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Re: [IP] Basal Rate Adjustments
On Sun, 16 Nov 1997 email @ redacted wrote:
> To those of you with kids who have been on pumps for a while,
> How often do you find that you need to adjust your child's basal rate? Is
> there anything in particular you look for that lets you know it needs to be
> done, or do you just base changes on basal rate checks?
Watch for a consistent pattern of either lows or highs at a particular
time of day over 2-3 weeks. This can be fasting or with meals.
there are two things that may need adjusting, each of which can be tested
1) Insulin to carb ratio.
2) basal rate requirement change.
- ----- 1 ------
This can generally be tracked by looking at the history of carb intake
for ALL meals vs the need of high blood sugar bolus or hypoglycemia.
If there is a repetitive pattern that is NOT related to miscalculation,
an adjustment to the carb ratio can be determined. Warning -- approach
this with incremental changes.
- -------- 2 --------
After separating out (1) above, the remaining variations are usually
attributable to basal variations. Usually only a 0.1 adjustment is
needed to fix this type of problem. However, adolescents man under go
one or more large changes in basal rate requirements and may have two
stable states on and off while making the step change. These variations
may require very aggressive changes in basal rates. It is necessary to
verify these kinds of changes with fasting basal profiles. I have only
found it necessary to profile Lily on a 6 to 18 month schedule. i.e. she
has made large changes, but they have remained stable. The biggest
problems are the day to day ones having to do with adequate rest,
exercise, pizza, etc... see my post of yesterday.....
Hope this helps,
email @ redacted