# Urgent question re overnight basal testing



## SilentAssassin1642 (Oct 2, 2010)

blood sugars currently 14.3  No idea how, I thought I'd carb counted dinner right

anyway

I was planning on doing an overnight basal test tonight. Can I still do it even if I've corrected now? My sheet says to do the first test at middnight or so...

brb not feeling well.


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## everydayupsanddowns (Oct 2, 2010)

I think doing it by the book (John Walsh's?) recommends that basal tests should begin with in-range bgs. 

I've had a rubbish day too. Hope we both have a better day tomorrow!
M


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## SilentAssassin1642 (Oct 2, 2010)

everydayupsanddowns said:


> I think doing it by the book (John Walsh's?) recommends that basal tests should begin with in-range bgs.
> 
> I've had a rubbish day too. Hope we both have a better day tomorrow!
> M



If I'm heding towards in-range by middnight, I think I'll do one. I've got an hour and twenty to let the insulin do its work. Something needs doing tonight, I'm not sure how much longer I can go waking up with levels over 12 

Hope you have a better day tomorrow too x


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## bev (Oct 2, 2010)

Sam,
If your levels are not within the required range for basal testing then dont do it. Its never really 'urgent' to do a basal test - its when its convenient to do it. Why do you need to do it tonight?Bev


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## SilentAssassin1642 (Oct 2, 2010)

bev said:


> Sam,
> If your levels are not within the required range for basal testing then dont do it. Its never really 'urgent' to do a basal test - its when its convenient to do it. Why do you need to do it tonight?Bev



bev, i've been waking up with levels of 12-14 most mornings and mostly with trace ketones. I want something done and sorted because i'm so close to crying yet again over this stupid blummin pump  plus, this is my only free night to do so as am not at work tomorrow, but at work monday. And I don't really want to leave it another week


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## SilentAssassin1642 (Oct 2, 2010)

14.9

oh epic 

had the same problem this morning, they just kept rising and rising before deciding to crash through the floor. what on earth is going WRONG! And why did it have to happen tonight of all nights when i actually wanted to basal test

*grumble*


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## bev (Oct 2, 2010)

SilentAssassin1642 said:


> bev, i've been waking up with levels of 12-14 most mornings and mostly with trace ketones. I want something done and sorted because i'm so close to crying yet again over this stupid blummin pump  plus, this is my only free night to do so as am not at work tomorrow, but at work monday. And I don't really want to leave it another week



Right - I see what your saying - how about testing at 12 - 3 - and 6 and seeing what your levels are and where the rise starts. If you want to post your levels in the morning I am sure we can all try to suggest changes. Ketones are fine up to 0.6 - so dont worry.Bev


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## SilentAssassin1642 (Oct 2, 2010)

bev said:


> Right - I see what your saying - how about testing at 12 - 3 - and 6 and seeing what your levels are and where the rise starts. If you want to post your levels in the morning I am sure we can all try to suggest changes. Ketones are fine up to 0.6 - so dont worry.Bev



thanks bev (she says through the tears). I'm hoping by bed they start to come down. I'm refusing to correct because I *think* dinner insulin is still kicking around, as well as the tiny teeny correction from earlier. It won't be a "true" indication but I guess it would give something of a picture?

I know *something* is going wrong overnight, but I don't really understand where. The last time I did one was oneof those random enigma nights where everything was perfect :/ 

not a problem maybe, but they still make me feel rubbish  I'd never seen anything higher than 0.1 before the other day. Got a 0.4 and may have freaked out a little... 

(I am currently in the middle of a huge rage/upsetted-ness over this whole stupid thing right now, blasted pancreas!)


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## bev (Oct 2, 2010)

Sam, 
Although your starting off high - it will be good to see what happens because it will give us an idea of how and when you rise so we can see if there is a trend going on. Could you post your levels in the morning and we can take it from there? Dont worry and take yourself off to bed - sleep will do you good and you need to set your alarm for the various times.Bev


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## SilentAssassin1642 (Oct 2, 2010)

bev said:


> Sam,
> Although your starting off high - it will be good to see what happens because it will give us an idea of how and when you rise so we can see if there is a trend going on. Could you post your levels in the morning and we can take it from there? Dont worry and take yourself off to bed - sleep will do you good and you need to set your alarm for the various times.Bev



thank you  I will totally post them in the morning, and will compare to the last one I did (bar the odd enigma night). Most nights around 3am I find myself between 11-13 :/

Alarms are set on both meter and phone. Sgonna be a loooooong night


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## Adrienne (Oct 2, 2010)

bev said:


> Right - I see what your saying - how about testing at 12 - 3 - and 6 and seeing what your levels are and where the rise starts. If you want to post your levels in the morning I am sure we can all try to suggest changes. Ketones are fine up to 0.6 - so dont worry.Bev



Hiya

I'm around tomorrow as well Bev.   

Sam don't get so stressed about it, it can be sorted.  You may find you are fine all night and it is about 5 am and those levels just go on up, it may be that simple.  Do what Bev said and test at those times only.


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## SilentAssassin1642 (Oct 2, 2010)

Adrienne said:


> Hiya
> 
> I'm around tomorrow as well Bev.
> 
> Sam don't get so stressed about it, it can be sorted.  You may find you are fine all night and it is about 5 am and those levels just go on up, it may be that simple.  Do what Bev said and test at those times only.



oh adrienne, you make it sound so simple!!! Do you know what its like though, when you just try and try with something and can never seem to get it right? Its kind of irritating me :/ 

will do that though, and fingers crossed something crops up. Am at 13.6 now, hurrah. 

Thanks guys - tears have been shed tonight, matts shoulder is a bit soggy lol but thanks for the help.


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## Adrienne (Oct 2, 2010)

SilentAssassin1642 said:


> oh adrienne, you make it sound so simple!!! Do you know what its like though, when you just try and try with something and can never seem to get it right? Its kind of irritating me :/
> 
> will do that though, and fingers crossed something crops up. Am at 13.6 now, hurrah.
> 
> Thanks guys - tears have been shed tonight, matts shoulder is a bit soggy lol but thanks for the help.



See the thing with me and Bev and the other mums, we really have no idea how you guys feels.  We feel a totally whole load of other emotions as it is our children who have this horrid condition/illness/whatever you call it.  I would love to be able to help you with emotions and of course if you are higher then you are even more emotional, it must be a nightmare for you all and I take my hat off to each and every one of you, 1's, 2's, 1.5's etc.  

We can only help you with the practical bits.  Good luck tonight.   I'm going to be up as well as Jessica seems to have a temp.  It started at 39 and now down to 37.7 or .8 ish.  She levels are fine but they went to the 20's last night so am bracing myself.


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## SilentAssassin1642 (Oct 2, 2010)

Adrienne said:


> See the thing with me and Bev and the other mums, we really have no idea how you guys feels.  We feel a totally whole load of other emotions as it is our children who have this horrid condition/illness/whatever you call it.  I would love to be able to help you with emotions and of course if you are higher then you are even more emotional, it must be a nightmare for you all and I take my hat off to each and every one of you, 1's, 2's, 1.5's etc.
> 
> We can only help you with the practical bits.  Good luck tonight.   I'm going to be up as well as Jessica seems to have a temp.  It started at 39 and now down to 37.7 or .8 ish.  She levels are fine but they went to the 20's last night so am bracing myself.



ee gads adrienne, big virtual hugs being sent your way for you and jess. Will be sending groggy silly o clock thoughts your way too 

right with the emotions coming out when high. that's when i burst into tears all over matt bless him. I don't know how he puts up with it  he gets the utter anger when I'm hypo and the tears/sadness when high. Poor bloke


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## Rainbow (Oct 3, 2010)

How did you go last night?


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## Ellie Jones (Oct 3, 2010)

Sam

Didn't see this last night otherwise Iwould have posted then..

You'll stacking your insulin when you end up crashing after running high, easy to avoid by using the IOB feature of your pump...  This will give you the active amount of insulin in the body at any one time..

What did you have for your tea? if it was high in fats this could make you insulin resident causing the high!  I don't mean chips etc, but food iteams such as high fat meats, cheeses etc..

If you did the fasting test last night, the info gained isn't sadly going to be that helpfull...  As you do really need the starting BG to be in range of what you would normally expect, also the afternoon etc to be near normal, otherwise the changes in routine etc can diguise what is really happen, with time lags ect..


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## SilentAssassin1642 (Oct 3, 2010)

Bev and Adrienne,

If i learnt anything last night, it was that doing it was the wrong idea. I was perfect all night :/ Rose a bit at 6am then down to 6.4 at breakfast (admittedly that was only about 10 minutes ago)...

I'm going to give it another go on tuesday night when we get back from london. 

Now I'm going to go and hide away from diabetes today. Having a rough time of it at the moment again but nevermind. There's ice cream in the freezer that's got my name on it. I'll catch you all soon, dunno when though.


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## Ellie Jones (Oct 3, 2010)

Sam you?ve got your answer, you going to have to basal test every night, as it seems you don?t get problems when you are testing!

If you take a look at this link http://www.diatribe.us/issues/13/learning-curve.php it will show the criteria needed for achieving a good quality basal test that produces useable data.

If you read this is explains why last nights data is really unusable, as you made corrections so this would have influenced your night time basal.  Also it shows why it isn?t a good idea to do your next night time basal test when you go to London, as you will be out of your normal routine so there will be no knowing whether any of the readings you get, have been impacted on from earlier events...  (I know that when I do any long distance driving,  that it?s not only the driving I need to adjust my pump settings, but I also have to adjust my pump over night, due to a time lag that happens over night or face a hypo)

Another tip to good basal testing, is avoid slow carbs, and high fats foods, keeping constant carb amounts for meals for several days before the basal test..  This makes it a lot easier to see what is happening with your food and then when it comes to the basal testing it?s a lot easier to see what is actually happening..

I understand that you do shifts as well, so here you need to concentrate on each shift separately building a separate profile for each shift...   I?ve managed to fine tune my profiles for work that they are actually tailored to what Kennels blocks I?m working in (so I have 3 work profiles in total)

While you collecting data, it would also be wise to keep an eye on whether you wizard perimeters are set correctly, as if you?ve used data that was fundamentally incorrect, then you?ll never going to achieve good control, as in reality a pump can only do what it is told, wizards can only calculate the information it?s given if this is out, then any calculation will be also be out..

And sadly there isn?t any fast track method of collecting the necessary information...  It?s a slow methodical collection in all the years pumping, I?ve not come across a pumper who?s gained good control using any fast track methods they?ve dreamed up!


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## Northerner (Oct 3, 2010)

Thanks for that Ellie - I have come across Gary Scheiner's site a few times and it seems to be one of those excellent guides, a bit like Jennifer's advice for the Type 2s  I'm trying to take in all I am reading about the ups and downs of pumps, should I ever get the chance of one. Reading the other posts about the pros and cons is really starting to sway my opinion, but it's useful to read of the problems that do occur and how best to deal with them (although obviously I would wish that people weren't having problems!). I'll put the link into our Newbies 'Useful Links' and also the Links section.

Sam, I hope that you get settled with the pump soon, it must be very frustrating.


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## SilentAssassin1642 (Oct 3, 2010)

I'm wondering whether to do one tonight and risk being a bit tired at work tomorrow? After all, I'm in tomorrow on a 12-8 and then off for 2 days. I just don't even know.

I'm so fed up of it. I'm not even sure how to begin working out which profile I have for a 12-8 or a 9-5 (they're the only shifts I do...).

This is pants and I'm starting to hate it.

During the day I seem to be *mostly* ok. Last nights 14 was odd...it just means I'm never having roast duck for dinner again 

Its korma tonight and I know exactly how to play that one! It might be worth just doing a couple of tests overnight tonight just to see how it goes. Unfortunately basal testing every night might be a little bit too much for me


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## SilentAssassin1642 (Oct 3, 2010)

Northerner said:


> Thanks for that Ellie - I have come across Gary Scheiner's site a few times and it seems to be one of those excellent guides, a bit like Jennifer's advice for the Type 2s  I'm trying to take in all I am reading about the ups and downs of pumps, should I ever get the chance of one. Reading the other posts about the pros and cons is really starting to sway my opinion, but it's useful to read of the problems that do occur and how best to deal with them (although obviously I would wish that people weren't having problems!). I'll put the link into our Newbies 'Useful Links' and also the Links section.
> 
> Sam, I hope that you get settled with the pump soon, it must be very frustrating.



frustrating indeed. Theres a nice body of water just around the corner that I'm tempted to introduce Florence to it :/


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## Northerner (Oct 3, 2010)

SilentAssassin1642 said:


> frustrating indeed. Theres a nice body of water just around the corner that I'm tempted to introduce Florence to it :/



Aw! Don't take it out on poor Florence! It's the diabetes that isn't cooperating and she doesn't know yet how she can help you!


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## SilentAssassin1642 (Oct 3, 2010)

Northerner said:


> Aw! Don't take it out on poor Florence! It's the diabetes that isn't cooperating and she doesn't know yet how she can help you!



ooooh, she needs to be educated quick sharp or I'm sure I can find some form of medieval torture to make her cooperate 

oooh hurrah my new sig works! ITS ALL PINK


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## Adrienne (Oct 3, 2010)

Hiya

I've heard Gary Schneider talk and will do again at Friends for Life at the end of October.  He comes over here with the USA CWD contingent.  Interesting chap.


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## Adrienne (Oct 3, 2010)

Sam, all is not lost.  You actually did test something and I would say it works very well.    The sensitivity factor, ie the correction ratio.   You corrected at the 14 odd and bingo you were ok all night so it obviously works just fine.

If you want to test tonight then test at midnight and 3 am.  That's it.

Tomorrow if you want to test, then do it at 11 pm and 2 am

Just a couple of tests.


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## Sugarbum (Oct 3, 2010)

OMG! The penny just dropped- is he the "think like a pancreas" guy?

I would love to hear a talk by him.

Great link Ellie. Im super impressed how you have 3 basal rates for work. Im also holding my head in shame that I dont! Im feeling enough shame I should do something about it....


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## Ellie Jones (Oct 3, 2010)

Didn't think that you would

Some of your problems is actually trying to create one basal that fits all, adjust it to suit a day off it doesn't fit early shift, and well afternoons leaves you a sniffling wreck..  Can you see what I'm saying?  If I tried to work in either of the kennels using my hone profile, I be decked within an hour...  If I forget to change back to my home profile, I be high as a kite by brekkie...  Making sense now?

Your home/day off will be your lead profile so you use the setting from this to set up your two other profile as a starting point...  I would at the moment concertrate on getting this home profile settled first (while at work manage with TBR's, correction dosage as best as possible in the intrim) then when it is, then sort out just one of you work profiles..  How I achieved mine, was setting a TBR using an educated guess..  Noted down what it delivered every hour (for each hour) and tested frequently to see what the effect was, using this information I tweak my settings, then see what happened, tried another tactic based on this new profile, perhaps a tweak eariler, or a TBR at certain points until I got results I wanted...

I also keep the data for each profile written down, only combining it all when I'm using the computer software, lot easier to see patterns..

It's time consuming I must admit, but it's worth it just think poor ickle florance won't get tortured nor drowned and she become your very best pal..

Never say never to duck, as once you've got the basal sorted, you can then work on your tactic to sort out the duck, I know that with some high fatty foods I eat, not only do I use a dual-wave but combine it with a subtle TBR basal as well to sort out the very extended tail end it creates..


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## SilentAssassin1642 (Oct 3, 2010)

Adrienne said:


> Sam, all is not lost.  You actually did test something and I would say it works very well.    The sensitivity factor, ie the correction ratio.   You corrected at the 14 odd and bingo you were ok all night so it obviously works just fine.
> 
> If you want to test tonight then test at midnight and 3 am.  That's it.
> 
> ...



I like that idea  just a couple of tests. I'll do the 12 and 3 tonight, 11 and 2 tomorrow. Will leave me less tired

as for the changes re shifts, i amn still mega confused :/


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## Adrienne (Oct 3, 2010)

SilentAssassin1642 said:


> I like that idea  just a couple of tests. I'll do the 12 and 3 tonight, 11 and 2 tomorrow. Will leave me less tired
> 
> as for the changes re shifts, i amn still mega confused :/



Just get your nightime sorted Sam, then worry about the shifts.  Too much too soon.   

Lots of school kids have a weekend profile and then a school day one.  On the Medtronic pump they are called patterns.   You get three.  The main one is called Standard and then you have A and B.   

Jessica however has just one which suits her for school and weekend.  Not everyone has different ones.  You may find you need to eventually due to your shifts but get your night sorted first, at least you can sleep then.


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## Ellie Jones (Oct 3, 2010)

Not quite sure which aspect of the basal profile the notion of working with or setting the actual profile in the pump part?

But this is my profile settings for part of my day,

Home 5am 0.3 6am 0.4 7am 0.5 8am 0.6 9am 0.6 10am 0.6

Work 1  5am 0.3 6am 0.2 7am 0.2 8am 0.2 9am 0.1 10am 0.1

Work 2 5am 0.3 6am 0.3 7am 0.3 8am 0.3 9am 0.3 10 am 0.3

Using these keeps my levels steady, I can flick from one profile to another miminising the adjustments/corrections at any one time...

So in your case you would create one profile to use on your day off that gives best control, then work out what your basal is up to when on an early shift to create your second, and then your late shift, then all you need to do is flick to what ever profile suits what you'll up too..

Can you see from looking at what I've done, how confusing and poor the out-come would be if I tried to cover all by using one profile...  Because the adjustment or data I collected for being up home, would cause an hypo but if I used the data from a work day, I be high as a kite on a day off..

The easist way of achieving some clarity, get the basal setting for you day off sorted, by using only information collected/tested on that day..  if you have a hypo or high in work don't use this to make any adjustments to you basal..  (that will come later) then when you settled on your day off (you will have to ignore the frustrations work control might give you)

Then you tackle the most problematic shift first, you load all you settings from you home profile (main) into profile no 2, on your pump..  

Now look at your past BG readings, from just before you go to work any in work, and try to see either a pattern or danger points of high or hypo's...  This will give you some idea at what points you may need to make adjustments to the basal on this profile...

When doing this, I don't make any changes to start with, but use the TBR to see what sort of adjustment to make then review my data to see if it worked, then make the changes to the acutal no 2, profile...  

To help keep it all as clear as possible when sorting it all out I keep all the data in separate record books, other wise one day tends to merge into another, and it isn't easy to see if the 22nd was a day off or the 23rd was either early or late shift....

If you still confused, let me know exactly which bit you are finding confusing..


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## bev (Oct 3, 2010)

Ellie Jones said:


> Not quite sure which aspect of the basal profile the notion of working with or setting the actual profile in the pump part?
> 
> But this is my profile settings for part of my day,
> 
> ...



Hi Ellie,
Sorry to butt in - but just wanted to to say - great advice and its amazing how different your home and work basals are isnt it - although it should be different - but one is a huge amount.

We have been pumping for 1 year now and still trying out new basals and ideas and it seems to change after a couple of months but I think thats probably due to growth hormones and puberty starting - something that you probably dont suffer from anymore luckily.

Out of interest what is your hba1c and how long have you been on your pump for.Bev


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## bigpurpleduck (Oct 3, 2010)

Sam,

Just wanted to say I really feel for you. I'm struggling at the moment too and can't be bothered with it anymore.

Well done for continuing with the basal tests regardless of being totally fed up. Hope you get better BG results as a reward!


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## SilentAssassin1642 (Oct 3, 2010)

bigpurpleduck said:


> Sam,
> 
> Just wanted to say I really feel for you. I'm struggling at the moment too and can't be bothered with it anymore.
> 
> Well done for continuing with the basal tests regardless of being totally fed up. Hope you get better BG results as a reward!



thanks hun  the thing is, I know if I don't keep at it i'll go back to the way i was before...and i don't really want that :/


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## Ellie Jones (Oct 3, 2010)

Hi bev

I've been using my pump now for almost 3 years, I had to battle 3 year battle to get my pump, which involved building my own medical case, of all the aspects of my diabetes that MDI couldn't control, and how pump therapy worked and would have over-come situations..  with I could have avoid that hypo as I could have done this with a pump, or if I had the pump available that high caused by stress wouldn't have happened if I could have turned my pump up etc...

My last HbA1c's was 6.7% slightly higher than I had hoped for, but sadly did go off kilter a little after losing my dad...  I'm due for another very soon, and by my reckoning this one should be around the 6% mark...

Nope no growth spurts for me, just (not) looking forward to the menopause which is not that far around the corner


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## Sugarbum (Oct 3, 2010)

Impressive HbA1c Ellie, well done! Great to read of your sucesses, but the hard work you have put into it has paid off also.


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## Ellie Jones (Oct 4, 2010)

I'm chuffed with my results, more so has I've got the spirt pump which doesn't come with the bells, whistle and wizards of the newer pumps  nor the ability to deliver a very fine dosage as the other pumps can do..  

So it's been a challange at times to over come some of the pumps failings, with how to get around the glitch of needing a 0.05 incredment, and the pump can only do a 0.5u incredment, means thinking out the box to achieve..

I do wonder what I could do if I the advanage of wizards?


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## tracey w (Oct 4, 2010)

Ellie Jones said:


> I'm chuffed with my results, more so has I've got the spirt pump which doesn't come with the bells, whistle and wizards of the newer pumps  nor the ability to deliver a very fine dosage as the other pumps can do..
> 
> So it's been a challange at times to over come some of the pumps failings, with how to get around the glitch of needing a 0.05 incredment, and the pump can only do a 0.5u incredment, means thinking out the box to achieve..
> 
> I do wonder what I could do if I the advanage of wizards?



I have the combo which indeed dpoes th 0.05 increments, dont know where id be if i could only do 0.5, that seems a lot  youo have done remarkably well and much take much effort.

You have inspired me today I have set a seperate pattern for my days off, I was using only the one. I want to really fine tune things as much as possible now.


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## bev (Oct 4, 2010)

Ellie Jones said:


> I'm chuffed with my results, more so has I've got the spirt pump which doesn't come with the bells, whistle and wizards of the newer pumps  nor the ability to deliver a very fine dosage as the other pumps can do..
> 
> So it's been a challange at times to over come some of the pumps failings, with how to get around the glitch of needing a 0.05 incredment, and the pump can only do a 0.5u incredment, means thinking out the box to achieve..
> 
> I do wonder what I could do if I the advanage of wizards?




Great hba1c Ellie.
I cant believe your pump only does 0.5 - you have done really well. Alex's pump goes down to 0.025 of a unit - we need this as he is insulin sensitive.

You must be due a new pump in a year - I bet you will be amazed with all the new gadgets that will be available when you get it.Bev


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## Ellie Jones (Oct 4, 2010)

yes it was a typo error and the mim delivery is 0.1u

yes another year before I get a replacement  I did and in many do still like the Animas 2020 which had just come out, but it was the case of the spirit or nothing without having to battle for my right to choose my pump...  But battling for 3 years for funding was enough, so excepted what was on offer...

The wizards were there when I first started to research insulin pump, and the Animas 2020 had just come out, this was the one I really wanted, but alas it was spirit or nothing, and after 3 years of battling for funding I really didn't have it in me to battle for my right of choice...

I've looked at the different wizards on the pumps, and to be honest I can't actually say whether I would or wouldn't benefit from using them...  But I do intend to have a word with my consultant when I'm in clinic in January, to see if they will up-grade my pump early just to find out..


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