200% basal rate

[kel4han]

Anyone ever increased to 200% for highs that dont budge? Was it for illness? End of the honeymoon?

We were at 150% all day yesterday with no luck....we just started a few hours ago on a 200% (from .10 per hour to .20) So far it looks better, but man its a drastic measure that freaks me out with nightime approaching!!

[mathcat]

Jacob has been at 200% or more for many growth spurts (I guess) or illnesses. (To avoid confusion, no his pump will not do a percent above 200% so often I just do a temp basal with a specific per hour amount or sometimes I put everything into pattern A or pattern B - minimed)

Just make sure the site is good. If it is then the issue may truly be that a significantly higher basal may be called for but monitor, monitor, monitor. If I feel very unsure then sometimes I test at least every 1 1/2 hours at night. This is certainly not all the time - just those impossible growths spurts or illnesses where the total insulin involved is so far above Jacob's norm.

Be sure to throw in a ketone test or two when you can - just to be sure.

Lori
Jacob (age 7)(dx 8-30-04)(pump 3-29-05)


P.S. I read your question again. Maybe some of his 200% or more basals have been for end of honeymoon but there were many times that I thought that and a few days later he would be back in his low insulin needs. Often the growth spurt thought would seem more fitting. I would notice a day or two after his basal went up that he was eating more, that his pants were getting too short, etc. Sometimes though I suspect it is just that pesky cow jumping over the moon again.

[Lee]

Yep - a week and 1/2 ago due to illness - 150% got her to the 300's, 200% got her to the 200's - so I finally created a new pattern that was 225%...scared the heck out of me - but it got her to the HIGH 100's - then wouldn't you know - 2 days later and she was back to normal!

And now - we have decreased her insulin by almost an entire unit-lows, lows, lows!

[bethdou]

We've had to go that high too, Kelly....first time was a nasty headcold coming on, and the second time was during her first...um....visit from Auntie Flo, if you get my drift. LOL

When it rains, it pours, huh?
Give me a call if I can do anything for you...
{{{{hugs********

[thebestnest5]

For the last 2 cold type viruses that Liv had, she needed almost triple the insulin to come back into numbers with ones in front of them.:cwds:

[kel4han]

Thank goodness for you all!! I was scared to death to go 150%......We have never, ever had highs like this. 200% seems a little better so far....but man I was freaking having to move that far up!! Especially with an ISF of 220!! No ketones at all. Changed the site twice in 5 days, not the site. This could be the end of the honeymoon, we were just 20% basal and 80% bolus on Monday before this craziness! Could have been the Pink Eye from last week.....growing? The weather????Hmmmmmm the moon? This will be another long night that's for sure! Poor sweetie has dark circles and falls asleep at bedtime in an instant. :(

[Lee]

I hope she is doing better - I wouldn't make it a full time change just yet - we saw high #'s 2 days before the virus (sore throat and fever) showed up!

[WestinsMom]

We definitely have used it for when Westin was taking steroids! And I should have even gone higher :)

[OSUMom]

I read the title and thought prednisone!

[kel4han]

We are good this morning, FINALLY 120 by 4am after hanging around 280-240 all day......(chose the wrong night for a higher fat dinner) 5am brought 109 and 630am she was 96!!!! Still going with the Temp basal of 200% and I am still nervous to send her to school with that! Half day today though thank goodness. It will be interesting to see if the honeymoon has ended...hopefully no illness is around the corner!

[liasmommy2000]

Um, wow. Am I doing something wrong I wonder as I've never increased or decreased it more than 20%, usually 10%.

Maybe I need to get more agressive (ok, I know I do).

[kel4han]

Well we have Medtronic so the smallest basal increase or decrease is .05/hr compared with Animas that is .025 (I think) so when we are at 100% basal that is normal set rate (not a reduction) 120% wouldn't even bump us up to an increase because it can't dose a small 20% increase/decrease...make sense? My daughters basal has ALWAYS been .10 per hour for daytime. That is a tiny amount. At 150% we were at .15........at 200% we were double making it .20/hr.

This morning she started breakfast at 96......one hour post (with 20 min prebolus) she was 255!!!! CRAZY for her!! Two hours post she was still 292...then 3 hours post 258 THATS IS WITH OUR 200% basal which is double basal.......I just tried to go up to 250% and the pump won't let me do that. CRAZY.

[Lee]

Yep - no 250% - we had to create a new pattern and do the math! This sounds exactly like what happened to my DD's BS with that illness 2 weeks ago - okish nighttime and waking numbers and then through the roof! I still say wait another day or two before making permanent adjustments to see if anything manifests!

Don;t ya just love D sometimes? It's like being on a game show - give me Why increase basals?

[kel4han]

Lee....Maddison isn't even sick so I am envisioning crazy post pink eye issues or the end of the honeymoon. Just changed the site AGAIN, will wait a few hours to see if I need to do the math for 250% :eek:

[Rachel]

Kelly,
I just finally got up the gumption to do a 200% last night ... it was dreamy. Not a single middle of the night correction! And no AM crash from a 5 am correction. (I clearly need to adjust the ISF for 5 am!)

He seems to just need it from 10 pm - 3 am, not any other time during the day. So I am thinking either growth spurt or a basal need change. The highs at that time have been going on for almost a week ... I keep thinking the needs will go down again so haven't done the basal change. One more night and I change the basals.

One thing that helped me was to remember how little insulin our kids are actually getting ... even at 200% the actual amount increased each hour for my guy was only .05 - .15. It seems larger when I think about it in % - actual numbers seemed less frightening!

ETA: just saw what you posted as I was writing.

I wonder if the pink eye was a honeymoon buster? Or if not a complete bust, at least bumped it along a little more.

Do you ever use the Pattern feature? You could set a new plan at these higher levels, then quickly switch back to the main basal settings when and if the needs go down.

[tandjjt]

We had to do the 200% a couple of weeks back when Tyler was sick - numbers high, ketones and corrections weren't doing enough so endo said to double up for 3 hours and re-check - more directions came too, but that seemed to be just enough to do the trick. It scared me too, but worked like a charm :)

Funny you mention pink eye -- I think pink eye was Tyler's "trigger" for onset. It was the only thing he had in the few months prior to dx and the emotional outbursts / behavior issues started soon after the pink eye and within about 3 months, the bathroom trips increased and finally after 2 overnight accidents (Tyler NEVER had bedtime accidents) - we went in and sure enough... D so, I wouldn't be surprised if the pink eye finished off the honeymoon - of course we'll never be able to know for sure, but it sounds awfully logical to me ;)

[kel4han]

Wow Teresa, Pink eye hugh? That is definetly what brought on our highs....but not during, it was a week after!

I do use the pattern feature, I just now made a new pattern for the higher basals. From 2.55 to 5.20......scary to make that change, this will be another long night for sure. Thanks guys! I feel much better!