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How do your daytime/nighttime basal rates differ?

Discussion in 'Parents of Children with Type 1' started by rutgers1, Nov 3, 2011.

  1. rutgers1

    rutgers1 Approved members

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    Matt was programmed for the same basal rate 24 hours/day when his pump was first given insulin last week (was pumping saline in week #1). We quickly found that, although the daytime number was fine, the nighttime was not high enough. We bumped it up one step, nothing. Two steps, nothing. And unless he had a fat spike or an adrenaline spike (late football practice), then I think three steps isn't enough. The initial was .125/hour and now we are at .2/hour. We have Matt receiving more basal from 10PM, as his blood sugar starts to rise soon after he stops moving and falls asleep.

    I am curious to hear how different your daytime/nighttime rates are, as well as when you start bumping up the insulin to account for the pre dawn phenomenon.
     
  2. emm142

    emm142 Approved members

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    Midnight - 6AM: 0.65u/h
    6AM - 8AM: 0.75u/h
    8AM - 10.30AM: 0.85u/h
    10.30AM - 9PM: 0.90u/h
    9PM - midnight: 0.80u/h

    So I get less at night than during the day, in general. That's partly because I give a little too much basal during the day because it helps me with meal spikes.

    My basal needs change a lot, though. I usually run 2-3 temp basals in a given day, so it would be unusual for me to have a day where I actually get these basal rates all day. These are just sort of standard.
     
  3. KRenee

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    Here are my daughter's rates. 2am is when we start dealing with dawn phenomenon and she is very insulin resistant.

    midnight .3
    2am .8
    6am .975
    8am .85
    9am 1.8
    10am .6
    11am .4
    9pm .3
     
  4. mom24grlz

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    I know our nighttime basals are higher. I think we start bumping them up around 8pm. I don't have Ashleigh's basals written down. but i think they go something like this

    midnight: .775
    3am: .825
    5am: .85
    8am: .875
    10am: .65
    4pm: .675
    8pm: .75

    Or something like that LOL!
     
  5. manda81

    manda81 Approved members

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    School Days:

    12a-2a .35
    2a-4a .15
    4a-10a .30
    10a-11a .05 (this low one is for PE in the afternoons =P)
    11a-8p .20
    8p-12a .40


    Weekends:

    12a-2a .20
    2a-6a .15
    6a-8p .30
    8p-12a .45
     
  6. obtainedmist

    obtainedmist Approved members

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    12 am .6
    4 am .675
    7 am .65
    11 am .5
    10 pm .6
     
  7. rutgers1

    rutgers1 Approved members

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    So, I guess what I am seeing here is that there is no pattern whatsoever, lol. It seems like most have a higher basal rate at some point in the night, though that isn't always the case, and even when it is, some have the highest rate closer to midnight and others closer to sunrise.

    I guess we'll just keep fiddling around.
     
  8. mmgirls

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    An hour after my dd falls asleep she jumps up 100pts.

    We double if not more her basal to deal with this.

    She goes from .4 basal to .8 or more from bedtime till 12am then it dropps to the lowest of the day till an hour before wakeup.

    I would test for a couple of night without correcting (as long as no ketones)and see when the "sleep induced spike" starts and for how long then I would take the correction that you would have given and bump up basal by half it amount to start. then you can work from there. But try not to be afraid of significantly increasing but be aware that it maybe from a growth spurt and the possibility is that it may not last very long.
     
  9. swellman

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    We used to have a pretty variable basal program but I think we are now down to 2 and the vary between 0.35 and 0.45.

    My gut tells me that the basal should be flat and one should adjust IC and CF preferentially ... not that I do.

    There are so many factors ... for instance, this summer, when my son was sleeping in late and not participating in physical activities I saw flat line BGs for many hours. I had the basal down perfectly.

    Then came school and I have concluded that the basal is not the issue but the IC and CF and physical activity that makes all the difference.

    $0.02
     
  10. rutgers1

    rutgers1 Approved members

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    I just tested Matt and he was at 260 (11:50PM). He seems to rise (or at least stay high if he is already high with insulin on board) from about 10PM to at least midnight. I am going to start by raising the basal a notch up again tomorrow between those hours and see what happens. My gut says that if I make it past those hours without a spike, he will stay relatively stable the rest of the way.
     
  11. swellman

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    260 seems high to me but it would definitely depend on when he ate and what he ate.

    I would suggest giving him a meal of almost zero carbs at dinner and watching what happens. Just try a relatively low carb, low fat salad and watch what happens - chicken Caesar salad. The only way to assess basal is to take carbs and fat out of the equation. That's my take on it at least.
     
  12. rutgers1

    rutgers1 Approved members

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    swellman.....agreed. I have to find a day/night when I can go into the bedtime hours knowing he doesn't have carbs still digesting inside of him. The kid is a carb eating machine, and on top of that, he loves fatty foods.
     
  13. NomadIvy

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    What helped me in determining basal profile was a lot of records before K even went on the pump. I had a log sheet with space for hourly BGs. So, for one, we knew that her greatest basal needs was from around 9pm to midnight and then drop drastically after that.

    Soo... since she was on 6 units of lantus I kind of tried my best to split 6 units into 24 hours. It was CONSTANT testing and adjusting the first few months (not talking of days, talking about 3 months here -- and it's never ending really!)

    I have her pump set-up to have 24 different basal settings so I don't have to keep changing the time when I adjust something so here's hers:

    12am .325
    1am - 3am .175
    4am - 5am .225
    6am 12pm .150
    1pm - 7pm .225
    8pm - .350
    9pm - 11pm - .6000

    Most CDEs and endos wouldn't like this profile becuase of that .225 from 4am to 6am and that .350 at 8pm. However, I've changed it so many times and this is the one that seems to work the best. It is not a "smooth" profile but, hey, it works (for now)!
     
  14. Lize

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    It is normally suggested that you rise the basal 2 hours before the rise occurs which will be 20h00 in your case, but YDMV.
     
  15. Beach bum

    Beach bum Approved members

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    Abby is 11 and this is our most recent plan:

    12-3 .425 going to bump this up to .450 soon I think
    3-7 .400
    7-3 .350
    3-5 .300
    5-10 .425
    10-12 .425

    I too agree with the carb free meal to assess if it's a basal problem.
     
  16. Amy C.

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    YDMV. You have to discover your child's patterns.
     
  17. thebestnest5

    thebestnest5 Approved members

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    http://www.ncbi.nlm.nih.gov/pubmed/15955383

    http://www.diatribe.us/issues/13/learning-curve.php
     

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