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Re: [IPk] Basal checking (was) RE: ip-uk-digest V4 #94

Hi Lynne and others,

some comments about basal checking:
1) protein definitely affects insulin requirements both because
protein (and fat) eaten together with carbohydrates can delay the rate
of absorption of the carbs, and because in the course of digestion
some glucose or other sugar molecules (don't remember details of my
biochemistry!) are released from the protein and fat molecules. If you
are eating a little protein and fat with lots of carbs, the glucose
etc from protein and fat is often negligible, but if you eat it with
essentially no carbs, then it is not.

2) because of this, for serious basal testing if you really want to do
it (see point 3 below), it is usually recommended that you fast and
only drink water and other liquids containing no carbs, no fat, no

3) some people, myself included, find fasting basal testing an
overrated pastime - not because fasting is not fun, but because my
basal requirements alter when I fast - so I could have a basal profile
that is perfect for fasting but far from perfect for eating - I know
that many DSN's have never mastered this simple little concept - ones
body metabolism can change when one doesn't eat in the normal way for
several hours - not that surprising

4) Like Iain, I wouldn't recommend eating tv dinners while adjusting
basals and boluses - unless you plan to eat them always, which
wouldn't be the healthiest diet. Not only, as Iain wrote, may the true
carb, protein, fat content of an actual meal stray considerably from
the average written on the packet, but in addition, since it is not
only the amounts of carb that affect how much you have to bolus for,
but also because there may be variations in your insulin needs due to
the differing amounts of fat and protein, and also sometimes weird
individual things about combinations of ingredients. IMHO, it is best
to eat things that you normally would eat, but with the restriction of
eating pretty much the same things each day while trying to get basals
and boluses right. That way at least you know exactly how much to
bolus to get good results most of the time (see point 6 below) after
some of your most commonly eaten meals, regardless of whether or not
they follow the exact calculations of needing x units of insulin for y
grams of carbs. And after all, that's what you really need to know -
what's most important is to know how to control your blood glucose
levels while you are leading your normal life, eating meals that are
'normal' for you to eat, doing activities that are 'normal' for you to
do, not while you are fasting - unless that is what you do frequently
- we're all different!

5) In case you are not aware, you should also know that not only basal
but also bolus requirements can vary at different times of day.

6) Many people also have a substantial 'random weirdness' factor which
means that even doing exactly the 'right' thing all the time, eating a
healthy diet etc, there are too many other factors, not only exercise,
illness, but also emotional state, stress and 101 other factors you
can never estimate accurately, exact calculations of basal and bolus
will work most of the time, but not 100% of the time.

Hope some of this helps

On 4 June 2011 00:20, Iain Jenkins <email @ redacted> wrote:
> Hi Lynne,
> Sounds like your basal is too low for this period - try adjusting up and have
> another go - that's the idea of it, to see what happens without food or
> bolus.  Also try to fast as it will give the most accurate results.
> Alos, I would try to make your own food as packets are only done by average,
> and are allowed something like a 30-40% margin.  I find packets lie *a lot*!!
> If you are having trouble with see sawing I would also look at temporarily
> lowering your carb intake at least until the swings are better...
> With every good wish,
> Iain.
> T1 Essex, UK.
> minimed 515 pump
> Current A1C February 2011 5.7.
> Help diabetics to reach their full potential through athletic endeavours:
> http://www.insulindependence.org
> --- On Fri, 3/6/11, Charkham <email @ redacted> wrote:
> Hi,
> I wonder if anyone has any ideas which might help me.  I have been on a
> parigidm pump for 4 mths now and I have been having great difficulty
> stopping my BGs fluctuating so much and each time I try to test my basal
> insulin something stops me.  I am eating just 'TV dinners' as I call it.  My
> diabetic team said to only eat labelled food items for a week so we know
> exactly what I am eating and do 8 basal tests over this week as I don't
> think they or my TDD is correct.  I have tried since Wednesday to do a basal
> test.  A breakfast no carbs started off okish with BG of 9.5 with 1 soft
> boiled egg for breakfast and then it shot up at 10am to 13.5 so I gave up.
> Yesterday I tried again and it was 6.3 (better) at 8am and then at 10 was
> 11.5.  at 12noon I gave up again as it was 14.6. Any ideas?  I am beginning
> to lose hope!!!
> Lynne
> .
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