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examples of their basal rates and the rationales behind them

Discussion in 'Parents of Children with Type 1' started by C6H12O6, Jan 11, 2014.

  1. C6H12O6

    C6H12O6 Approved members

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    Can people post examples of their basal rates and the rationales behind them i.e. why they run it higher or lower at a certain point in the day

    I am just curious on this subject, and peoples various experiences
     
  2. GChick

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    Ive just started and am still figuring it out, so it aint perfect for me yet... but its getting closer.

    Below is my "general" basal rates. On days that I have planned physical activity at certain times I lower it a little before and stop it during and resume afterwards and correct if necessary afterwards (it isn't always necessary... and sometimes is VERY necessary).

    General:
    12:00am-6:00am -0.6 [I:C - 1:15] (Correction=1:50)
    (sometimes I wake up as high as 180, sometimes in the 70s, occasionally in the 50s haven't quite got this timeframe down yet)

    6:00am-11:00am -0.62 [I:C - 1:13] (Correction=1:40)
    (Because breakfast time and shortly after needs a little bit more help)

    11:00am-3:00pm -0.61 [I:C - 1:15] (Correction=1:50)
    (just works)

    3:00pm-9:00pm -0.58 [I:C - 1:15] (Correction=1:50)
    (started getting very persistent lows at about 4:00pm pretty consistently... today will actually be my first time trying this rate for this timeframe. Used to just let the 0.61 ride through)

    9:00pm-12:00am - 0.59 [I:C - 1:15] (Correction=1:50)
    (had it higher at first but started to go low by midnight)

    Being new to all of this myself, I'm actually very curious to see others responses (even though comparing children and adults can sometimes be like comparing oranges and grapefruits ;) ). I think this would be a good exercise.
     
    Last edited: Jan 11, 2014
  3. nanhsot

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    Just had to re enter into a replacement pump so the worksheet was right here.

    12a 1.2
    2a 1.3
    5a 1.65
    7a 1.8
    11:30a 2
    1p 1.55
    6p 1.05
    10p 1.2

    My son is 19, has rising insulin needs beginning at around 4am, more than likely due to cortisol/grown hormones. I think the noon basal needs a tweak, he's been going a bit low midday but is heading back to school so assumably the daytime stuff will all need tweaks as his activity level increases from his lazy holiday. The other rationale for the higher noon basal is that tends to be his first meal of the day, he's not much of a breakfast eater. His first meal tends to shoot him high so a little more basal while awake has worked pretty well for him.
     
  4. mamattorney

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    Here are my daughter's:

    [TABLE="class: settingstable, width: 100%"]
    [TR]
    [TD="class: settings_bg_sub borderbottom, width: 20%"]Start Time[/TD]
    [TD="class: settings_bg_sub borderbottom, width: 20%, align: right"]Basal Rate[/TD]
    [TD="class: settings_bg_sub borderbottom, width: 20%, align: right"]Correction Factor[/TD]
    [TD="class: settings_bg_sub borderbottom, width: 20%, align: right"]Carb Ratio[/TD]
    [TD="class: settings_bg_sub borderbottom, width: 20%, align: right"]Target BG[/TD]
    [/TR]
    [TR]
    [TD="class: dottedBottom"]Midnight[/TD]
    [TD="class: dottedBottom, align: right"]0.980 u/hr
    [/TD]
    [TD="class: dottedBottom, align: right"]1u:50 mg/dL[/TD]
    [TD="class: dottedBottom, align: right"]1u:15.0 g[/TD]
    [TD="class: dottedBottom, align: right"]140 mg/dL[/TD]
    [/TR]
    [TR]
    [TD="class: dottedBottom"]4:00 AM[/TD]
    [TD="class: dottedBottom, align: right"]0.900 u/hr[/TD]
    [TD="class: dottedBottom, align: right"]1u:50 mg/dL[/TD]
    [TD="class: dottedBottom, align: right"]1u:10.0 g[/TD]
    [TD="class: dottedBottom, align: right"]130 mg/dL[/TD]
    [/TR]
    [TR]
    [TD="class: dottedBottom"]11:00 AM[/TD]
    [TD="class: dottedBottom, align: right"]0.900 u/hr[/TD]
    [TD="class: dottedBottom, align: right"]1u:50 mg/dL[/TD]
    [TD="class: dottedBottom, align: right"]1u:15.0 g[/TD]
    [TD="class: dottedBottom, align: right"]130 mg/dL[/TD]
    [/TR]
    [TR]
    [TD="class: dottedBottom"]8:00 PM[/TD]
    [TD="class: dottedBottom, align: right"]1.100 u/hr
    [/TD]
    [TD="class: dottedBottom, align: right"]1u:50 mg/dL[/TD]
    [TD="class: dottedBottom, align: right"]1u:15.0 g[/TD]
    [TD="class: dottedBottom, align: right"]140 mg/dL[/TD]
    [/TR]
    [/TABLE]


    There are only three basal settings - 8:00pm to midnight, midnight to 4:00am and 4:00am - 8:00pm.

    8:00 pm to midnight is the highest - otherwise she just climbs from about 9pm to midnight; it must be hormones. Then things taper off after midnight, but her regular rate just doesn't isn't enough. I actually think this rate needs to be reduced a little. Then at 4:00am starts her daytime rate. She doesn't show a strong dawn phenomenon, it's just overall nighttime climbs. The only other change is an I:C change which covers breakfast and the higher target number overnight, which is really just my lazy way of not changing the insulin sensitivity. With a 140 target, a correction at night will drop her to 120-130.
     
  5. StacyMM

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    This is my daughter's:
    Start Basal Correction Carb Target
    Midnight 2.1 1u:40 1u:15 100
    6:30 AM 1.85 1u:22 1u:15 90
    11:00 AM 1.5 1u:22 1u:15 90
    1:00 PM 1.85 1u:22 1u:15 90
    4:00 PM 2.1 1u:22 1u:15 90
    8:00 PM 2.9 1u:40 1u:15 100
    No particular logic - it gives us a fairly consistent result. The 8:00 bump is recent and I'm thinking it's a growth spurt. After running 200-250% basals for two hours every night, I bumped up the basal to offset a spike we were seeing nightly. The ratios are consistent all day, which is fairly recent. DD wants to start self-managing at school so I've been tweaking things to find numbers that can give her consistent numbers to divide by if she is evaluating a dose.

    This is my son's:
    0:00 1.1 25 20 95
    3:00 1.2 25 20 95
    6:00 1.75 25 20 90
    7:30 2.3 25 20 90
    9:30 0.1 25 20 90
    11:00 1.7 25 22 90
    11:30 2.35 25 22 90
    12:30 1.4 25 18 90
    13:30 0.3 25 18 90
    15:00 1.45 25 18 90
    20:00 1.15 25 20 95
    He spikes from breakfast and doesn't get up early enough to prebolus enough. He also hates prebolusing for lunch at school. His basals are set to cover the lack of prebolusing.
     
  6. Megnyc

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    Segment: U/Hour
    12a-4:30a .25
    4:30a-7:30a .15
    7:30a-10:30a .35
    10:30a-1:30p .40
    1:30p-5p .65
    5p-10p .95
    10p-12a .40

    Total is 11.8 units. Target is 90 at all times. Correction factor is 1:90 and carb ratios are 1:26 for first meal/snack of day and then 1:14 the rest of the time.

    Rationale:
    I am really sensitive to insulin in the morning so that is why my basal is low then. I believe this is because I either go skiing or for a run each night. If I don't, I am then really resistant to insulin in the morning (so I set a temp basal).
    The higher basal during the evening helps avoid a large spike from dinner. I like to be around 80 to go to bed and it also helps me get there as well (so I am kind of using basal to pull me down).
    I use a ton of temp basals though. I would guess I have a temp basal going at least 50% of the time (and it is nothing consistent enough to change my actual set basal).

    ETA: Also, I just quit taking birth control pills (due to risk of interaction with other med) and haven't figured out how to handle the whole period thing yet (since I took the pill continuously before). Well, I have figured out that I need WAY less insulin than usual. But it is a carb ratio problem not a basal problem. I am going to try a 1:40 ratio next time and see how it works. Probably more than you want to know but I think it is interesting that I can need different carb ratios but the same basal.
     
    Last edited: Jan 11, 2014
  7. obtainedmist

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    DD:
    midnight : .5
    2am : .55
    3am : .6
    11am : .575
    10pm : .6
    11pm : .55

    Correction always 1:50
    I:C is 1:10 at breakfast, 1:15 all other times


    reasons: insulin resistance in am starting at 5am
    insulin sensitivity in late am to evening
    insulin sensitivity midnight to 5am
     
  8. wilf

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    DD gets 29 Lantus daily, or just over 1.2 IU/Hr..
     
  9. wearingtaci

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    We just dialed back basal again this morning. Right now Sophie is

    12am .66u/hr I/c 1:7 target is 120 correction is 1:40
    11am.6u/hr. I/c 1:10
    4pm.58u/hr. I/c 1:12
    Give it a few days and we will up basals.....again
     
  10. cm4kelly

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    I am interested in this thread too. We run higher basals before breakfast to try to head off spikes. I have just raised the morning and mid-morning basal due to recent high blood sugars and that seems to be helping. We also drop basal around 11:00 due to heavy recess in the afternoon at school and afterschool care.

    The only thing I am wondering after looking at everyone's posts here is that there is a big difference in my son's basal rates. Not sure if that is wierd - but it seems to work for us. Maybe I need to balance it more across the day.

    My son is 6 and we have been pumping for 3 years.
    12 AM .3
    4:30 AM .45 (just raised to this from .425)
    9 AM .375 (just raised to this from .35)
    11 AM .30
    5:00 PM .325

    If anyone thinks this is really wacky - I am open to trying new things. Our last A1C (with G4) was 6.7.
     
  11. Mish

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    enter teen boy basals:

    12a 1.75
    6a .6
    2pm .575
    10p 1.25

    We've got much much higher overnight basals due to hormones. We also eat a lot of pasta so those basals help in that regard too. ;)
     
  12. emm142

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    12am - 0.975
    6am - 0.95
    9pm - 0.875

    Not that variable atm, they have been a lot more so at times. I think that the higher basal during the day is mostly to cover the effects of protein/fat in my diet, since I don't bolus for it. If I fast I tend to go low, but if I eat zero-carb foods I stay pretty steady, so I set my bolus based on that because I'm just too busy atm to figure out TAG-bolusing, which IE keeps trying to autocorrect to blousing - wtf is blousing?.
     
  13. mmgirls

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    I wonder if there will ever be a Pump with a bolus calculator that would account for fat/protein?
     
  14. kirsteng

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    "As I walked over an hvac vent at street level, the air caught my shirt, and suddenly it was blousing outward, making me look like the goodyear blimp".

    lol

    Not at all the same as bolusing though, huh?
     
  15. emm142

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    Not sure if it will ever be required by a pump (some people seem to do very well without it, and it's extra hassle) but I'd love it if it were. Since I stopped being vegetarian and started eating a high protein/fat diet it's become much more of an issue.

    Rofl, thanks for enlightening me. ;)
     
  16. jenm999

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    Bumping this very informative thread (which was started before my son was even diagnosed...) because I'm baffled by the divergence between my and my endo's opinions on basals. My son's basal at night was at .15, while his highest rate was after breakfast, at .8 - quite a difference. Last week, my endo thought that was odd and wanted to simplify and streamline, so she took the total basal and divided it into equal parts, but kept the surge after breakfast: default basal was now .5 around the clock (she also tweaked the carb ratios and those seem to be right on).

    Night one I got up 3 x for juice, dropped it to .4. Night two I got up 2 x, dropped it to .3. Night three I just put it back where it was and lo and behold, nice flat line on the Dex. Been sleeping through the night ever since.

    A1c was 6.3, so I don't really see why a change was needed, except that she thought I might be stressing myself out by micromanaging. Needless to say, not sleeping through the night is much more stressful!

    The other problem I was/am having is that my son gets back in range about 3 hours after dinner but then starts climbing, sometimes as high as 300. I am steadily increasing basals by .05-.1/hour every few days, but am wondering if this is normal. The reason I think our endo increased his overnight numbers is that I would often correct during this time and it wouldn't "stick" - probably because his basal rate during that time was just too damn low. But I would rather avoid the correction at 10pm than have him high at 12 and have the too-high basal doing all the work (if that makes sense).

    So, overall question, does this seem rational or should I be trying to level things out? I mean, his body does what it does, I'm only trying to learn its secrets, right?

    Midnight: .15
    4am: .25
    6am: .5
    8am: .75-.85 (depending on whether it's a weekend)
    11am: .1 (school - to compensate for heavy recess) / .6 (weekends)
    3:30: .6
    5: .65
    8: .75 (just increased from .65 last night which sent him to 300)

    I should note that he stays pretty much in range during the day. Night is what has me flummoxed, and I hate to see him high, especially at bedtime when we want to be snuggling and reading but are instead dealing with Mr. Cranky Pants, who probably feels like crap.
     
  17. mamattorney

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    I don't think it's odd at all. But I also don't think your endo was wrong for trying to simplify. For whatever reason, sometimes changing basal overall by a little has a nicer effect than trying to address just the troublesome hours of the day. This time it didn't work, so your way seems better. That doesn't mean I would dismiss the theory though when you are having trouble. It could be just the right thing to do next time.

    My daughter's current basals are similar (drastically different amounts), but basal is highest after dinner to 11:000pm, then it drops a ton, drops a little more at 3:30 and then starts at the "daytime" amount at 6:00. I posted her basals in this thread and what a difference a year makes (and some of her current rates seem duplicative, guess I have some cleaning up to do as well)!

    Current:
    [TABLE="class: settingstable, width: 100%"]
    [TR]
    [TD="class: dottedBottom"]Midnight[/TD]
    [TD="class: dottedBottom, align: right"]1.400 u/hr[/TD]
    [TD="class: dottedBottom, align: right"]1u:40 mg/dL[/TD]
    [TD="class: dottedBottom, align: right"]1u:15.0 g[/TD]
    [TD="class: dottedBottom, align: right"]120 mg/dL[/TD]
    [/TR]
    [TR]
    [TD="class: dottedBottom"]2:30 AM[/TD]
    [TD="class: dottedBottom, align: right"]1.400 u/hr[/TD]
    [TD="class: dottedBottom, align: right"]1u:40 mg/dL[/TD]
    [TD="class: dottedBottom, align: right"]1u:15.0 g[/TD]
    [TD="class: dottedBottom, align: right"]120 mg/dL[/TD]
    [/TR]
    [TR]
    [TD="class: dottedBottom"]3:30 AM[/TD]
    [TD="class: dottedBottom, align: right"]1.200 u/hr[/TD]
    [TD="class: dottedBottom, align: right"]1u:40 mg/dL[/TD]
    [TD="class: dottedBottom, align: right"]1u:15.0 g[/TD]
    [TD="class: dottedBottom, align: right"]120 mg/dL[/TD]
    [/TR]
    [TR]
    [TD="class: dottedBottom"]6:00 AM[/TD]
    [TD="class: dottedBottom, align: right"]1.500 u/hr[/TD]
    [TD="class: dottedBottom, align: right"]1u:40 mg/dL[/TD]
    [TD="class: dottedBottom, align: right"]1u:13.0 g[/TD]
    [TD="class: dottedBottom, align: right"]120 mg/dL[/TD]
    [/TR]
    [TR]
    [TD="class: dottedBottom"]11:00 AM[/TD]
    [TD="class: dottedBottom, align: right"]1.500 u/hr[/TD]
    [TD="class: dottedBottom, align: right"]1u:40 mg/dL[/TD]
    [TD="class: dottedBottom, align: right"]1u:11.0 g[/TD]
    [TD="class: dottedBottom, align: right"]120 mg/dL[/TD]
    [/TR]
    [TR]
    [TD="class: dottedBottom"]6:00 PM[/TD]
    [TD="class: dottedBottom, align: right"]1.500 u/hr[/TD]
    [TD="class: dottedBottom, align: right"]1u:40 mg/dL[/TD]
    [TD="class: dottedBottom, align: right"]1u:11.0 g[/TD]
    [TD="class: dottedBottom, align: right"]120 mg/dL[/TD]
    [/TR]
    [TR]
    [TD="class: dottedBottom"]7:00 PM[/TD]
    [TD="class: dottedBottom, align: right"]2.300 u/hr[/TD]
    [TD="class: dottedBottom, align: right"]1u:40 mg/dL[/TD]
    [TD="class: dottedBottom, align: right"]1u:11.0 g[/TD]
    [TD="class: dottedBottom, align: right"]120 mg/dL[/TD]
    [/TR]
    [TR]
    [TD="class: dottedBottom"]11:00 PM[/TD]
    [TD="class: dottedBottom, align: right"]1.400 u/hr[/TD]
    [TD="class: dottedBottom, align: right"]1u:40 mg/dL[/TD]
    [TD="class: dottedBottom, align: right"]1u:13.0 g[/TD]
    [TD="class: dottedBottom, align: right"]120 mg/dL[/TD]
    [/TR]
    [TR]
    [TD="class: dottedBottom"]Calculated Total Daily Basal[/TD]
    [TD="class: dottedBottom, align: right"]36.5 units[/TD]
    [TD="class: dottedBottom, align: right"][/TD]
    [/TR]
    [/TABLE]
     

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