just curious and seeking some helpful hints and answers:
for what reason do you use your pump’s temp basal feature? i know so many people on this site talk about changing their own basal rates throughout the month/ week (or whenever) w/ out speaking w/ their endo, but i am not adept at that. no matter how much research i do i seem incapable of making accurate changes on my own. i may tweak here and there, but nothing near worth writing home about.
originally, i learned about using my temp rate for exercise, then i learned to use it for illness, like the flu, for example, and now i have found that i am using it for those odd ball days/weeks when i just need to bump up my insulin rate w/out going into my “profile” and making any major changes on my own.
do any of you out there do this? and if so, do you find it useful/helpful? my endo says that anything i choose to do when i need more insulin, is to give myself more insulin. makes sense to me, but i wonder
i use temp rates just about every day, as I am active. one rate, used for years, is my “base” rate. activity dictates I reduce the rate for several hours, typically. I don’t often use a higher rate. Instead, I just do correction boluses to bring bgs down as necessary. About the only time I personally use a temp rate above 100% is to try to combat the effects of cortisone which I refuse to take anymore for minor issues, as it keeps me above 200 day and night, for as long as I’m on it. Even with triple amounts of insulin.
just curious: what’s your daily basal rate amount? not including boluses. and then, what is an average day for you insulin unit-wise? my basal rates amounts to 11untis per 24 hours, and my average total units per day are about 20.
i just came off of a period of temp basil’s. I used it to compensate fro taking steroids for three weeks (declining doses. Since my Blood sugar was constantly adjusting I had to adjust it almost every 2 hours or so. Yeah I could have stepped it up but once at such a high rate, I was living with a fear of going overboard.
Yes, I set my own temporary basals, and love that feature. My MM 530 has a temporary rate that I use to reduce my basal by a certain percentage, for a specific time. I use that most often for exercise; for a ten mile bike ride, I’ll set the temporary basal at 60% for 2 hours.
The other temporary they call ‘patterns’. I have my main / normal pattern for my typical activity level, which is not that high because I’m a programmer so I sit down all day. Pattern A is for my ham radio vacations when I’m away for a week being very physically active, carrying tower sections, assembling antennas, climbing towers and the like for 12-16 hours a day. That pattern is about 20% less insulin than the normal pattern, and I switch to that when I get to the mountain. It stays on A for a week, and I’ll switch it back to normal the day after I get home.
The best thing about the alternate pattern is that I can tack on a temporary rate on top of that, so if I’m on the mountain and I’m going to be really busy unloading the truck for the morning, I can set a temporary rate at 50% for 4 hours which reduces the basal 50% below the already lower rate that pattern A is using. Very nice.
At some point, mucking around with my basal rates is more for my mental benefit than my BG, because it’s just not possible to 100% account for every nuance of activity, food, metabolism, and health at any given hour of the day. But I like to think I can get closer, so I try.
I’m a creature of habit, I don’t find it necessary to do temp basal rates all that often. I need to increase during my monthlies, for a couple of days. I just started on Victoza and you have to titrate up to the recommended dose. There are 3 stepping stones and I’m on the middle right now. Victoza causes the liver to produce less glucose so I’ve been using some temp rates until I can get everything figured out and squared away. While taking walks in the summer I decrease it.
It’s so much easier than doing corrections or continuously feed myself. I’m in charge of my diabetes and only I know what is best for my disease. After 26 years of adjusting my doses as I needed to, the pump just makes it easier.
IT works well for me with questionable estimates when eating out. Sometimes you get the “hidden” sugar that you can’t estimate for during initial carb count. Also helps for high fat content that makes insulin absorption slow. By adding a bit more insulin per /hr over a couple of hours it lessens or avoids a high spike long after you go to sleep. I don’t get to worried about it being to low as it is low and slow approach that won’t really crash you out.
I will sometimes do 200% basals instead of corrections as it’s sort of easier to wait for the drop and then “untake” the rest of the basal. Like if my BG is running up after a meal, I will hit the 200% “gas pedal” as it gets to like 117-124-130 even though that’s a delta 7,delta 6 so sort of slowing down and there’s IOB. I can either hit a correction, which might be cut by the IOB,override the cut (I also do this, it’s sort of a coin toss, if I override the correction there, I will do like 1/2 the calculated correction amount…) or maybe hit 200% basal for like 2 hours, see where I’m at in an hour, which might have hit the 130-132-132-129 or something and kill the temp basal when it starts to come down, as shown by my CGM. It might make a 132 peak instead of a 145 or 150, which isn’t a huge difference but I figure every little bit helps.
Re adjusting basal rates, if I see a time of day where I’m regularly running low, I might experiment by cutting it back at that time, maybe a 2-3 hour window, by .025U/ hour. I also did an experment where .775U/ hour wasn’t quite enough but .8U/ hour was too much so I did 1/2 hour increments back and forth between the two to fake a .7875U/ hour rate, which seemed to help nudge my A1C down a shade, from 5.2-5.4, where it had sat for a couple of years, to 5.0-5.1. Although I have been less active and switched to .8U mostly again recently and hit 4.9. The 5.0-1 was also at the time I switched to Enlites so maybe that was the cause of the improvement too?
@acidrock23, I know you use a Medtronic pump. I just want to point out that the difference in temp basal terminology in different brand pumps can be confusing and lead to unexpected results. A 200% basal in this example doubles the basal insulin rate. In an Animas pump, a +200% basal, triples the basal rate.
I don’t mean to nit-pick but that slightly different terminology represents a relatively large change in insulin amounts.
I agree that the beauty of a temp basal is that it can be canceled before the programmed duration ends, something you can’t do with an immediate correction. Although an immediate correction can be effectively downsized with a subsequent temp basal turn off.
Good point, Terry4, about the difference between Animas and Medtronic pumps.
Now that I have been using Animas pumps for 3 years, I still miss how Medtronic pumps handle temporary basals. With Animas you are allowed to use only percentage changes in basal. With Medtronic, you have the choice of using a percentage change or setting an actual rate. I personally prefer the ability to set an actual rate, but that’s life. No pump is perfect.
I use temporary basals almost every day. My morning basals are set to accommodate a long walk after breakfast. If I don’t walk, I set an increased basal rate for a couple of hours. When I am trending low especially at bedtime, I’ll set a temporary basal of 0% which is Off for 30 minutes or an hour. I never suspend my pump because I would then have to remember to turn it back on. Instead it’s temporary basals. When I play golf or hike, both of which mean 4+ hours of exercising, I usually reduce my basal by 30% or so.
One thing about temporary basals is that you have to remember it’s effect several hours later. If I use a temporary basal all morning and then eat lunch, I might need to increase my lunch bolus to replace the basal that was reduced all morning. I don’t get overly mathematical about this, but just might bump up or down a bolus to cushion previous basal decisions.
Remember that our bodies don’t know the difference between bolus and basal insulin, so sometimes you just do what works.
i had NO IDEA that a +200 temp basal rate triples the basals. the highest i went up yesterday was 125%. it helped and now i have slowly been decreasing it. i am currently down to a 105% temp. i have absolutely no clue why i all of a sudden out of nowhere i needed to up my basal. this D is one tricky and weird disease. it is filled w/ endless corrections.
i would like just one day/week, in which everything went smoothly and i could feel like a “master of my domain” (Seinfeld episode quotation)
I use the Animas Ping. Your Medtronic pump works differently. A 200% temp basal increase with a MedT pump doubles the basal rate. The semantic difference is the “+.” MedT does not use the “+” terminology.
just a reminder, w/ my MM pump, when i push SUSPEND, my pump gives me low alarms every 15 minutes or so to remind me that i have made a change in my pump. i also receive the same alarm w/ any temp basal. this is one of the features which i find extremely helpful.
Terry,
i don’t quite follow you in your last post. 200% of 100% is double the basal rate. its just mathematical. what difference is there in your Ping Pump?
Daisy, I believe what Terry might have been referring to is the difference between 100% of a value versus a 100% increase of that value. The denotes a percent increase of the value so +100% implies twice as much.
Without the plus sign the 100% supposedly implies a percentage of the value. In that case 100% just means the value without any increase.
In symbols, 100% of V is just V. But +100% of V is V + 100% of V or V + V which is twice the original value, V.
I use the temp rate if my CGM tells me that I am going downward. Based on the bg reading, and the speed of the downward pace, I will lower my basal and that keeps me in range without having to add the calories of OJ etc. (as a dancer I have to keep my weight way down - gotta remember guys have to carry me around) Depending on the bg reading, I will pop some glucose tabs in my mouth as well. It is most helpful in the middle of the night - I don’t have to leave the nice dark bedroom to the bright kitchen!
denotes a percent increase of the value so +100% implies twice as much.