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[IP] Re: Basal testing

<original post>
<Alright, I have written and asked this question before but thought I'd
do it
one more time to see if I can get a more consistent answer- I have asked
people, doctors, and read the newest Pumping Insulin - How long before a
or decrease in blood sugar do you change the basal??  Some have said 1
2 hours, and the PI book said 3-6 hours for humalog which seems way off
me.  I am frustrated with this, please give me some advice.  Thanks>

For most people the humalog peaks in 2 hours (with a substantial amount
left through three hours). A few folks here have said it peaks in less
time than that for them. So my answer would be change your basal at
least 2 hours ahead of when you want it to take effect. You might
experiment with + or - 1/2 hour, but 1 hour ahead is definitely too
short. According to my extraction from the humalog graph (printed in the
paper that comes with each humalog bottle), after 1 hour only 24% of the
insulin is used; after 1 1/2 hours, 45% (total) is used; after 2 hours,
64% is used; after 2 1/2 hours, 77% is used, and after 3 hours, 85% is

Part of the key to your question is, how long a period do you want the
change in basal to take effect? Given the statistics above, I don't
think it is unusual to change the basal 3 hours ahead either--because we
are really talking about a cumulative effect of the insulin entering
your system (not like a bolus). The only danger I see with 3 hours ahead
is that you might get too much insulin too quickly (assuming you are
increasing your basal rate), but depending on the change in your basal
rate, probably not. So though I haven't seen the PI book yet, 3 hours
doesn't sound unreasonable for a small basal rate change--gives time for
the insulin to accumulate slowly. I'd try two hours and see how that
works (using fasts), then probably go closer to three hours.

It's not such a simple question, because everyone's body is a little
different in how humalog is absorbed, and basal rates work more on a
cumulative basis (boluses are easier to figure out).

Hope that helps somewhat--no claims to be an expert here!



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