- advertisement -

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

    Mar 4, 2011
    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

    Sep 7, 2008
    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

    KRenee Approved members

    Jul 23, 2008
    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

    mom24grlz Approved members

    Mar 30, 2010
    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

    Feb 17, 2010
    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


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

    obtainedmist Approved members

    Aug 3, 2010
    12 am .6
    4 am .675
    7 am .65
    11 am .5
    10 pm .6
  7. rutgers1

    rutgers1 Approved members

    Mar 4, 2011
    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

    mmgirls Approved members

    Nov 28, 2008
    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

    swellman Approved members

    Jul 30, 2008
    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.

  10. rutgers1

    rutgers1 Approved members

    Mar 4, 2011
    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

    swellman Approved members

    Jul 30, 2008
    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

    Mar 4, 2011
    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

    NomadIvy Approved members

    May 20, 2010
    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

    Lize Approved members

    Jul 14, 2010
    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

    Nov 17, 2005
    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.

    Amy C. Approved members

    Oct 22, 2005
    YDMV. You have to discover your child's patterns.
  17. thebestnest5

    thebestnest5 Approved members

    Aug 16, 2006


Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice