# temp basal stuff



## Patricia (Jun 21, 2010)

Hello all

We always use temp basals -- high, low, whatever -- but recently have been using them quite a bit, as my son is keen on earning money and therefore doing a lot of gardening work at weekends...

This translates to loads of lows. And more lows. And lows again.

Last weekend we set him up on 50% or so, but he still had loads of lows. Sigh.

This weekend we set him on a lower temp -- 20% -- but he still had lows, unbelievably, on the Saturday.

So Sunday we changed tack: same temp, but we under-carbed all meals. This came to my husband like a light bulb turning on... IF the sensitivity to insulin is enough to warrant a major temp basal, then surely it will be enough to warrant an ad hoc change of ratio?

So we put all meals at around 75% of the 'right' carb -- and voila, no more hypos. 

We also always use a temp basal on the night of exercise, as I'm sure all do... for a school PE class, 95% does the job. Yesterday (after a run then gardening), 75% temp basal did us fine. He woke on 7.4mmols.

Just thought I'd share this. It was a bit of a revelation for us! May not work next time , but hey.

Hope everyone is well.

xxoo


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## bev (Jun 21, 2010)

Hi Patricia,

Yes we have done this too, but on the other list someone cautioned that if you are giving a lot less insulin then your more prone to higher levels with the exercise and such tiny amounts.

What we are also finding useful is to give less bolus and also taking pump off for an hour - then re-connecting and giving a small snack with a bolus (about 12 carbs) and again giving only about 60% of the bolus - then putting on temp basal for an hour and repeating process if doing lots of exercise over a few hours. It seems that for Alex he cant be off the pump for more than an hour without a dose of insulin or he goes high hours later!Bev


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## Red Pumper (Jun 22, 2010)

When I go hillwalking I find that I get the best control by reducing by basal rate to somewhere between 30-50% of my usual rate depending on how strenuous the walk is. i also reduce my bolus rate to 0.5units/10gCHO from my usual rate of 1.5units/10gCHO.
When I've finished the walk, I return to my normal basal rate but usually keep to the lower bolus rate for the meal following the walk.
I use the same sort of rationale for other long periods of exercise such as cycling or DIY.


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## Patricia (Jun 22, 2010)

Extremely useful stuff! This all makes sense. I like the idea of keeping the lower ratio for the meal following -- I can see how this would act as a 'cushion'. Great.

Bev, yes I see what you mean about small amounts of insulin and exercise... I've never thought of why that has never seemed a problem (eg E even spent six hours on 0% while walking over Easter) -- and I think it's because he's almost always eating


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## Patricia (Jun 22, 2010)

Oops, hit the wrong button -- what I meant to say is LOL. He's always eating, so always doing little boluses, so is never starved of insulin...Saying that, if we were to reduce the ratio AND be on 0%, it's CERTAINLY something to think about.

Never thought of this advantage to having a ravenous teenager!

It's SO peculiar and interesting (and frustrating) that everyone is so different -- we've never run into a problem with E being off the pump, even for two hours or so, swimming. He still fights lows afterwards, has never gone high... But I also remember that your A can tend to go high after a set change? Again, E has never done this.

Sigh.


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## tracey w (Jun 22, 2010)

If im exercising I always lower my ratio for the next meal and sometimes the next day (breakfast one)

I always disconnect pump for exercise and have a differnet basal rate not temp (dont seem to ever use this one), when i recconect for a few hours. Might be worth setting up a new basal rate for long periods of exercise?


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## Patricia (Jun 22, 2010)

Thanks Tracey -- what I *really* wish is that the medtronic could do different ratios along with different basal rates... It would be so much more direct, somehow. At the moment we are just 'under-carbing' regularly -- whatever that means -- and actually have done off and on for ages if he's 'running low'...but never very systematically. What I see from these responses is that some are doing it systematically, and this seems a good idea -- but one we have to enact *each time* -- a pain. Can you change ratios with basal rates on the Roche?

xxoo


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## tracey w (Jun 23, 2010)

Patricia said:


> Thanks Tracey -- what I *really* wish is that the medtronic could do different ratios along with different basal rates... It would be so much more direct, somehow. At the moment we are just 'under-carbing' regularly -- whatever that means -- and actually have done off and on for ages if he's 'running low'...but never very systematically. What I see from these responses is that some are doing it systematically, and this seems a good idea -- but one we have to enact *each time* -- a pain. Can you change ratios with basal rates on the Roche?
> 
> xxoo



No you cant, and this is the one thing i would change also, I have to change the units manually. I dont think it would be difficult to put in a program that lets you set up a basal rate along with ratios required. Its simple isnt it but i dont think some professionals can quite get their heads around this concept.

On my last hospital visit the nurse wanted to know my ratios for different times of day she wasnt happy that I said, well they differ depending if im working, resting, exercising etc? If its common sense to alter your basal surely its also common sense to alter your ratio. I find with small snacks i need to lower ratios too?


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## Freddie99 (Jun 23, 2010)

Patricia said:


> Thanks Tracey -- what I *really* wish is that the medtronic could do different ratios along with different basal rates... It would be so much more direct, somehow. At the moment we are just 'under-carbing' regularly -- whatever that means -- and actually have done off and on for ages if he's 'running low'...but never very systematically. What I see from these responses is that some are doing it systematically, and this seems a good idea -- but one we have to enact *each time* -- a pain. Can you change ratios with basal rates on the Roche?
> 
> xxoo



Is E on a Veo? With mine I've discovered that you can set different ratios by setting a new ratio with a new start time. That's only in the bolus wizard option mind. You first need to decide on the time period you want a certain ratio to cover then decide when you want it to stop. You the put on the other ratio you want after that. It's sort of similar to setting up a basal. 

At the moment I am being affected by the heat despite working in an air conditioned lab. I'm thinking as I'm hypoing about two to three hours after meals that I might want a new ratio. Here's hoping it isn't my basal that needs changing.


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## randomange (Jun 23, 2010)

Patricia said:


> Thanks Tracey -- what I *really* wish is that the medtronic could do different ratios along with different basal rates... It would be so much more direct, somehow. At the moment we are just 'under-carbing' regularly -- whatever that means -- and actually have done off and on for ages if he's 'running low'...but never very systematically. What I see from these responses is that some are doing it systematically, and this seems a good idea -- but one we have to enact *each time* -- a pain. Can you change ratios with basal rates on the Roche?
> 
> xxoo



Hi Patricia,

I'm on an Animas, and on that, I have my ratios set up for different times of the day as you normally would, but on the bolus wizard I can also change the ratio as I'm putting the carbs, blood glucose in etc for an individual meal/snack.  Is it possible to do that on Medtronic?

The reason I ask, is that I had no idea I could actually change it for an individual bolus until I was playing around one day!


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## tracey w (Jun 23, 2010)

randomange said:


> Hi Patricia,
> 
> I'm on an Animas, and on that, I have my ratios set up for different times of the day as you normally would, but on the bolus wizard I can also change the ratio as I'm putting the carbs, blood glucose in etc for an individual meal/snack.  Is it possible to do that on Medtronic?
> 
> The reason I ask, is that I had no idea I could actually change it for an individual bolus until I was playing around one day!



That sounds like exactly what i do with the roche pump. No big deal but would be nice to have different ratio settings pre programmed like the basal ones?


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## Cate (Jun 23, 2010)

Isn't there a way of setting an A programme and a B programme, and just swapping between the two?  Or does that only work for basals?  I thought the programmes were entirely seperate.

Not set them myself yet, as I need to do it for pre & post ovulation monthly, but having recently given birth it's not a problem just yet!  Thank goodness for breastfeeding


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## tracey w (Jun 24, 2010)

Cate said:


> Isn't there a way of setting an A programme and a B programme, and just swapping between the two?  Or does that only work for basals?  I thought the programmes were entirely seperate.
> 
> Not set them myself yet, as I need to do it for pre & post ovulation monthly, but having recently given birth it's not a problem just yet!  Thank goodness for breastfeeding



Yes just for basals. I regularly swap between programmes but would be good if you could set different ratios for the differing programmes. Sure it will happen on the new stuff coming out, or even on other pumps that we obviously dont have


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