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Re: [IP] when to change basal rates

> I was just wondering how do you know when you need to change your
> basal rate. My daughter is 13 and started pumping with the minimed
> 507C about 6 weeks ago. Her nights have never been really stable,
> (Except the one night she was in the hospital getting trained on the
> pump. Then she was 100 all night, of course) Some nights she runs in
> the 80's all night, some nights in the 160's but most nights , it
> seems, she is in the  high 100's - low 200's.  By the way, I should
> also add that she is very active in sports.  Last weekend I tested
> her night basal. 

I have a 15 year old who has been pumping since she was 11. She is 
also active in sports and sometimes works out as often as 4 days a 
week with 2 - 4 games on weekends. Other times much less. This leads 
to fairly erratic night time bg's. When activity is high, nite time 
bg's may be as much as 100 points or more different from non-active 
period. We have a routine at my house. I get to see my daughter every 
night at 2:30 - you get used to it. We used to try and keep her night 
time bg's closer to 100 to 120 range, but the incidence of lows was 
uncomfortably high (no pun intended) so we uped the target to allow 
her bg's to nominally rise 25 to 50 points during the night. What 
this usually means is that at 2:30 she will be 120 to 200 and after a 
bolus, will have a 100 to 160 bg in the morning. There are infrequent 
lows as bad as 30 but this is rare. However, when it occurs it is 
apparent she is on the edge of a crash since it usually takes a large 
amount of glucose to bring her up, enough to raise bg's by several 
hundred points but only getting 80 to 100. I don't wish to alarm you. 
This is not frequent, but it is why I still check 'every' night at 
2:30. If I did not wake her under these circumstances she would 

>From my experience with ONE girl this age, you can expect 
"unexpected" shifts in basal requirements that will stabalize after a 
couple of weeks at a new level. You may see a large "go to bed" jump 
in basal requirement that we have found easier to deal with by 
setting a very late basal increase (1:00 AM increase over waking 
rate) and then setting a temp basal rate at bed time (whenever that 
is) to cover until 1:00. This gives her the flexibility of adjusting 
for an evening low or high as well by not increasing her initial 
sleep basal or by increasing it more than normal. This has worked 
well for us for 4 years now.

Hope this helps, it's only 1 kid's worth of experience.

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