# overnight basals (again...sorry...too many questions!)



## SilentAssassin1642 (Aug 2, 2010)

Me again, sorry - just wanting to pick your brains.

So it looks like my overnight basals are a little off. After days 1 and 2 my nurse said to lower my basals from o.65 to o.55 and then on day 2 said to lower them to 0.45 between 11pm and 7am. 

So I've been waking up most night around 2/2.30 and checking and its mostly ok (somewhere between 5.6-7.0ish) but then I wake up and ithe fasting BG is above 10  as you can imagine its starting to annoy me because until I get this one right, I can't do a basal test during the morning!

My thoughts are to raise my basals from about 2am to 7am to 0.55u/h from 0.45 and just see how that goes. Obviously if I'm still waking up higher than I should I'll raise it again. It's just I REALLY want to do a basal test during the morning one day but can't until I'm waking up with good levels.

Obviously I'm going to give nursey a quick bell later on, just wanted to pick some of your brains. I love my nurse but I really think that the advice she gives isn't as brilliant as the advice of an experienced pumper


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## Freddie99 (Aug 2, 2010)

Just see what happens with your three in the morning tests and an upped basal. I've got the same problem at the moment, Going to sleep on sixes and sevens and waking up on tens. I've got to do a few days of three in the morning tests and then go from there. I hae the sneaking suspicion I may be getting too much basal. 

Tom


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## SilentAssassin1642 (Aug 2, 2010)

TomH said:


> Just see what happens with your three in the morning tests and an upped basal. I've got the same problem at the moment, Going to sleep on sixes and sevens and waking up on tens. I've got to do a few days of three in the morning tests and then go from there. I hae the sneaking suspicion I may be getting too much basal.
> 
> Tom



thanks tom

I've set it to 0.55 from 2am to 7am and I'll see what happens. I think I'm getting enough basal til I do my 2am test but then must need more from then til wake up. We'll see what happens


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## Freddie99 (Aug 2, 2010)

Sounds like a good plan you've got there. I've got to do a few day's worth of 3am tests possibly with corrections or a need to put on a temp basal. The first is tomorrow so we'll see what's going on in a few days time.


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## Rainbow (Aug 2, 2010)

think we've all been where you are at the mo isn't it frustrating. Took me a good few weeks to get my overnight levels where I wanted them. I ended up testing hourly from 3am til 7am nightly for about two weeks  to pinpoint exactly when things needed tweaking.  Not at all pleasant but as you say you can't get a grip of your daytime basals until this is stable for you. I found I needed a sharp rise in basal between 5-7am.  No doubt now I dare say I've cracked it things will change  Woke up with a 15.0 this morn for no reason so have learnt to let the rogue ones go or I'll end up going crazy looking for answers. Pumping is brill but still not perfect!  Had my 3 month pumping check up with the consultant this morn and my HbA1c is down  a wee bit further to 6.4%.  I'm chuffed its been hard work.  Keep up the good work you're doing great for such early days  Sue


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## Rainbow (Aug 2, 2010)

forgot to say my DSN works on the theory that its less frustrating if you take the day in 3 hourly blocks, less daunting than looking at the whole 24 hour picture. Get one block ok then move on.  I know we all have our own systems but it sure helped me keep my sanity in the early days!


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## novorapidboi26 (Aug 2, 2010)

When you say basal does this mean background insulin?

Think  it does.........

So my first question is how many times are you taking it.......seem like more than twice.......is that normal for a type 1?

(just clicked your on pumps)

And also on the morning readings, has the dawn phenomonon been considered? (so does the pumps tackle dawn?)

Sorry for answering questions with another question!!


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## SilentAssassin1642 (Aug 2, 2010)

novorapidboi26 said:


> When you say basal does this mean background insulin?
> 
> Think  it does.........
> 
> ...



to answer your question, I'm on a pump so I don't take background insulin at certain times anymore, I get small amounts per hour. Also, I do suffer horrifically from dawn phenomenon but not overnight, I get mine nearer to midday.


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## Freddie99 (Aug 3, 2010)

So, my three in the morning test told me I was 12.7 when I'd gone to sleep on 7.2 mmol/L. I've corrected and woke up to a 5.4 mmol/L. I've upped my over night basal from 1.15 units from midnight to 1.2 units. Hopefully that'll do it!

Tom


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## bev (Aug 3, 2010)

The best way to sort out basals it to take it in chunks. Start at midnight until 3am. Once you have got this right for 2 nights - then do the 3am to 6am and so on and so on. Remember that the 'previous' basal has a knock-on effect to the next basal - so if you dont have the right basal at midnight - then you wont get the rest right.
It is easier to do midnight basal because normally there is no food etc to mess with the levels. When you do your first midnight basal - try to have a relaxing day and eat very low carb - so that you get a 'true' picture of what is going on before you start changing things. 
This does mean lots of night testing for a couple of weeks - but it is worth it so that you are certain your basals are right. If you get your night-time basal right - then this gives you a great start for the rest of the day.

Also, remember that when you need to change a basal - you have to do it up to 2 hours before you need it. So, if you are hypo at 3am every night - you need to lower your basal from 1am for it to have an effect at 3am - hope that makes sense.Bev


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## tracey w (Aug 3, 2010)

bev said:


> The best way to sort out basals it to take it in chunks. Start at midnight until 3am. Once you have got this right for 2 nights - then do the 3am to 6am and so on and so on. Remember that the 'previous' basal has a knock-on effect to the next basal - so if you dont have the right basal at midnight - then you wont get the rest right.
> It is easier to do midnight basal because normally there is no food etc to mess with the levels. When you do your first midnight basal - try to have a relaxing day and eat very low carb - so that you get a 'true' picture of what is going on before you start changing things.
> This does mean lots of night testing for a couple of weeks - but it is worth it so that you are certain your basals are right. If you get your night-time basal right - then this gives you a great start for the rest of the day.
> 
> Also, remember that when you need to change a basal - you have to do it up to 2 hours before you need it. So, if you are hypo at 3am every night - you need to lower your basal from 1am for it to have an effect at 3am - hope that makes sense.Bev



Well said Bev, this is what i would do, I dont understand how anyone can have the same basal settings from 11 - 7, maybe the dsn just doesnt want to confuse at this early stage? My basal rate changes hourly with big differencee due to DP etc. Taking in 3 hourly blocks is the easiest way forward.


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