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Turning Down the Basal.

The Dexcom BEEEEEP!s and I swipe it off the bedside table, clicking the button to see what's up. 

62 mg/dL and an arrow pointing to the right.

(Or to see what's down.)

Morning lows can throw off my diabetes control for an entire day.  I have such a tendency to over-treat low blood sugars that it ends up thwarting my attempts at keeping things tightl.  One mild low blood sugar in the 60's can be over-treated (sometimes simply with one rogue, impulsive spoonful of Nutella chasing down the carefully calculated glucose tabs) way up into the 300's, effing up the entire day. This does not bode well for my attempts at lowering my A1C without letting that number become the average of lows and highs. 

So sometimes I dial down my basal rate when I'm experiencing mild morning lows.

This is not always the smartest move.  Low blood sugars in the morning are risky at times, the ones I drift in and out of sleep during, sometimes turning a 70 mg/dL into a tough 40 mg/dL. But armed with info from the Dexcom, I have the gist of where my blood sugars are going.  Am I low and dropping wicked fast, or have I been low for a while?  If that's the case, I'm reaching for the bottle of juice on the bedside table.  But if I'm lowish and holding steady, I'll turn my basal down to -70% for an hour and keep an eye on my blood sugar, hoping it goes up a bit in response.

It's hard to photograph the screen correctly when it's early in the morning.
My Animas Ping, changing up the basal rates

Almost 100% of the time, this dial-down works, so long as I'm not dropping fast. My basal rate for the majority of the day is 0.45u, but from 5 am - 9 am, it doubles up to 0.90u per hour.  Dialing it down when I'm holding at 60 or 70 seems to be just enough to bring me back into range without running the risk of over-treating and ending up in the 200's. 

Tweak ... tweak ... 

Could be the sound of the birds finally arriving for spring, or is it the sound of me making small, hopefully useful, adjustments to my diabetes management?  (Actually, I'll take both.)

Comments

Dude, I do the same thing. I eat breakfast about 45 minutes after I wake up (well, after I finally drag myself out of bed, anyway), so if I'm low to start, I just disconnect until breakfast or do the turn-down jig. It works for me, unless it's one of those jittery lows. Then all bets are off!

I do the same thing! As long as it's a steady drop, it'll work. Yesterday NOTHING would get my blood sugars up. I was running around 60-70 all afternoon and into the night. I completely forgot to set a temp basal, but I bet that could have worked. I'm glad to hear I'm not the only one who thinks this way!

funny i never think about dialing down for a temp basal when dropping low, but i use it when i am running high and dial it up. i should try lowering my basal, and avoiding the horrible spikes afterwards.

This is some advanced pumpology. We'll get there some day.

Would it be so terrible to treat a low with chocolate? It's Cadbury mini-egg season.

This sounds EXACTLY like my mornings lately. I guess that's the downside of getting back into shape...having to adjust basals back to pre-lazy winter levels.

Funny, I turn it down for a low (especially when I want to steal some more time in bed), but I never thought to turn it up. Today would have been a good day for it. Another thing I do is, if I know I've over-treated a low but just had to keep eating or drinking until I actually FELT results, I just bolus for the extra carbs. Doesn't anyone else do that?

12:30am and Dex sounds the alarm. 60 and level. Too tired to get up, I dial back the basal 40% for 4 hours and wake around 90. I knew what I had eaten and felt safe doing this. It doesn't always work that smoothly though.

Mornings lows aren't fun. I am not a fan of those, almost as much as I'm not a fan of middle-of-the-night lows. Usually, I go for the apple juice boxes for a quick fix. But the basal idea isn't bad, assuming I'm not already low. Might have to explore that - and temp basals overall, which are highly under-utilized on my part. I need to get on that.

I'll give this a try. Glad to know I'm not the only one who is one extra juice-correcting-swig away from a out of range bg. Sometimes I get so weary of living such a measured life, of walking such a narrow path. Fair game if I eat my way through the pantry.....but don't like being dinged for the last swig or the fourth tab. BTW.....just discovered Nutella! My life may never be the same:)

I love this concept -- I'm not a PWD, but my four year old daughter is, and managing overnight lows is one of the things I lose the most sleep over (both literally and figuratively). The one practical challenge here is that with her Animas pump I can't set a temp basal without fiddling with the actual pump rather than the remote, and in fumbling around for it while she sleeps I would probably wake her up. Then again, I have to wake her up to pump her full of sugar tablets anyway, so that's not a deal breaker, except maybe to her dentist. I'll try it.

Ah! I love this! I feel silly for not having thought of it myself yet...but we ( my daughter with T1d and I) have only been pumping for 5 months. I get so tired of feeding the insulin. Seems crazy to me to give her the insulin then give her sugar to get it back up only to send her over 200 again. I don't know how it feels, but I think that that roller coaster would not feel good.

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