Friday, January 13, 2012

Basal Dance - From Complex to Simple

I am a basal hound. I fix. I ponder. I test. I set up basal patterns and name them 'Test One' in her PDM. And I sometimes let them ride. But mostly, my life as a Mama to a kiddo with diabetes is focused on the basals. Cause you know that phrase 'If Mama ain't happy, ain't nobody happy?!' then, for me, it's true that 'If the basals ain't happy, ain't nobody happy.'  Basal settings account for the foundation of the building. It's on the basals that every other setting rests.

I don't change carb ratios until I know the basals are set correctly. I don't mess with correction factors until they are set correctly. I always come back to basals.

And some times, they surprise me, how much they change as Grace is growing. When she hits these pre-puberty growth spurts, watch out! She needs boatloads of insulin overnight. And less in the wee morning hours. It's quite a thing to witness,  these 2-3-4 weeks of growth. They group themselves into periods of time, then they fade. And I wait for them to come back.

I find myself wondering how high of an hourly unit she will need each time. Our last go-round resulted in an overnight basal rate of 1.25 units. Yeah, uh, she's 9 and weighs 77 pounds.

Two days ago I basal tested, because she was dropping low at night. And I found we have stepped out of this high growth period, to a lighter state of basals.

Here is a peek into Grace's basal setting during her last period of growth. Those hormones love insulin.

12a - 2a  1.25 u/hr
2a - 4a    .80 u/hr
4a - 7a    .40 u/hr
7a - 2p    .45 u/hr
2p - 9p    .55 u/hr
9p - 11p    .90 u/hr
11p - 12a    1.00 u/hr

And here we are now. Just set two days ago. Notice the change. And the simplicity of it all.
The simplicity is what strikes me. I never have just four settings of basal rates.
I always seem to have 6 or 7.
But, it is what it is.
Girl went to bed at 145, 2am check was 130 and woke up at 7am at 120. Boo - ya.

12a - 3a    .50
3a - 8a    .35
8a - 10p    .40
10p - 12a    .50

All I do know, about my daughter, is that when the BGs start to turn high, I go back to basals. And growth hormones. And LOTS of insulin.

I may be getting the hang of this!
(And now I have totally jinxed myself, you do know that don't you?)


Diabetes311 said...

It is a constant juggling act.. isn't it? Thaks for sharing-

Amy@Diapeepees said...

Loved that you shared the basals. I'm kind of obsessed with them, myself. And, I always appreciate the insight of others on the subject.

Unknown said...

YES!! I'm the SAME WAY with basals. When basals are good, they are very very good...but when they are bad, they are NAUGHTY!!!!!!

I'm in a constant state of basal fine tuning.

During growth/whatever, we've had 10-12 basal changes in a 24 hour period before. Usually it seems that we're hanging around 6-8.

I've learned over the years to give her body what it needs, when it needs it.

I can't get hung up on the weirdness of the big basal picture or I'll go mad!!!!

k2 said...

Basals can be such tricky little suckers - Not to mention weird!!!

Anonymous said...

Q was in the low 200's ALL last weekend no matter how many times I corrected her. Corrections didn't help at all. Just when I threw my hands in the air and called the CDE to talk about basal rates, she returned to normal BG's.

I should have temporarily increased her basals, but hindsight is 20/20.

I swore it was a growth spurt. Three days later, I kid you not, five people said she looked like she grew.

Anonymous said...

Yes, you got it! Your DD is about to go through toughest growth spurt period in childhood.... puberty until approx two years after her first period. It is a rocky ride, but it does end and get easier. Put that coffee pot on nightly... In our case, the basals came down at some point in the early morning, same night so not easy to get sleep as she could crash. You sound like you have the hang of it.

Tracy1918 said...

Penny, I love this post. I was just thinking we needed to do a Naked Pancreas. Remember when Reyna did that a year ago?

Anyway, You are totally figuring it out. I agree with you on basals. Matthew has been running high in the mornings. I thought it was a ratio issue, but hadn't done a basal test in a while. Turns out he was steady, so I changed the ratio with confidence. Can't beat that.

Love you!!

Denise aka Mom of Bean said...

Basal rates kick my ass! The nights seem to be the most challenging for us...constantly in need of tweaking, it seems.
It does always seem that if the basals are right o, everything else is easier to tweak!

Alexis Nicole said...

Basals!! Why I love our pump. And why I hate diabetes ;) but when basals are good. Its goooood.

Kristin said...

We've got a ridiculous # of basals (for a growing 3 yr old)! I love seeing the simplicity - hope you guys have a smooth ride with four basals for a while!