Since DM has been sick and has been adjusting her basal…
…it got me to wondering about crazy basal numbers people have had.
I don’t generally go back and look at entire days, but I know I was using a lot less the past couple of days, and I took a look some of my days.
I was shocked to see that yesterday my basal for the 24 hours was only 35% of a normal day.
People talk about the 50-50% guideline for basal/bolus for a day. Yesterday my basal/bolus split was 23% basal and 77% bolus for my TDD.
My basal is not set wrong, just a few days ago I hit 100% of normal, and it worked fine. Right now it is 2:45 pm in my time zone, and I have already used more basal units in less than 15 hours today than I did the entire 24 hours yesterday.
So I was wondering, how much craziness do people see with their basal percentages from one day to the next? How much do you adjust your basal?
I stopped worrying abut 50/50 a long time ago (when I found out it wasn’t practical for Liam). He always has more bolus than basal…it ranges from 55/44 to 70/30 depending on the day of the week and what he eats.
Yeah, I don’t worry about it either. Sometimes I glance at it as a curiosity.
What kind of adjustments to you make to your basal numbers from one day to the next?
That’s what was surprising to me. I knew I was a little lower than my normal basal numbers yesterday, but I had no idea it was only 35% of my “normal” basal setting. My basal for the day averaged out to about .25 units per hour.
Our basal adjustments only occur when we’re having a problem with his fasting bg’s being too high or too low. I’d say the last time we tested and changed those numbers was probably a month ago. Of course when he’s sick, we use higher numbers as everyone has too. Once we have numbers that seem to be dialed in, we just hang on, knock on wood and enjoy the bliss while we have it.
From one day to the next, though, zero basal adjustments. We only change when necessary due to high or low BGs.
My basal is way higher than 50% because I’m eating low-carb. I also use a lot of temporary basals, either up or down, so the percentage would vary a bit from day to day.
Our basal/bolus split somehow hovers around 50/50 whenever we go to the Endo and look at our stats, but I think that’s essentially meaningless in this scenario because we’ve got me bolusing, the openAPS microbolusing, and the openAPS high temp basaling. Between all three it’s hard to figure out which elements are functioning as basal versus bolus.
I would say we change Samson’s basal settings around once every two weeks; this typically means stuff like shifting the start time of a basal change up or down an hour, shifting up or down by 0.025 units per hour, etc. It’s pretty rare to make big changes in the basal profile at this point. However, some days his TDD is 5 units per day and others it can be 15 units per day . Even with this huge range, my guess is that the bell curve for his TDD distribution is pretty narrow: between 85% and 90% of days he hovers between 8 and 10 units of insulin per day.
We rely on the openAPS algorithm, phantom carbs (i.e. logging extra or omitting carbs eaten) and low (or high) temporary targets to adjust to these differences – openAPS uses an additional feature called autosens which will automatically shift your targets and your ISF based on the last several hours. If he’s running really high we have a sick-day basal profile which is about 125% - 130% of his usual basal, but other than that, we’re really relying on the algorithm to adjust to most of these day-to-day differences. Plus the occasional sprinkling of rage bolusing when numbers are stubbornly high.
Percentage-wise, that’s kind of what I see. Some days are double other days.
Do you also have particularly high or low basal days? Not in relation to your TDD, but just in relation to your normal basal - such as 150% day? Or a day where you have used only 1/2 of what you normally use for basal, or anything like that? (not counting sick days, I know that makes them get all jacked up).
How long does your pump let you set a temp basal? Mine only lets me go to 12 hours. I wish I could set it for 24 hours.
I have yet in all my yrs used more than 30 units TDD. When I was on hflc I didn’t use more than 3-7 units per day of bolus. Now that I am swimming my TDD is anywhere from 18 - 25u/day. But I have greatly changed my diet. I think I am currently pretty close to a 50/50% split. But my basal rates will change a couple times a year so it’s not ever stagnant
Nope, I don’t seem to. On a really active day I may have a lower basal, but it’s not usually lower than about 20%. The only time my basal goes to 150% is during hormonal periods, which I think are similar to sick days in that they muck everything up and all my pump settings need adjusting. I find lowering basal tricky—even just a 30-minute suspend will cause my blood sugar to rise. I can’t suspend or disconnect for an hour without shooting skyward and high ketones. And when lowering basal for long periods of time, anything below about -20% is apt to make me rise, so I tend to stick to that. I notice it even more with Fiasp, maybe because it works so much faster for me. I can’t even disconnect for a shower without replacing the missed basal.
Mine allows for 24 hours. My old Cozmo allowed for 72 hours, which I really liked. Though I suppose at that point it’s no longer so temporary.
@Eric, between the days when my son does a lot of sports and the days when he is sick, his basal needs oscillate by about 60% (from 18 to 28 right now, going up as he bulks up).
His bolus needs vary more than his basal. Some days he only uses 7-8 units of bolus insulin, others he uses up to 45. Today, for instance, he had a hormone peak that lasted more than 4 hours and that took almost 30 units of insulin.
At these moments you always wonder if an insulin pen did not go bad. But so far they never have…
What I have noticed is that when I am active or sick my basal profile flattens out so there is no peak/valley.
Last week I was exercising a bit more (doing house renovations), so was running a -30 to -50% temp basal but would have to put it back up to -20% in the afternoon. Now that I am back to the routine I just slid back into the old basal profile without a problem.
Same think happens when I am sick - I usually run +50%.
I do not worry about %split either - it really depends on how many carbs you pack away in a day. One day last week I was 35% bolus, 65% basal. Three days before that I was 69% bolus and 31% basal.
It is just like when your Endo asks - how much insulin do you take in a day? and my response is always - “Depends on the day”
Reading about all of the exercise related BG stuff here at FUD, for the first time ever, I can honestly say that I think exercise can save lives. I swear, I am probably one of the laziest people I know (loads of energy, no love for “exercise” and running hurts like hell). Inertia is a strong force when the kitchen table and chairs are involved in my day. But I feel pretty motivated by you guys and gals here.
And I was trying to convince EH that no one he works with will object to him needing to run as a life saving measure. I mean, you wouldn’t try to stop someone from taking their heart medicine or feeding their baby, so why should exercise be looked at in a different light? If running can prolong life, I am chasing that man into running shoes and out the door every night. He enjoys running too, so that is a plus!
