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[IPk] Basal rate testing
the precision of your carb/insulin ratio and the effect on BG of correction
bolus is impressive. I would like to determine these figures to improve my
I have a differing basal rate for each hour of the day, varying from 0.4u/h
at midnight to 1.3u/h to cover the dawn phenomenon at 6am. My carbs ratio
appears to be between 10 - 12g CHO/1 unit, though I normally use the 10/1
ratio as my BG is slightly high before meals.
Anyway....... the problems with my basal testing, which I am desperate to
persevere and make work, are;
1) there rarely is a period of longer than 3.5 hours in which I do not eat.
Given that a Humalog bolus lasts for roughly three and a half hours, there
are few waking moments which are suitable for basal testing. So..... I
ought to skip meals in order to take these essential tests. I have found it
very difficult to curb my appetite to allow me to take the tests - I am a
growing young man with a large appetite - normally eat aroud 100 carbs for
lunch, 150 for dinner . Is it safe to skip meals throughout the day?
2) I am not sure exactly how to alter my basal rate - in increments as small
as 0.1 units - based on the BG results. Should I alter a basal rate from
two hours before, for a current blood sugar? (I know this is a common
problem as a diabetes paper I read the other day suggested that many
patients do not know how to alter their basal rates according to BG result)
3) I am not sure what blood sugar to *aim* for? Orthodox figures are 4 -6
mmol, but I *feel* hypo at 5mmol
4) activity levels vary from day to day. Should I find a 'resting' basal
rate first, and then adapt to activity accordingly?
Any suggestions on how to go about practical basal rate testing would be
IDDM 10 - Years, Disetronic D-Tron - 1 year
For instance, say you are normally on a 1.3 u./hr. basal rate, your
carb : insulin ratio is 13 g : 1 u, and your normal correction bolus
is 1u per 2.2 m/mol above 5.6 m/mol. You need to think about the amount
basal insulin you are missing if you disconnect, unless you are doing
strenuous exercise (or at least really moving around) to burn glucose.
If you had the set-up I just described, which is basically my afternoon
profile, you would have underbolused by almost a unit. You would have
1.3 + .6, or 1.9 units, for 1.5 hours off pump. Not taking (say) .7 u.
your bg reached 6.7 would mean that it would keep going up--there's no
intermediate-acting 'safety net' (as it were) anymore.
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