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Thursday, November 4, 2010

Deciding to Change

I have a confession to make:  I've never really done basal testing.  I say "really" because I kind of call it basal testing after the fact.  I notice a trend over time and usually try to rule out all the other factors it could be:  I didn't bolus or count carbs correctly, it was towards the end of the reservoir so my absorption was messed up, I must have over-corrected.  If I can't find any reason from my doing with food and bolusing, then I note it as a basal trend that needs attention. 

This methods works pretty well because the trend has to be really noticeable for me to make a change to my basal rates.  Unfortunately, it takes a long time for the trend to become noticeable before I'll make a change.  If I were to do true basal testing, I might notice the trend a lot sooner and saving me some headache.  I used to never want to change my basal rates except if I discussed it with my endo.  I felt like my pump was going to blow-up if I did anything other than bolus for food.  But when I told my endo I was thinking my rates were a little off, he said, "That's fine.  You can change it.  You know better than I do."  Another point showing how little involvement my endo has with my management. 

But with the weather that seems to change daily, so does my basal rates.  I'm constantly tweaking my nighttime numbers because I savor my sleep, and I do my best to keep Constance from BEEEEEEEEEEPing at me.  With the temperatures getting colder (again), I'm noticing that I may need to up my early morning basal again.  I'm also noticing that I need to up my afternoon basal after lunch, because for the past week I seem to like to get to 200 mg/dL and stay there for several hours. 

I'm just now noticing these trends over this week, so I would like to see these trends be solid for at least another week.  Because I could probably explain away most of these instances from delayed carbs, not carb counting, or over-indulging in leftover Halloween candy.  So I'm taking a mental note during these time and trying to make sure I'm doing everything right as to eliminate everything except basal rates. 

So how do you guys determine when to change basal rates?  And how often?  I feel like I should do a full basal analysis once a month to keep up with this fickle disease that is diabetes. 


  1. Well you can do fasting. For instance, get your blood sugar reading in the morning, skip breakfast, and see where you are at by lunch. Then you are ruling out any bolus or delayed carb issues, etc... Then you could do a lunch fasting, dinner fasting, and so on. I think this is the ideal way to do basal testing.

    BUT, in all honesty... lately I've been doing it the way you described because I'm too lazy (or in love with food) to be fasting. haha

  2. I do it like you do, adjusting basals if my carb ratio's are bringing me close and so are my corrections. I also need more insulin in the night nowadays.

    I do small changes about every 3 days until I see things straighten out.

    I know what you mean though about the sites and stuff. Sometimes I will wait to see if a new bottle of insulin changes things...some bottles are more aggressive than others. I have a range of pump settings that I function in and if I feel the need to go outside of those settings I contact my endo.



  3. I'm about to delve into official basal testing. Next week. I am nervous, and scared -- mostly because I know I'm going to get very hungry and very frustrated.


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DISCLAIMER: I am not a doctor, nurse, certified diabetes educator (CDE) or any medical professional of any kind. (But I did stay at a Holiday Inn Express!) Therefore, please do not use any of my postings as medical fact. I am simply a blogger expressing my highs and lows (pun intended) with diabetes. For changes in your medication, exercise regiment, or diet please consult a qualified physician.

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My name is Holly and I live in north Alabama with my hubby, two cats, and a dog.