FUDiabetes

Basal Pumping Question

Went low last night at work, thanks to CGM Alarm I caught in time and had a shot of apple juice. I am a bartender so my work is fairly active. According to pump I had no IOB.

My question is should i try suspending my Basal? cut the amount in half? eat right before my shift? Basal rate is 0.5u/hr…THanks in advance for your ideas…

Early on my CDE told me “If your blood glucose is too high, you need more insulin.” Similarly, if your BG is too low you need less insulin. For me, that’s the fundamental truth that cuts through confusion about what is happening and what to do. If course in the short term you can adjust your BG by correcting with carbs or insulin, but a repeated pattern of BG falling or rising (away from meals) suggests looking at the basal. But I wouldn’t suspend basal or cut in half. That’s a huge drastic change. Make a small adjustment and see if that’s enough or if you need to go further.

If I have a pattern of going low around the same time of day (like 3 days in a row), I will slightly reduce my basal starting 2 hours before that time. Then I watch and readjust every few days until it seems to be working. In general, if there’s a tendency for my BG to rise all by itself around the same time each day and it’s not because of eating, I suspect too little basal, and if my BG falls all by itself (again, not because of bolusing for eating) then I suspect too much basal.

3 Likes

Just for clarification, on the omnipod, suspending is different than a temp basal set to zero. A suspension will STAY suspended until you actually turn it back on. A temp basal of zero will turn back on when the time runs out. This is an important difference to know!

It takes a little experimenting to get it dialed in correctly.

If your work is several hours, you probably don’t want to go zero basal for the entire time.

Just as @bkh said, I would suggest not going to zero. Maybe a more conservative adjustment a little bit before you start work. Try it a few times, see how it works, and then adjust it up or down.

In general, a shot of carbs will be much faster raising your BG than a basal change. So as a bartender, if taking shots of juice is practical, that will be a good thing to have as a backup.

For most of my day-to-day, I use carbs instead of basal changes, since carbs are much faster.

5 Likes

It probably depends if this was a one time event or something that constantly happens when working. If it always happens then you probably need a “work” Basil rate. All the walking, bending, runnying…will drop your BS.

4 Likes

Thank you!!! Gonna wait a couple of days and see how I trend.

4 Likes

A new question…I am now seeing a trend where my BG is great during the day but at night I trend upwards and wake up in 160’s. I have woken up in the middle of the night and made a correction but to no avail (fasting BG is about 150 every morning, when on MDI I would wake up right around 100). I get up, make a correction and get right back down to the 100 mark after a dog walk. Any thoughts?

I do tend to eat a late dinner so this could be the issue, but last night I ate around 9 pm and did not go to sleep until midnight, Even had a dance party with the pups (they like George Clinton). as I was going to sleep looked at the dexcom and sure enough 160.

“If your blood sugar is too high, you need more insulin” is what my CDE said. If I have a pattern of too high BG starting around the same time every day, I change the basal schedule in my pump to slightly increase the basal 2 hours before that time, and continue to adjust little by little every couple of days until it is working right.

1 Like

A lot of us find we need a lot more insulin for a night-time correction. At night I generally triple whatever the PDM recommends.

Also, if it was a CDE or other nurse who programmed your PDM, they tend to set safe basals and targets to prevent lows, and so you may find in general you’re higher than you want to be. It took me about a month to get the right numbers dialed in.

As for lows at work, the suggestions so far – separate basal profiles for “work day” and “day off,” or keeping an eye on your CGM and taking a bit of carb as needed – will work. Find which method works best for you. When I spend all day in the kitchen, I’ll be perpetually low, even if it’s not what most people think of as “activity.” So I keep a jar of sugar syrup for cocktails or a juice box nearby and just take periodic sips or swigs as needed.

I am a big fan of shots of simple syrup when I fee la low coming on during service. The CGM is a nice addition as the warning comes before getting foggy.