Wednesday, December 29, 2010

Basal Testing - Take One

I was inspired by Reyna's post about basal testing, so I got off my ever expanding and sloth-like lazy butt and set to testing Grace. For those of you who don't know, basal testing is the process by which you ensure you're receiving the correct amount of insulin from your pump to keep your blood sugars in range when NOT eating food. Basically, your body needs insulin even when not eating. If you can get your fasting insulin needs figured out (you basal), as well as how much insulin you need for every carbohydrate you eat (your bolus amounts), in an ideal world your blood sugars will remain stable. Now, we all know this fictional ideal world does not exist due to variables such as exercise, growth hormones, illness, and let's not discount the fact that diabetes just likes to screw with us sometimes. But getting your basal and bolus amounts set is half the battle.

Figuring out bolus amounts, or insulin to carb ratios, is pretty straight forward. Count carbs to be consumed, give insulin, check blood sugar later. If BS is high, chances are you didn't give enough insulin to cover the meal. Adjust the dosage and try again later.

Basal amounts, for me, seem a bit trickier. You have to test without any carbs in your system. So I planned to test Grace's basals this morning, and hold off breakfast and excessive activity for as long as possible. I figured TV would distract her for a while.

Her overnight numbers were steady. At 10pm she was 70, so she had half a banana. At 11:15 she was 166, and at 12m she was 159. By 7am she was still 166, so though that's a bit high for her in the morning, she seemed to stay flat all night.

Here's where things started to go awry. At 8am she was 185. I've suspected for a while that she was creeping up in the mid-mornings, but she usually starts her day around 110 and goes up from there. Starting at 166 doesn't leave much room for her to go up without me correcting her. By 9:15 she was 211 and the basal testing was over almost before it started.

So though it was a much shorter test than I had planned, I did see that she is, in fact, going up mid mornings. I increased her basal from 7-10am and plan to test her morning basals again tomorrow. When they seem in line I'll move on to lunch time, then dinner. And by that time I'm sure her needs will change and I'll have to start all over again.


  1. I did some basal testing last week and could have sworn we wouldn't survive the morning. So happy you guys were able to get in and get out quickly!

    Keep up the good work!

  2. Wow, it amazes me daily at the amount of energy, thought and calculating that goes into this darn complicated disease...and we're living it!!! Although I don't have either of my girls on a pump yet, the demands are never ending...when you see it spelled out like that it's just exhausting. The constant tweaking and 'figuring' out...though it never seems we can 'figure' it out just right.

    Great job on the basal testing and good luck with the lunch and dinner tests :)

  3. I started basal testing today, too! Not fun, but gotta do it! I'm making adjustments as well.

    Like you said, I hope we can figure it out before everything changes!!!

    : )

  4. Way to go Pam! I tweaked Joe's settings a bit and want to get another look at them in a day...when the "thaw" happens. It is the only way to get one in...when he cannot skate...LOL. Gotta be a pancreas AND let him be a kid I guess.

    You are a ROCK STAR - Keep up the great work. I am looking forward to taking one of those Type 1 U classes on-line as well. I feel like I can do better than I am at trying to keep Joe's BGs within range.

  5. Great job Pam! My Grace also needs a huge amount of basal insulin in the morning between 7 am and 10 am, and a low I:C ratio. Did you continue after the 211? I've gone to about 250-260 before I call it quits. I love how much basal testing informs us. I gotta do a night time one soon, ugh. Great job mama pancreas!

  6. Isn't that the truth - by the time you get it all figured out it will be time to make changes! Exhausting! I look forward to a time when we are able to basal test Nate. That information will be so helpful. Right now my little 2-year old would be a nightmare with no breakfast, lunch or even dinner carbs. UGH - I shutter at the thought!

    Great work, sista!

  7. any attempts we have at basal testing quickly get cancelled due to lows or highs. so frustrating that even the basics are hard to figure out in growing kiddos that change faster than the weather.