# Adjusting Basal rates - What's the rationale...



## Alzibiff (Jan 3, 2010)

.... behind John Walsh's instruction: "If your blood sugar falls more than 1.7mmo;/l during a basal test....Lower the basal rate at least 4 to 8 hours before the time at which the low occurred." ?

I am refering to the text in the "Pumping Insulin" book by John Walsh which has had great reviews on this and other forums. The "basal test" is when you measure BG levels on a regular basis (every hour for example), five hours or so after any food and insulin intake in order to gauge whether your basal insulin is appropriate. (Over the period of the test, you take no insulin, no food and aim for no more than a 1.7mmol/l change in your blood glucose level.

I would have thought that adjusting the basal rate, (down or up - the same advice applies), *4 to 8 hours *prior to any low or high BG reading would be far too early and that 2 hours would be a more appropriate time. The duration of insulin action may well last 4-8 hours but isn't  the insulin delivered 2 hours prior to any high or low likely to be of more significance? (During my basal tests I have always used the 2 hours figure).

It's just that John Walsh talks a lot of sense in his book and must have some justification for his 4 to 8 hours direction - I can't see this being out of date  because newer and quicker acting insulins have come on the scene since his book was written.

Anyone any ideas?

Alan


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## tracey w (Jan 21, 2010)

I always change my basal rate two hours prior to when i want the action to change, ie lower or higher bg.


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## Viki (Jan 21, 2010)

tracey w said:


> I always change my basal rate two hours prior to when i want the action to change, ie lower or higher bg.



2 hours has worked pretty well for me too. Mainly in battling higher peaks though.


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## Adrienne (Jan 21, 2010)

Hi Alan

Makes no sense to me so have asked on the childrens support group where there are some truly great minds and they all read John Walsh (seems to be just me who hasn't) 

I'll let you know if I get any replies.


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## Alzibiff (Jan 22, 2010)

Thanks all. I posted my question on John Walsh's site some weeks ago but as yet it has not been answered. (It appears to me only as a question "awaiting moderation" (or words to that effect).

Alan


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## Adrienne (Jan 22, 2010)

Well no-one has the answer to this.   The few that answered me said they all tweak their basal 2 hours before the change is needed.

But one mum did say that after reading the same bit as you she did do that and tweaks 4 to 6 odd hours beforehand and it seems to work for her.

Bizarre.   Not much further forward really.


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## bev (Jan 22, 2010)

Adrienne - we can ask him at the FFL!Bev


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## Adrienne (Jan 22, 2010)

Oh yes.    For those that read the thread I started a week or so ago about the Friends for Life conference that I'm going to and Bev Ragnar Hanus is going to be there this time and will be doing a talk, apparently he is excellent.

How exciting is that


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