Basal testing- thoughts on this scenario?

Hello! Apologizes as I posted something similar months ago but am trying basal testing on my own and have questions!

We switched my basal even lower again. I stated at 1.75 and with a weight loss of 30 pounds I’m now down to 1.15 around the clock versus 1.75 which is awesome. I’m starting to get close I think because I’m not going low near as often. Overnight my basal seems to be perfect. I went to bed at 131 and woke up at 122. Great. But I ate breakfast today at 7:50 and now it’s almost five hours later. At the 3 hour Mark I was 160, 4 hour Mark 139, and just now I’m at 118. Is this enough of a drop to warrant an even lower basal. I keep going low right before dinner or after lunch so I’m wondering if this is actually the culprit since it typically seems to be 2.5-4 hours after lunch. Feedback is appreciated. Thanks!

How long ago did you first make the change? It can take a few days for things to “settle in.” I give it 3 or 4 days but if you are having frequent lows you might lower it a bit - you’ll have to experiment with the time frame.

Taylor @Tee25 , on the surface it appears as if your basal dose was correct. But I suggest that you keep it at the new level for a few days before making any more changes.

Keep in mind, that you are also taking a meal-time bolus, and that both of these insulin doses work to lower your BG. Also, the bolus has a couple of variables: first, your estimate of carbohydrates eaten [plus protein and fat]. Second, your insulin-carbohydrate ratio.

totally agree with @wadawabbit and @Dennis 3 days for a basal change… plus you are soooo close (if not, spot on).

I could only get my basal good during the day and dropping at night, or good at night and rising during the day. Very frustrating. anyway good luck!

Okay thank you all! I ended up being 107 before lunch so I’ll continue to keep an eye on it over the next week! So if I continue to have lows between lunch and dinner would you suggest taking a look at IC ratio at lunch then or should I test that basal segment without eating first and see if it’s an issue from 12pm-5pm?

Taylor @Tee25 , diabetes management teaching that I experienced always recommended three meals a day, and three small snacks, mid-morning, mid- afternoon and then evening before bed. This is especially important when using a 24 hour background insulin; the snacks are usually taken without additional insulin. Quite naturally, if you are “high” at snack-time, you will not eat that snack.

Super interesting! I have never been told that so this is news to me. Mine have always said that basal should just hold you steady so you don’t need to eat, can skip meals, etc. which I obviously don’t skip meals often if ever. For the small snacks, are you talking like 15 grams or would it just be whatever the equivalent of 1 unit of insulin is for me?

Taylor @Tee25 , it would depend on how low you are. How many mg/dl would 15 grams push up your BG?

You will only sneak like this when you might be heading towards hypo. In theory, basal, when proper rates are set, does allow you to completely skip meals.

Okay thanks! That makes sense. I’m still playing around with that. It feels like some days I really need 15 grams to get me up other days it feels like I could do 7-8 and be completely fine. So sounds like trial and error until I learn what works best for me.

Another strange question but I always appreciate your guys advice as all 3 of you give great tips. So last night I did go low but it wasn’t until after dinner this time. I had a baguette and salad from a local chain restaurant looked up the carb count and took insulin accordingly. I ended up crashing about an hour after dinner so drank 22 grams of Gatorade. I did completely suspend my pump for 15 minutes because I had went from 136 to 80 in literally 20 minutes and then dropped after that into the high 60s. The treatment worked and I stayed in the low 90s until about 3 hours later. Then I started slowly climbing but climbed up to 180. I took a small correction and woke up at 120. So questions I’m having would be more related to why. Has anyone seen a delayed spike like this after low treatment? I don’t think the spike was actually from my meal since it was bread and a salad. The other thing I’m thinking is I way overshot insulin even though I looked it up because there was less berries on the salad than normal- so that’s on me. Would it be possible that the Gatorade would have been an overshoot or that suspending my pump for the 20 minutes I did would be enough to spike me that much later on?

Taylor @Tee25 you did a lot of “GOOD Stuff” - the proof of that, if you need proof is the 120 mg/dl when you awoke in the morning. If I was living through what you were experiencing, I may have taken very similar steps to your steps.

You may have read several times in this Forum that T1D can be unpredictable and that doing eacatly the same thing two days in a row can result in radically different results - just one thing about diabetes and our body. You may see me write “effective diabetes management” - I use that expression because I truly believe that TypeOne can NOT EVER be controlled.

Like you experience with reputable chain restaurants, I have found that sometimes [my excuse] the carb count can vary on a particular meal from week to week. Like you said, fewer berries a couple of nights ago. My wife adds handful of nuts and berries to the salad she prepares for us - sometimes her hand is larger than other days, or when she took her portion, she took fewer berries than one half those in the bowl. I empty the bowl onto my plate and blame that for my higher BG.

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I normally fast when setting new basals. I find it easier to get the correct basal that way. By fasting, I don’t need to worry about blousing incorrectly for food. If eating food, how do you know if a high or low BG reading is caused by an incorrect basal or bolus?

That’s also true. I should try that. I think it’s right for the most part, but dinner time seems to be an issue so maybe looking at the hours between lunch and dinner would be helpful with a fast.

There are actual guidelines on how to test basal rates. Here are some I found online - I don’t know if they are universal or if your doctor uses different ones, so check these out but do find it what your doctor uses:

In addition to the obvious fasting you need to avoid caffeine, and not start a test if you had hypoglycemia shortly before (see the link for details). And If you take meds that raise glucose ask your doctor how to handle those - you may just need to note them to explain a spike.
People often split the test so they don’t get “hangry” in the course of it - if you’re only testing a portion of the day see what the guidelines are for eating - or not - in the hours before you start so your test is good (and you don’t have to repeat!).