinner.
Testing Segment 3: Evening
Test 2 hrs after lunch, 6pm, 8pm, 10pm. Eat a late dinner.
Eat a low-fat meal five hours before the start of the testing segment.
Begin a test only when your BG is in a desired range.
During the approximately ten hour testing segment, you will fast, you will take no boluses, and you will not exercise. The goal is to see what your blood glucose does with nothing but basal on board.
Repeat the test for 2-3 days and compare the results.
If you experience a low during the testing segment, abandon the test and treat the low.
I generally use the 1-2 hour beforehand rule that you mentioned. I’d say you’re actually getting excellent numbers, but I don’t know what your personal target BG is. Don’t think I’ve ever seen that kind of 24 hour stability. Your range is confined to just 40 mg/dl!
I find Pumping Insulin to be a good resource for adjusting basal rates. But I usually adjust basals two hours before the high or low (perhaps my doctor suggested this?).
But you should not change your basals based on one basal test. You should see the pattern in at least two or three tests (I know it’s a pain…and I’m good if I do one!).
Also, I count an increase/decrease only when it increases/decreases by 30 mg/dl.
I think most people will tell you 2 hours. That is what I use and it seems to work pretty well. Your numbers are pretty good overall. Be patient you will get where you want it to be!
You are actually doing a very good job of managing your BGs. It is extremely difficult to have a variability of less than 100 with type 1 diabetes. If these BGs are indeed a pattern, then your basal rate is where it needs to be. If you are going to make basal rate changes based on a pattern, the rate should be changed about 2 hours prior to the time you want it to take affect.
for me, i do the basal change 2 hours before the episode of highs occur. i was in that same situation when i started pumping. it wasnt easy and very frustrating, but when you get your right basals, it will be all worth it… I have been pumping for 4 months now, and still do some fine tuning/tweaking of my basals from time to time. This is one of the challenges being on pump, you strive to find the right basals and when you do, you still do the tweaking every now and then. depending on the stress level, what i am eating and on my days off. i have different settings for my basals…
You’re doin great for a starter, I know you;re much eager to finally set your basals, you can do it. remember, you just started pumping for 2 weeks, dont expect everything to be in place. it will take time. Just watch out for your BGs, especially the lows…
I have several sheets lying around about it and have combined some info, based on what works for me. You can split the segments up differently. I’ve tested as many as 5. Here are three that are good to start with though.