# Changing basals šŸ¤” **URL:** \ **Category:** New T1/LADA\ **Tags:** basal-rates\ **Created:** [December 9, 2017, 2:26am UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802 "2017-12-09T02:26:21Z")\ **Posts on this page:** 19\ **Page:** 3
**Author:** ![Jen](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/jen/32/4777_2.png) [@Jen](https://forum.fudiabetes.org/u/Jen)\ **Post date:** [December 9, 2017, 5:21pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/45 "2017-12-09T17:21:10Z")
> [@Eric](#): > > Just an aside note - are you verifying your CGM numbers with BG tests often enough? Sometimes my CGM is super wonky. Maybe you should rule that out if you havenā€™t already. Yep. I test 6-10x a day even with using the CGM. I rarely take insulin or glucose without verifying. ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [December 9, 2017, 5:39pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/46 "2017-12-09T17:39:03Z")
> [@Jen](#): > > Does anyone else experience this? Would you lower basals or try something else (and if so, what)? @Jen, for the past 4 months we have experienced the same thing as you. It clearly sounds difficult to believe to those who donā€™t experience itā€”yet it is exactly as you describe. Some of these changes, for us, are sports-related and we understand why they occur: we can even predict them reasonably well. But others are not, and we have no idea why/how yet. For instance, we had several days last week at 0.75U/hr, following 24 hours later by several days at 1.1U/hr, with reasonably flat nights after IOB is gone, clearly indicating that, at least at that time, the basal is reasonably set. We have essentially dealt with it the same way as you. If we have to deal with a sustained high that stays stubbornly up after bolusing more that 4-5 times, then we set a temp basal. The same is true when dealing with a stubborn sustained low (several hours) IF we cannot explain the low with IOB. When it becomes clear that we have to take sugar every 30-60 minutes or bolus injections every 60-120 minutes without an end in sight, we set a new temp basal. If we keep the temp basal for 48 hours or more, then we set up a permanent basal profile. It is extraordinarily frustrating. I have described some of our problems here: [Three months pumping and really frustrated](https://forum.fudiabetes.org/t/three-months-pumping-and-really-frustrated/2656) As much as changing basals sometimes almost daily is a difficult thing to do, the alternative, which is taking carbs every hour or more, or insulin every 90 minutes, does not make sense. ---
**Author:** ![TravelingOn](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/travelingon/32/1583_2.png) [@TravelingOn](https://forum.fudiabetes.org/u/TravelingOn)\ **Post date:** [December 9, 2017, 6:09pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/47 "2017-12-09T18:09:24Z")
> [@Jen](#): > > Maybe people are reacting to one of the preservatives Novo Nordisk uses in their insulins. Just heard this at the endoā€™s office the other day ā€“ that some people canā€™t take novolog, some people canā€™t take Humalog, and it usually has to do with the preservatives or carriers that the insulin is in. Regarding changing basals, EH switched to the pump for that ability basically. It was really difficult even with Triseba to lower it enough for exercising. Or, he was fiddling with it because of variable exercise patterns, is maybe a better way to put it. So, I know there is a lot of contention about changing basal rates here at FUD, but I think that it must vary from person to person. It is hard to consider NOT changing your basal and having to feed it all night long. That, for us makes a roller coaster effect. Yesterday he ran, and being able to reduce the nighttime basal rate by X% is great. Although, 20% wasnā€™t enough, and he ended up going low ā€“ so he ate some candies in the middle of the night, and he woke up higher than heā€™d like. I think the basal adjustments will help with nighttime lows. ---
**Author:** ![Jen](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/jen/32/4777_2.png) [@Jen](https://forum.fudiabetes.org/u/Jen)\ **Post date:** [December 9, 2017, 6:30pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/48 "2017-12-09T18:30:14Z")
> [@TravelingOn](#): > > Yesterday he ran, and being able to reduce the nighttime basal rate by X% is great Post-exercise is one area that Iā€™ve actually figured out. Being able to do a -10% to -30% basal for 8-12 hours after exercise (like swimming) makes a major difference in avoiding lows. Iā€™m not sure how one handles that on MDI. With Lantau, it just meant I went to bed high and woke up low in the middle of the night and the next morning. ---
**Author:** ![Eric](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/eric/32/9209_2.png) [@Eric](https://forum.fudiabetes.org/u/Eric)\ **Post date:** [December 9, 2017, 6:53pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/49 "2017-12-09T18:53:17Z")
> [@Jen](#): > > Being able to do a -10% to -30% basal for 8-12 hours after exercise (like swimming) makes a major difference in avoiding lows. Iā€™m not sure how one handles that on MDI. On MDI, having lots of carbs immediately after the exercise helps with that, in addition to a big meal soon after. ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [December 9, 2017, 7:00pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/50 "2017-12-09T19:00:37Z")
> [@Jen](#): > > I donā€™t often change basal segments, only the total amount of basal up or down. Neither do we. Itā€™s only when we see a very clear daily pattern change that we do so. We have changed one segment once in the past 2 months. But we have changed overall basal, maybe 20 times? ---
**Author:** ![Jen](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/jen/32/4777_2.png) [@Jen](https://forum.fudiabetes.org/u/Jen)\ **Post date:** [December 9, 2017, 7:04pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/51 "2017-12-09T19:04:46Z")
> [@Eric](#): > > On MDI, having lots of carbs immediately after the exercise helps with that, in addition to a big meal soon after. That makes losing any weight really hard, though. ā˜¹ ---
**Author:** ![Jen](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/jen/32/4777_2.png) [@Jen](https://forum.fudiabetes.org/u/Jen)\ **Post date:** [December 9, 2017, 7:10pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/52 "2017-12-09T19:10:07Z")
This is what I do, too. But part of what seems challenging about my body is just how much my insulin needs change. My basal has ranged from 22 units to 56 units over the past month. And this happens with ratios, too, but I find those more clear-cut than basal. Tryibg to keep up with such changes is really challenging! ---
**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\ **Post date:** [December 9, 2017, 7:11pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/53 "2017-12-09T19:11:10Z")
> [@Thomas](#): > > Yes. However there are multiple medical issues that may impact what choices are available for a particular individual Hmm if only there were certain people whose job it was to determine which medications were appropriate for certain people taking into account their unique medical history. That would be amazing! ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [December 9, 2017, 7:57pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/60 "2017-12-09T19:57:06Z")
> [@Jen](#): > > And this happens with ratios, too, but I find those more clear-cut than basal. We find that adjusting CF is as hard for us as basal, even possibly harder: we are now keeping track of CF for carbs (1U:40mg/dl) and CF for other problems (1U:20mg/dl right now, sometimes 1U:10mg/dl). > [@Jen](#): > > Tryibg to keep up with such changes is really challenging! It is for us too ā˜¹ We have not figured it out a good way yet, and it is quite stressful. ---
**Author:** ![Jen](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/jen/32/4777_2.png) [@Jen](https://forum.fudiabetes.org/u/Jen)\ **Post date:** [December 10, 2017, 12:19am UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/62 "2017-12-10T00:19:37Z")
> [@Michel](#): > > CF for carbs (1U:40mg/dl) How does this work with carbs? For me, I have a Carb ratio thatā€™s 1:14 (units:grams) currently. If I go high after repeated meals I lower the ratio, and if I go low after multiple meals I raise the ratio. ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [December 10, 2017, 1:16am UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/63 "2017-12-10T01:16:18Z")
By CF I meant the Correction Factor, which I know has many names! The factor you use to calculate how many units to inject if you are high. We use a different one if the cause is carbs or hormones. The Insulin to Carb Ratio we use to dose for carbs before eating has not been too difficult for us to deal with. For us, it does not appear to vary as much as the rest, although still some. To change it we use the same strategy as you. We do have a different one for each meal. Breakfast is 1U : 7 carbs, lunch is 1:14, and dinner is 1:15. We donā€™t seem to need to change it very often, maybe every few weeks or couple of months. As a note, we often have misfires with the ICR, but the ICR appears to have more long term stability for us, so we are ginger about changing it: a lot of the problems we see with it appear to be ā€œnoise.ā€ ---
**Author:** ![Jen](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/jen/32/4777_2.png) [@Jen](https://forum.fudiabetes.org/u/Jen)\ **Post date:** [December 10, 2017, 2:28am UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/64 "2017-12-10T02:28:02Z")
Speaking of trying to determine and account for every factor, hereā€™s another one thatā€™s not in our direct control but has a big impact on BG: stress. Late for flight due to terrible airport service, and then finding Iā€™d need to go through security again, and then security swabbing ALL my food in addition to the standard pat-down since I refused to go through the body scanner. I made my flight because it was delayed, but even fast walking through three terminals after a day of entirely in-range BGsdidnā€™t prevent the stress spike. I blouses 1.5u, so hereā€™s hoping the exercise doesnā€™t kick in after another half hour. ![IMG_0143](https://canada1.discourse-cdn.com/flex030/uploads/fudiabetes/original/2X/c/cb50568fea160eae64345e8653e35a48f68e1f49.JPG) ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [December 11, 2017, 6:04pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/65 "2017-12-11T18:04:41Z")
14 posts were split to a new topic: [Comparing long-acting insulins](https://forum.fudiabetes.org/t/comparing-long-acting-insulins/2821) ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [December 11, 2017, 6:06pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/66 "2017-12-11T18:06:58Z")
14 posts were split to a new topic: [MDI: frequency and methods of injections](https://forum.fudiabetes.org/t/mdi-frequency-and-methods-of-injections/2822) ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [December 11, 2017, 6:32pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/67 "2017-12-11T18:32:32Z")
> [@Jen](#): > > so hereā€™s hoping the exercise doesnā€™t kick in after another half hour. How did it turn out? ---
**Author:** ![Jen](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/jen/32/4777_2.png) [@Jen](https://forum.fudiabetes.org/u/Jen)\ **Post date:** [December 11, 2017, 6:50pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/68 "2017-12-11T18:50:41Z")
> [@Michel](#): > > How did it turn out? I ended up using about 3.5 units to correct and rising to about 12.5 mmol/L before turning around and coming back down into range. Now Iā€™m sick with a cold (took the day off work in hopes of speeding recovery), so BGs have been insanely high (up to 22+ mmol/L) the past 24 hours. At least this time around I know why Iā€™m running high! ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [December 11, 2017, 6:51pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/69 "2017-12-11T18:51:23Z")
> [@Jen](#): > > At least this time around I know why Iā€™m running high! Soemtimes that is enough to feel good about it šŸ™‚ ---
**Author:** ![Jen](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/jen/32/4777_2.png) [@Jen](https://forum.fudiabetes.org/u/Jen)\ **Post date:** [December 11, 2017, 6:52pm UTC](https://forum.fudiabetes.org/t/changing-basals-thinking/2802/70 "2017-12-11T18:52:52Z")
> [@Michel](#): > > Soemtimes that is enough to feel good about it šŸ™‚ Yes, it makes a HUGE difference! I donā€™t mind being high (I mean, relatively speaking) if I know whatā€™s causing it. Itā€™s not knowing what causes so many of these fluctuations that I find stressful. [Previous page](https://forum.fudiabetes.org/t/changing-basals-thinking/2802.md?page=2)