Tweak Problems

for example, this morning

for example, this morning

Bigfoot attempt fix basal program via increasingly ridiculous series micro-tweaks. Pretty sure problem is midnight basal. Most recent adjustment series:

DAYS 1 – 5

took me a while to notice the pattern

0.5 u/hour 12AM/3AM —> (Dzzzt dzzzt! HIGH) @4AM

DAYS 6 – 7

increase by tiniest increment

0.525 u/hour 12AM/3AM –> (Dzzzt dzzzt! LOW) @4AM

DAYS 8 – 9

shorten duration of tiny increase

0.525 u/hour 12AM/2AM, then 0.5 u/hour 2AM–> (Dzzzt dzzzt! LOW) @4AM

 DAY 10

shorten duration even more

0.525 u/hour 12AM/1AM, then 0.5 u/hour 1AM–> (Dzzzt dzzzt! LOW) @4AM <–Today. Pictured. Pffft. Tonight, plan is try again w. original 0.5 u/hour 12AM/3AM. Seems like stupid game, not really want play anymore, always forget point is health.

Yesterday TCOYD. Three favorite things:

  1. Dr. Steven Edelman use up escalator for descent. Narrowness escalator allows good use hands/arms on railings; Dr. Edelman move like gymnast parallel bars, only downhill. Frustrated building security man “Excuse me, sir!” “EXCUSE ME, SIR!” then give chase—but give chase via crowded single-file down escalator, all the while excuse me sir, excuse me sir!, but trapped on crowded single-file escalator. Dr. Edelman complete unfaze, disappear into crowd; unclear if even realize rule broken
  2. Glucolift inventor Christopher share fabulous Japanese pens! (Also this news: each cherry Glucolift tablet now engraved w. rocket icon)
  3. Dr. Jeremy Pettus’s video paean wee hours Dexcom.


  1. type1dmom · September 22, 2013

    How incredibly frustrating. At least you have the dex to “help” you. I am going to be talking to my 10 y/o’s endo on Thursday about getting CGM and also starting more independent settings adjustments (big deal for us. We’re six months into T1 and only 2 months into pumping, but I feel ready).

    I also just wanted to say THANK YOU for posting about TCOYD. I was not aware of this organization and we are only 2 hours or so from San Diego. I think I might try to make it to the next conference in November. <3ing the DOC this afternoon.


  2. Mary M · September 22, 2013

    Try changing earlier basal? Like increasing from 10 pm to 1 am? It looks like he was pretty high at 10 pm.
    Just an idea off one Dex day.
    And of course, not medical advice, yada yada, because my only qualification is taking care of one CWD and yours is completely different…


    • Scott E · September 22, 2013

      I’d agree with Mary — the descent was already in progress by midnight, so a 10pm basal adjustment might be better. Remember, your goal in basal-tuning is to flat-line, not to reach a particular target at a particular time. Once you’ve got that accomplished, the meals and boluses will determine the actual levels (I know, easier said than done.)

      What is the basal rate at that time, by the way? For what it’s worth, my midnight-to-4:30am basal is 0.5 u/hr, the two hours preceding it (10pm-mid) is 0.4, and from 5:30pm to 10pm is 0.35. The gradual increase reflects the gradual decrease in activity as I get ready for – and go to – bed. His diabetes may (and probably does) vary, as he doesn’t chase after two rugrats in the evening hours, but there may be some similarities.


      • Katy · September 22, 2013

        So if I reduce the basal at 10PM, and he flatlines at, say, 150…the next night can I keep the basals the same but add a tiny correction so he’ll flatline closer to 120? I mean, I know it won’t actually work that way, but is that the idea?


      • Katy · September 22, 2013

        Did I ever know this? I am flummoxed.


      • Scott E · September 22, 2013

        Exactly. And if you really play it right, you won’t even need that correction down from 150.

        But like you said, it won’t actually work that way — it’s the thought that counts. But getting proper basals are about figuring out how much insulin is needed to maintain a constant BG (not counting any effects from meals or boluses, which is why the “true” basal testing involves not eating — and is why I don’t do it).


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