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Re: [IP] basal testing <attn Michael> (warning! contains bg data
> Michael, thanks for your help here.... I have a question. (or two).
> I have already checked my nightime basals and they are OK through
> the night and up until around noon. Today at noon (fasting all
> morning), my bg was 110, then at 1:00 it was down to 86 and down to
> 63 at 2:00 at which time I ate lunch. I think I need to decrease my
> basal rate around 11:00 or so, but if I am to "adjust as I go" like
> you suggested, how do I know how long the duration of the change
> should be? Seems like I really can't make any adjustments until
> I've tested the remaining time from 2:00 till bedtime. Am I missing
> something here?
No, you're just thinking ahead. The problem is that if your bg's drop
in the afternoon, you must get tha straightened out first before
attacking the one(s) that follow.. If you think that later ones are
OK, then insert and extra rate. Try it on the graphic simulator on
the website to see what happens. What may happen is that you
will end up with some extra rates during testing that later can
be consolidated if they only differer by a tenth or two. This sort of
thing has come up for us as well and usually works out once the
basals are tuned the first time. A week or two later, after some
minor adjustments, they become more stable.
> Why do you recommend always starting with skipping dinner? Pumping
> Insulin implies that you should start with the nighttime basals,
> then the early day ones and then the late day ones. Just curious,
> not trying to criticize....I don't see that it really matters one
> way or the other.
It gets the most typical unknown out of the way first.
Different way of saying the same thing. In order to check night time,
you have to fast and have no bolus for at least 5 hours. That usually
puts Lily at bed time since we eat at 6-7. She sometimes eats a
snack at 2:00 or so if testing is going to happen. This is an every 6
mo to a year thing right now. Usually minor adjustments are made with
nothing but daily averages to look at.
I think the reason Pumping Insulin say do nights first, is that is
when the unexplained highs/lows occur that really screw you up. I
suspect that so called "brittle" diabetics probably suffer from some
sort of daily high/low swing that causes their liver to kick in and
spill glucose into the bloodstream. I know when L. was having trouble
last time, it was impossible to stabalize any part of her day, but it
was all triggered off a repeating night time high that was hard to
pin down. Sometime she would have a low first. The high was not in
response to the low, it was just her metabolic change when she goes
to sleep and the adolescent growth hormones kick in. That's when we
upped her basal to 1.7 - scared me to death to have her do that, but
it works, she's stable as a rock (soft rock).
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