Interesting Basal Test

AccuChek Aviva blood sugar of 95I have been having some problems with my blood sugar lately and thought that I should do some basal testing. I think having your basals set correctly is important for anyone – I feel it is the foundation for your control. For me it especially important because besides all the other whacky things that can screw up my blood sugar, adding food to the mix with gastroparesis can really make things unpredictable. I haven’t done basal testing for a few months so yesterday, I decided it was time and I should just do it. If you are landing here looking for more details about how to do basal testing, you can check out the article I wrote with details how to do basal testing here.

Both John Walsh and Gary Scheiner recommend starting with the basal test overnight because that is the most important period. They also break up theirs in 8 hour shifts. I prefer to do mine for a full 24 hours so that I know I don’t have any residual food screwing things up. Normally nights are not a problem for me, so depending on what is going on, I may or may not start the testing period at night. For this particular test, mornings and late afternoons were my problem areas so I decided that I would start the test first thing in the morning. Before going to bed Wednesday night, I put my Apidra pen out of reach so I would not just grab it and take my usual first dose of the morning without thinking.

Thursday morning, my alarm went off at 7, which is the time I take my first Levemir dose of the day. I tested my blood sugar and was 95. Off to a good start!

AccuChek Aviva blood sugar of 95

When I tested at 8, I was up to 112 – 17 points higher than where I started. Gary Scheiner has a 30 point plus or minus spread, so I was within that spread. In Using Insulin though, John Walsh recommends not going up by more than 15 points. Since I was only 2 points over and there is a possibility of my meter being a few points off and I have DP, I decided to keep doing the test. Before anyone says that a meter can be up to 20% off, I use the AccuChek Aviva and they perform much better than the standard 20% and I am always only a few points off when compared with an actual lab.

The morning was actually going pretty good blood sugar wise. I thought for sure that I would have to lower my morning basal a unit. So far, signs were not pointing to that happening. I had a bunch of things going on this week, so by Thursday, my energy levels were pretty zapped. Skipping my morning coffee to do basal testing didn’t help the energy levels any. Besides being tired, I wasn’t feeling great and I was freezing. Since the basal testing was going so good, I decided that it would be safe to go crawl in bed and take a nap. I tested my blood sugar one last time at 11 before crawling into bed. I saw this on my meter (sorry for the crappy picture but my camera wants fed and I am out of batteries):

AccuChek Aviva blood sugar of 94

Four hours after I started the test, I was one point different. I thought about setting my alarm for 12 but decided not to do that. My morning basal was good and I was tired so I felt I would benefit more from a nap than waking up to test my blood sugar. WRONG! I slept until a little after 2. Before reaching for my meter, I knew what I would see on my meter was not going to be good. I was soaked from sweating.

AccuChek Aviva blood sugar of 40

I really, really was not expecting that to happen. I am going to do a repeat of that test to find out exactly what time I am dropping before I change anything. If I cut back my Levemir in the morning, my mornings will run higher before they level off in the afternoon. I also want my Levemir adjusted so that if I have a situation that I can’t eat, I won’t worry about going low. This is the first time in over three years since I started doing basal testing that I ended up sitting here scratching my head over what happened.

Excel spreadsheet for basal testing

Comments

  1. Good luck with your basal testing Kelly. I know I tend to follow the way John Walsh sets up the time zones for basal testing – and usually it works okay for me – but sometimes like what happened to you with this basal test – you’ll have to redue it again to see where you are starting to drop low. That’s never been my problem with basal testing – I’m the reverse – but tend to stay within the “zone”. All I know – probably like you – I have diffferent basal settings for situations that aren’t the “norm” (what day is ever “norm” for us – actually – what non-D person doesn’t have that happening to them as well – except they have a functioning pancreas).

    I have to admit – that’s one thing I do like with the pump over MDI – the ability to pin point accurately where the prob is in the basal settings. I never did basal testing when I was on Lantus – I just did my own thing (I split the dosage against my endo’s wishes but that’s me – devil diabetic). I eventually had figured out where to adjust with MDI – and that’s when I decided to give a pump a try (with no intention of buying one – boy oh boy – was I ever wrong – right?).

    Have you ever done a test of your insulin to carb ratio? That’s something I’d like to try one day – am sure John Walsh or someone out there has written about it (and maybe you have already). First tho’ – getting basals perfected is priority before that.

    • Usually when something goes wrong with the basal test, it doesn’t go wrong that far into it. Nights seem to be going really good lately, so it seemed stupid to start there.

      I never did basal testing when I used Lantus either. I wish I had heard of it back then – maybe things would have gone better! I switched to Levemir before learning about basal testing. You are right, it is a lot easier to fix a basal problem on the pump. I think I had 7 different basal settings when I was using the pump.

      I have never tested mine officially, but since I eat the exact same foods every day, when I set my ratios, I kind of backed into them. It seems to work when I have a different food item. John Walsh does have a section on testing that in the Using Insulin book.

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