Welcome back to Day 3 of Diabetes Blog Week 2012!

The topic for today is “One Thing to Improve:”

One Thing to Improve – Wednesday 5/16: Yesterday we gave ourselves and our loved ones a big pat on the back for one thing we are great at.  Today let’s look at the flip-side.  We probably all have one thing we could try to do better.  Why not make today the day we start working on it.  No judgments, no scolding, just sharing one small thing we can improve so the DOC can cheer us on!

One thing that I do need to improve is adjusting the basal rates on my pump. Basal rates are the baseline amount of insulin that my pump is programmed to deliver. They’re the little amounts of insulin I get every hour, the pump equivalent to taking a shot of long-acting insulin to maintain my bloodsugar through the day. They can be adjusted to fine-tune each person’s needs, which is what I need to improve.

It’s not as simple as just adding more here and there, or reducing them just a bit every so often. Each change should be calculated precisely so as to keep myself from being too low or too high at any point in the day. Insulin is a hormone that lasts in my* body for about 5 hours. So, to adjust the basal rate that’s affecting my bloodsugars at noon, I would have to analyze my basal rates at 7am and earlier. (*I said my body because, like food, different people metabolize insulin at different rates–thus adding to the complications of diabetes management.)

Recently, I kept waking up low, but then my bloodsugar would spike about an hour after I got up, even though I had determined that I wasn’t over-treating the low (a.k.a. eating too much). After uploading my CGM data to my computer and verifying when the drops and inclines were happening, I actually ended up increasing the amount of insulin I received in the early morning hours, while decreasing it in the late evening. The process of fine-tuning my morning basal rates took a few tries over a week or so until I finally got it to work decently. But it caused another problem… Since I made that adjustment, I’ve been having more mid-to-late-afternoon lows than I was. Now what? It’s time to adjust those basals again! In the meantime, I’ve been stocking up on juice and granola bars for my afternoon snack.

As you might guess, basal adjustment is an on-going process, and I need to get better at keeping up with my body’s needs!