DM's new basal and IC numbers

Type 1 & LADA
1

Hi DM,
From our talk today, there are a few things that struck me as being good things to change.

Let me start with posting your current numbers.

Current IC ratios:

  • Breakfast IC = 1:6.2
  • Lunch IC = 1:12
  • Dinner IC = 1:16
  • You said your dinner is generally at 6:30 pm.

Current Basal Profile:

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Look at your current basal profile. Your dinner IC is too weak, and you are covering that with a higher basal at 10pm. Yes, you can do it that way, your body does not care if you call the insulin basal or bolus, it works the same.

But for a more consistent and logical approach, I would advise

  1. Adjusting the 10pm basal down
  2. Changing your dinner IC
  3. Making your dinner bolus a dual bolus - because your dinner carbs are taking longer, since you said you spike later at night, and that is why you have been using a higher basal at 10pm to cover that spike.

Here are some initial recommendations.

New IC ratios:

  • Breakfast IC = 1:6.2
  • Lunch IC = 1:12
  • Dinner IC = 1:12

New Basal Profile:

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And for the dual bolus at dinner, do it at 75% immediate, and 25% extended for 4 hours. I looked at the numbers, and that seems like a good starting point.

You have to remember this though, or you will get messed up…

Don’t forget to do the DUAL bolus at dinner!!!

If you change your dinner IC and evening basal, but forget to do dual bolus at dinner, you will drop right after dinner and then spike later in the evening. Do not forget to make it dual!!!

Okay with all of that :arrow_up: stuff?

Next thing to add will be the higher and lower basal profiles for when you need to make changes up or down. Like after exercise or on weekends for lounging around and goofing off.

But let me stop here for now, and make sure we are on the same page with all of that stuff.

As always, please feel free to reach out to me with questions.

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Thanks Eric!!! I just made the changes in my pump. I made an enormous highlighted notation on my journal for today so that I won’t forget to do the dual bolus for dinnertime.

please tell me what you think about my lowering my TB after my swim.i usually lower it very modestly to 97% until dinner or bedtime.

looking forward to hearing back from you. am on my way to the pool in about 15 minutes.
2 hours of ZB and my BG is 81 so I would say that I am on target :ok_hand:

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So yesterday’s swim was awesome (which you can read about on my swimming thread if you’re in the mood).

at first, I turned my basal down to 97%, but soon realized that that was not significant enough, so I lowered it down to 90% and that worked out very well (at bedtime, I turned it back up to 97% for my overnight and morning. this worked well also.) before bfast, my BG was 97 and 2.5 hours after that bolus my BG was 69. I took 1 Gtab. 45 minutes later and my BG is 92.( right on target for my swim!!!)

the dinner “experiment” using the dual bolus worked out very very well. I only had one low which was minor (66). easy to correct. at 10pm my BG was 68 (which is when I turned my TB up to 97%) and then I went to sleep.

when I woke up at midnight, my BG was 92. no spikes, no lows. seamless. :ok_hand:

I can’t wait to see what happens today. I am making one minor change in my basal, as this issue has become more than just a pattern; at 12am midnight, I am lowering my basal bc at 2:30am I drop into the 40s. I only lowered the basal by .025 u/h. hopefully that will keep me from crashing at 2:30am.

oh yeah, when I get out of the pool today, I am going to do a TB of 90% (instead of just 97%) I think that should be a bit better. otherwise, all is well in the Land of Daisy Mae! :sunglasses:

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Good morning DM!

Hey, pretty good for just putting the numbers together for the first try!! That was a pretty big change to your normal routine, so those numbers sound great to me for such a big adjustment.

If the dual bolus numbers are pretty good, and the adjustment to your 10pm basal was good, the next thing will be to make the 3 profiles for you.

  • Normal
  • Higher
  • Lower

You can still do it as a temp basal if you want. Like a 4 hour 90% TB after you finish swimming. But having the 3 profiles is also another option.

Let me put them together and I will post them below.

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yeah, this surprised me in a wonderful way. how brilliant you are!!! :smiley: I suppose with all your D years of experience, something positive must come out of it!!! And what tops that is how willingly and generously you share your knowledge with so many others without hesitation :heart:

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I wouldn’t say that. Even a dumb squirrel occasionally finds a nut!
:grinning:

Here are your 3 profiles.

Normal:

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Higher - 110%

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Lower - 90%

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So please remember, that dual bolus at dinner time is important! Your evening basal will no longer be covering dinner.

The nice thing about the dual bolus for dinner is that you can cancel it if you start to drop low around 9pm or 10pm. Instead of having to do a TB in the evening, you cancel the rest of the dual. That is an easier thing, I think!

The more difficult thing is to always remember to do the dual for dinner…

So that is the trade-off. But just make a note and remind yourself of it, and once it becomes a habit, it will be easy.

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just to clarify, I changed my 12midnight basal by .025 so now it will be .525 u/h to avoid the 2am crash.

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I suppose you should also adjust your Higher and Lower profiles:

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Are you comfortable using Excel? I can sent you a spreadsheet that will make it easy to change numbers and automatically give you all the higher and lower profile numbers.

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gotcha; will do.

question: do you think I need to have such a large increase in my basal for lazy days and very active days? ALSO, my pump does not allow me to program some of these basal rates. my pump only reduces or increases basal by .025 up or down.

PS: I don’t know what EXCEL is. please can you explain it to me? Thanks!!

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Ok, sorry I did not know that. I can re-work them for you! I apologize, I did not know what their rounding amount was.

I will re-do them and re-post, so ignore the ones above.

Excel is a program that is used to make number grids, like the ones I posted above. It can use formulas to automatically calculate things for your. That is how I put those numbers together. I just didn’t know how much I could round them to, which is why I need to re-do them. My fault, not Excel’s!

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no worries. thanks for taking the time. I can barely calculate when my birthday is :crazy_face:

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Hi @daisymae,

Here ya go…

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I fixed it so updates are now easy, and they are automatically rounded to the nearest 0.025 units.

It is easy to change either the hourly rates, or the percentages now.

I can send you the spreadsheet, but if you don’t have Excel, it won’t do you any good. But I am happy to update them for you whenever, if you want me to do that.

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of course you’d make an offer like that!!! You’re ERIC (need I say more :rofl: ?)

you’re fabulous. I am programming my pump right now!!! YAY for DM!!!

**** LATER…

OK, I’m back; I just finished programing my pump. lets see where it takes us :wink:

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14

so here’s another question for ya:

what if I am eating a meal that normally requires a dual bolus (something fatty like Japanese sashimi along with some rice); how do I go about blousing for that? normally I would do a 60/40 split over 2.5 hours.

also, what if I am eating dinner at 5pm or at 8pm? how do I compensate for that meal?

eagerly awaiting your sage response.

DM

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Do you normally drop or spike right after the meal, or do you normally stay pretty flat with the 60/40 split?

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no spiking and no crashing. just nice and flat. although, sometimes I use your trick and double bolus to account for mysterious carbs so there can be some crashing involved. nothing too serious though.

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17

It looks to me like 65/35, extended for 4 hours instead of 2.5 hours will be your best bet.

As always - try it and see, adjust, repeat…

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18

Just to keep everyone in the loop, I thought that I would post this latest info of this experiment.

I have been doing the 75/25% dual bolus split now for about a week, and it has been practically flawless. isn’t that great!!! and I owe the wondrous calculations and mathematical genius to our beloved Eric, Diabetic Mastermind of the Athletic Association.

aka: DMAA :wink:

after several days of not swimming I used the elevated basal profile of 110%, and it worked perfectly. ain’t that GRAND!!!

getting ready now to leave for the pool. will post later on the swimming thread :swimming_woman:

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@daisymae
Is this what you were looking for?

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Its perfect!!!

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