Basal Formulas
Ok, folks here are the basal rate formulas that I promised earlier:
1. Take your Total Daily Dosage, subtract 20%, divide by 2, then
divide by 24.
The concept is that you use less insulin on a pump, hence the 20%
subtraction.
Divide by two because you use half of the TDD for basal and half
for bolusing.
Divide by 24 because of the 24 hours in a day!!
2. The second formula is this: your weight in pounds multiplied by
0.1, then divided by 24.
Hope this helps everyone, & sorry about the delay, Mike
May 26th, 2006 at 11:07 pm
Thank you Mike!
Arianna
" You grow up the day you have your first
real laugh, at yourself."
~Ethel Barrymore~
May 27th, 2006 at 7:21 am
You are welcome!!!
Have a great day!!!
May 30th, 2006 at 5:08 pm
I’m curious as to how many of us have one daily basal rate? Frank, perhaps
that should be a poll.
Jan (~_^)
June 13th, 2006 at 2:47 am
As george dubbya would say "that’s fuzzy math"
Actually it’s not the math I have a problem with it’s the formula.
Personally I think your basal rate should be 70-80% of your TDD.
This works way better for me because I dont have to take these huge
boluses that can really throw me off whether I need that much or not.
I prefer smaller boluses with a heavier basal. I also have about
8 different basal setting thru the 24 day. The amount I use at 3am
certainly should not be the same as the amount I need at noon or
dinner time. I adjust my basal roughly based on my eating schedule.
-Brian
June 13th, 2006 at 2:23 pm
>>> I also have about 8 different basal setting thru the 24 day. The amount I
use at 3am certainly should not be the same as the amount I need at noon or
dinner time. I adjust my basal roughly based on my eating schedule. -Brian
>>>
Brian,
Aren’t you obligated to eat at those *set* times whether you are hungry or not
to feed the insulin being pumped into you at the times you have preset with
your basals changing? That would be taking away the freedom to eat
what/when/how much-little/if one wants. That’s why what works for one might
not work for someone else. (~_^)
June 16th, 2006 at 8:12 pm
J,
yes I am somewhat obligated to eat at certain times and loose
a little flexibility but I’m usually pretty hungry most of the
the time anyway. This is the plan that my doctor set me up with
and so far it has been working fairly well. I do have lows on
occassion but I think that’s just part of being diabetic. I am
interested in trying you formula for basal rates. Do you think
it would cut down my lows? How often do you have lows?
My biggest problem with that formula is the bolus. Such large
boluses tend to make me feel edgy and generally uncomfortable
I don’t really know how to better explain it. I just hate having
a ton of insulin pumping thru me all at once. Do you have any
clue as so what I’m talking about?
-Brian
June 17th, 2006 at 7:05 am
Brian, most of us do carb counting for meals and bolus accordingly. The idea
behind the basal is to keep an even bg level, sort of like your long acting
insulin would do before the pump.
I realize there are different methodologies, but in my humble opinion (which
anyone who is not using Humalog and
is worth what your paying for it!
counting carbs while using a pump is not getting the full benefits of it.
Patrick
The NC bluegrass pickin’ pumper
June 18th, 2006 at 8:11 am
Brian,
Do you use Humalog insulin? Is your pump trainer/CDE/endo familiar with pump
usage? It just sounds like (to me) that if your ratio is properly set, you
should have more *normal* BGs and freedom. I do believe I know what you are
talking about. There have been days I have skipped meals or have had just an
apple and a cookie for lunch (2:00 p.m.), maintaining normal BGs. Do you have
the book Pumping Insulin by John Walsh? You need not take a large bolus if you
do not plan to eat that much. That’s what’s so nice about the pump - you match
what you eat, when you, if you eat. When you are pumping the insulin in you
are obligated to match it and if you are not hungry you’ll be hitting lows.
June 18th, 2006 at 9:07 pm
<< My biggest problem with that formula is the bolus. Such large
boluses tend to make me feel edgy and generally uncomfortable
I don’t really know how to better explain it. I just hate having
a ton of insulin pumping thru me all at once. Do you have any
clue as so what I’m talking about?
>>
Hi Brian,
My name is Chrissy. Im Type I for 33yrs. Ive been pumping for about 1yr. I
dont know if this will help or not but if you werent diabetic your pancreas
would be naturally pumping alot of insulin in your body if you ate alot of
carbs. As long as your ratios are correct you dont have to be afraid. The
more carbs you eat the more insulin you bolus. Sometimes I have small bolus’
sometimes large (especially if I have a malted!). Its a natural thing. You
wont have a low unless you miscalculated. I was a brittle diabetic and yes
sometimes I still have reactions but not nearly as much since pumping. I
hope this makes sence. I would try it. But you have to decide for yourself.
Did your CDE teach you carb counting and give you insulin to carb ratios?
Chrissy
June 19th, 2006 at 8:34 am
Brian,
How is your weight? Are you gaining or overweight because you are forced to
eat to maintain your BG because of the high amount of infused basals? Many
people lose weight on the pump because they are not chasing the lows all day.
Just another thought among many.
June 21st, 2006 at 5:51 am
Jan,
my weight is fine. I get plenty of excercise which also tends
to make me crash a lot. Carb counting for me is actually quite
difficult for me because I am still in somewhat of a honeymoon
phase. My daily insulin requirement is constantly changing on me.
One day I’ll need 30units (humalog) and the next 14 depending on
how much exercise I get. Last summer before the pump I was down
to 3-5 units a day because I was running and biking almost everyday.
I doubt I could get down to that again. I’m coming out of the
honeymoon now.
I’ve decided to try your formula for a few days to see how it
goes. I’d like to elimate my lows before meals.
-Brian
June 23rd, 2006 at 1:58 am
Brian,
Being in the honeymoon phase has to make it difficult. I don’t know about
that, but I would think frequent testing would be the solution and correcting
a high if needed by the recommended dosage - not too much, but the right
amount your endo/dr./CDE prescribes for your case. That was someone else’s
formula that you are giving me credit for. If your basals are too high, you
will go low before meals. Have you tried basal fasting for several hours to
see if you remain at a *normal* level? Keep us posted.
Jan (~_^)
June 23rd, 2006 at 9:24 am
Brian, if you’re only using 14-30 units a day, that is a very low amount. I
read somewhere (and no, I don’t remember exactly where) that a person without
diabetes uses about 35-40 units a day, if on a diet that is not high carb.
Naturally, this is an average, and would depend on what was eaten.
Patrick
The NC bluegrass pickin’ pumper
June 25th, 2006 at 11:47 am
Ditto for me Patrick
Brain,
I am wondering then what you mean by large bolus???With carbo counting and my
ratio 1 unit per 10 carbos, I usally take 3 to 5 units each time I eat, not
too much at one time.? My basal rate, different from yours, I like to have
right or low, because I often "forget" to eat, until I am HUNGRY! my schedule
is so different from day to day, it is the backbone to the pump working for
me.
Bye for now, Melissa
June 30th, 2006 at 3:08 pm
Brian,
I too have issues with large boluses. Historically, whenever I take
more than 5 or 6 units I have a major reaction, regardless of how
much I eat! Therefore, I rarely take more than 5 units at any one
time, but that is gradually changing as I work the bounces and
rebounds out of my system. My "solution" is to figure my bolus, then
use a dual wave…with 5-6 units immediately and the rest over a 2
hour period. If you don’t have dual wave you can do the 2-step
substitute. Before I had the MM508, I used to take 5-6 units and
then check my bg 2 hours later and dose according to that. The big
problem with that was that my memory isn’t all that good any more.
Not to mention the long term affect on the A1C!
Of course, I think having the option of treating a high based on food
intake, with good base control would be a better option/use of the
insulin pump! That way you aren’t receiving too much insulin if you
eat light, change types of carbs, fats, etc., or move your mealtime
around a little bit. My instruction from my dr. is that if a trend
happens 2 hours after a meal change the bolus, if it is a trend
before a meal, or any other time change the basal. That made me a
lot more comfortable starting to alter my basals myself. I do baby-
step changes… 0.1 unit at a time for several days-weeks, but the
feeling of control and self-empowerment are incredible!
Suzanna
June 30th, 2006 at 11:16 pm
— In Insulinpumpusers@y…, Playmart@a… wrote:
>
> Brian, if you’re only using 14-30 units a day, that is a very low
amount. I
> read somewhere (and no, I don’t remember exactly where) that a
person without
> diabetes uses about 35-40 units a day, if on a diet that is not
high carb.
> Naturally, this is an average, and would depend on what was eaten.
Patrick…wow! I had no idea…I’d like to get my hands on that
article! I usually use between 34-41 units a day. Of course there
are ’sick’ days where I major unexplained highs, and then the others
where I run extremely low all day, but…! I guess if I can just get
my roller coaster levelled out a little, and my A1C responds
accordingly everyone will quit treating me like I’m self-destructive
with my diabetes! Oh, and maybe that’s part of the reason I’m so
sensitive to larger boluses! May be part of the reason Brian is too,
since it must not be a problem with our bodies using the
insulin ‘properly’ just a total lack of producing it.
Hang in there Brian…while I was in my ‘honeymoon’ phase, I only
took 10-12 units of combined NPH and Reg a day (of course that was
injected). I didn’t have a lot of lows, but the ones I did have were
pretty significant! Being on the pump should make it easier to adapt
to the changes (hopefully mild) that will come as your body leaves
that phase behind.
Also…is you dr. familiar with pumping? It sounds like he/she might
not fully understand the point of basals & boluses. My previous
doctor (even though he was one of the first to prescribe pumps in my
area) was still trying to get that difference down as recently as 2
years ago. It made it very difficult for me to figure out how to
make changes for myself. Anyway, if that’s the case be sure to talk
to a well trained, qualified CDE. Unfortunately I didn’t have one of
those to start either…the MM506 was just coming out and her
response to square wave was "I’ve never used it, and don’t need it,
so I don’t think you need to know about it"…she had been pumping
for 10-12 years. So I went for 3 years not knowing how to compensate
for those over-reactions to large boluses!
Suzanna
July 1st, 2006 at 9:18 pm
How in the world can they measure a non-DMer’s usage of natural insulin? I’m
assuming it’s an assumption. Someone clue me in.
July 2nd, 2006 at 1:46 am
Jan said,
>How in the world can they measure a non-DMer’s usage of
natural insulin? I’m
assuming it’s an assumption. Someone clue me in.,
Jan,
There are special tests done with an IV with glucose and an
IV with insulin called an "insulin/ glucose clamp" and a
few other mathematical calculations that can be done in a
medical research laboratory. From endocrinology medical
books in diabetes, and medical physiology books there is
information that says that an adult without diabetes can
produce 0.5 to 1.5 units of insulin per day, the average
being approximately 1.0 units per day of basal insulin. The
additional insulin will vary depending on amount of food
eaten and body weight/height, but it is usually an equal
amount, so the average is about 50/50 for endogenous
(normally produced) basal and bolus insulin.
Please be advised that I said "normal", meaning the average
person. Each individual is different.
July 2nd, 2006 at 5:46 pm
Don’t you mean ”units/hour’ rather than ‘units/day’ for your basal
numbers?
July 7th, 2006 at 11:49 am
David,
OOPS! yes, I did mean units per hour. Must have been a
senior moment. Thanks for having such a sharp eye. Now, if I
can only get the spell checker to fix what I meant to say,
instead of just the spelling and grammar.
:<)
BarbaraB.
>>Don’t you mean ”units/hour’ rather than ‘units/day’ for
your basal
numbers?<<
July 7th, 2006 at 7:41 pm
Thanks for the clarification.
My best friends wife was formerly Barbara Bradley; I doubt you are
related!
David
July 8th, 2006 at 4:04 am
>>Thanks for the clarification. My best friends wife was
formerly Barbara Bradley; I doubt you are
related! David<<
You are welcome, David.
Bradley is my maiden name. You never know who’s related
among the Bradley’s. We seem to be everywhere!
July 8th, 2006 at 3:51 pm
I LOVE it! Marj and Mike giving advice. Isn’t pumping great! Wayyyy to go, M &
Jan (~_^)
M!