It’s the time again-time for me to do the fun basal testing. For those non Type 1 Diabetics (T1D), basal testing is a T1D’s favorite thing ever. You have to fast for hours, hoping that your blood sugar doesn’t go too high or too low while not getting any sleep (if you are doing an overnight test) while starving. Sarcasm aside, basal testing is where you are trying to see if your hourly insulin rate (basal rate) is too high or too low. You have to fast for hours while you see how the insulin affects your blood sugar.
I say it’s that time again but really I feel like I am always trying to basal test. Every time I go to the endocrinologist they want to tweak my rates to get my A1C below-seven and since they never really spend much time analyzing my numbers, having me doing basal testing is the best way to try and make changes. I always vow after each appointment to do the basal testing but life always seems to get in the way. Well, I go back to the doctor in mid-April so I am determined to have some basal tests under my belt.
I essentially have three weeks before my appointment and I am hoping to do 2 daytime basal tests, 2 evening basal tests and 2 overnight basal tests. If I don’t have to repeat any of those, I hope to also do a mealtime bolus test and a correction bolus test. I started two days ago (Wednesday) with hopes of doing an evening basal test. For an evening basal test, I eat lunch but then skip dinner and don’t eat again until basically midnight. Before I start my basal tests, I like to eat a pretty big meal (not too many carbs though) so I don’t get too hungry while fasting. So I decided to eat some leftover baked chicken from the night before and 2 pieces of garlic bread. The garlic bread had 34 carbs in it so I under bolused slightly, giving myself 3 units of insulin instead of the 4.2 units my bolus wizard wanted me to use (didn’t bolus for the chicken). The reason I under bolused for my lunch was because I like to start my basal testing a little higher because I think I am getting too much insulin per hour so being a little higher will allow my testing to last longer (hey, it makes sense in my head). My blood sugar was a little high at lunch (209) so I did use my bolus wizard for that. I started my evening basal test with a full belly, slightly high blood sugar, anticipating it to go down as the hours passed. Unfortunately, my body did not react the way I was expecting at all. I tested my blood sugar two hours after lunch and I was 275! Despite the basal testing forms saying I should stop testing if my blood sugar goes over 250, I decided I would continue on, assuming that my blood sugar would definitely come down by four hours after lunch and then all would be good. Except my blood sugar kept climbing higher. By four hours after lunch, I was 342!! WTF?! I decided to go ahead and eat dinner and give up on my evening basal testing. Grr.
Knowing that I only have three weeks to do all of my basal testing, I decided after my evening basal testing was a bust to go ahead and do the overnight basal testing. Luckily, this worked out better. I ate dinner at 7PM and my blood sugar had managed to go down to 153.
My results for the overnight fasting:
As you can see, I stayed pretty even overall until the lovely dawn phenomenon hit. I was surprised by my results though because I have woken up many times recently with low blood sugar around 4AM. I thought for sure my blood sugar would dip more overnight than it did. I usually under-bolus for bed-time snacks because I do drop pretty low overnight but according to my testing from last night, it looks like I just need to tweak my 6AM-10AM rates. But I will wait until talking with my endocrinologist first (and a few more overnight tests to confirm).
If you are curious about how to do a basal testing, Medtronic’s website has great pdf documents to download