Accidental Basal Tests
Taking advantage of mistakes and making diabetes management more convenient
By Kerri Sparling
February 2013 — As the mother of a two and a half year old, I rarely sit still. (Actually, that's a bit of a lie. After she goes to bed at night, I collapse onto the couch and sometimes stay there for a full hour, giving thought to blinking my eyelids but mostly just concentrating on appreciating the fact that I'm not doing ANYTHING.) When she's awake, we're on the go. And we go, go, GO.
During these hours of the day when she and I are hanging out, she always has breakfast. And a snack sometime around mid-morning. And lunch is usually a touch late, since we eat a later-than-average dinner as a family. And it's usually as I'm making her lunch that I realize I haven't eaten a darn thing all day long.
Sure, I'll down a cup of coffee first thing in the morning to help unstick the sleep from my synapses. But after that coffee cup is drained, and refilled, I accidentally go a few hours without eating. (Especially if I wake up and my blood sugars are in range … I'll intentionally delay breakfast just to enjoy being in range a little longer.) It's not until I'm reheating my second coffee for the third time (often forgetting the mug in the microwave and finding it there, days later) that I notice I only have basal insulin on board. And that my stomach is growling like a grizzly bear after a particularly long hibernation.
I don't unintentionally skip breakfast. I feel guilty about it all the time, especially since I'm from the "breakfast is the most important meal of the day!" generation, and I don't like getting to the point of feeling "starved" before I eat something. But there are small blessings found in my staggered mealtimes… they become accidental basal tests.
When I was on shots, I spent a few days doing basal tests now and again, as a way of fine-tuning the amount of Lantus insulin I was dosing each day, and when I was dosing it. When I switched to pumping insulin, the basal tests became even more important as I tried to nail down a basal profile that kept me at a steady blood sugar baseline throughout the day. These tests were tough for me, as feeling hunger was a strange and new feeling after so many years eating constantly throughout the day to chase the peaks of my old-school NPH and Regular insulins.
But now? I'm able to conduct an impromptu basal test just by keeping tight watch on my Dexcom graph and my blood sugar meter on those mornings when I accidentally go too long without eating. Instead of planning a morning to focus on this part of my diabetes management, I grab these moments of accidental basal testing and run with them. And when my endocrinologist asks me, "Have you done a morning basal test recently?", I can answer with confidence, "YES." I feel good knowing that I can be confident in my basal rates without dedicating a whole block of time to checking them… at least not on purpose. It's convenient to back into basal testing this way, for me. And isn't it about time something about diabetes becomes convenient?
I'll answer that with another confident "YES."
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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Playing off of a #DSMA conversation and Kerri, one of my favorite bloggers at www.sixuntilme.com, I've concocted a job description for diabetes. Wanted Immediately! Extraordinarily patient individual with high pain tolerance, ability to multitask as if their life depends upon it, must be able to keep a stable job with solid health insurance (outside of the work described herein), able to stay up late and get up early, and undeterred by constant shifts in...