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[IP] Basal Testing Question
- Subject: [IP] Basal Testing Question
- From: Andrew Aronoff <email @ redacted>
- Date: Tue, 16 May 2000 02:10:24 +0200
>For me, and I think many members of this list, the night time basals
>cannot be set using the daytime insulin/BG ratio.
I, for one, have no problem using the same ratios night and day. I have
never understood the importance that's given to 0.1 unit at night by some
>Example: During the day it takes one unit of H to lower my BG 50 points.
>If I see a
>50 point BG rise between 3am and 6am, I only need to increase my basal
>rate by .1U/hr. between 3am and 4am to take care of it.
I'm sure you're convinced this is true, but it does not seem even remotely
possible to me. Given the variations in site absorption, metabolism, the
pump itself, and measurement error, I don't think a _single_ 0.1 unit dose
is reproducible, much less detectable, in the body. I'm referring to a
_single_ 0.1 unit dose, not a series of them.
To establish this, how, exactly, did you measure the effect?
>Put another way, I take a total of 1.5 units of basal insulin between 12
>midnight and 5am. If I were to decrease that by .1U/hr. for each of those
>5 hours, a total decrease of half of a unit, I would easily see a BG rise
>of over 300 points by 6am.
How, again, did you measure this? What I've seen is that with my basal, I
generally awaken in my target range. Generally, but not always. There are
changes I can't identify and don't control. I can, occasionally, wake up at
200 and I'll then need 2-4 units (2 units at a time) to bring me down to my
target level. The same kind of unexplained change can occasionally be
observed during the day, too. I'll adjust with the same bolus.
>I think that basal testing is the only way to set those basal rates. I'd
>be interested to hear if others experience this as well.
I'll be very interested to hear how people MEASURE what they claim is true.
If I said that I had a BS of 300 one morning, raised my basal 0.1 unit the
next night and was in the target range the following morning, I'd be
describing what happened but NOT cause and effect. In fact, I can have a BS
of 300 one morning without ever knowing exactly why. What ultimately counts
is *not* the 0.1 unit I took to compensate, but what's observed over a long
enough period of time (days or weeks) to be able to differentiate between
the signal and the noise by reproducing the effect.
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