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.
The apache wars by paul hutton
21 hours ago