Overnight Basal Testing Joy

We started using Apidra in Grace's OmniPod last week. I know some changes needed to happen, we were 'striking the spike' mightily, not getting high after eating, but we were also having some lows from overcorrecting the highs. But, as with all things, diabetic and otherwise, first things first. So, before I start adjusting things willy-nilly, I needed to get some basal testing in.

Overnight basal test last night. Trying to figure out what happens and why BGs shoot up around midnight - 2 am with this new Apidra. Something needs to be adjusted in her basals. So, I thought I would show you what I do to figure it all out.

She ate dinner and had her last bolus about 5 pm. That gave the go ahead for the overnight basal test to begin about 8 pm, and then be checked every 2 hours. I abide by Gary's rules for basal testing - stay within the 80-250 range and once she either dips low, below 80, or goes above 250, stop the test and treat. He has some great information about basal testing here and here. (Lots of info on it in his book Think Like A Pancreas too, which is coming out in a 2nd revised and updated edition in December 2011!)

Here's how it all went down last night:

8 pm - 106
10 pm - 95
12 am - 144
2 am - 213
9 am - woke up - 141

Got my information! She rose the greatest from 12 am - 2 am, but also had a rise from 10 pm - 12 am.
I write it all down and start my math to make sense of it.

8 pm to 10 pm = decrease of -11 (slight decrease, but I am looking for a 30 point jump up or down)
Keep the rate at this time the same

10 pm to 12 am = rise of +49 points (over the 30 point rise that is the parameter)
Raise her basal rate from 9 pm to 11 pm by .5

12 am to 2 am = rise of +69 points (whoa! way over the 30 point rise parameter)
Raise her basal rate from 11 pm to 1 am by .5 to begin with, then 1.0 if needed

So, then I go back to what her basal rates were when we conducted this test:

12 am - 2 am  .50
2 am - 8 am    .40
8 am - 10 pm  .55
10 pm - 12 am  .60

And I adjust accordingly:

12 am - 2 am  increase to .55
2 am - 8 am   keep at .40 (while the rising BG of 141 is above my liking, school will be starting next wk)
8 am - 11 pm  keep at .55, but lengthen the time to 11 pm instead of 10 pm
11 pm - 12 am  increase to .65

This is what it looks like in my log book. Hey, no judgements.

So, the real test is to try and test drive these new overnight basals. Then I will switch to a morning basal test, then a late afternoon/dinner one. Once I get these done, I will then look at I:C ratios once more and correction factors.

Just thought I would fill you in on how I do it. As always, I'm not a doctor, I don't play one on TV, I do know some doctors, but you should always consult yours or your kiddo's before you change anything.