These basal tests are really starting to get to me. On first glance, it feels like a carefully planned eating disorder. You skip meals, poke yourself repeatedly for blood, and then binge because you’d skipped a meal, thus throwing the rest of your day off because you are correcting your indulgence. Because diabetes management relies on discovering patterns and adjusting accordingly, each test requires at least 3 attempts per time of day. (Unless the basal rates are perfect the first go-around.)
There are four tests you can and should take: overnight, breakfast, lunch, and dinner. If the test fails by having the blood sugar go too high (over 250) or too low (under 70), you repeat the test the next day or whenever convenient to see if a pattern arises. Adjustments will be made and tests are to be repeated to try the new basal rate or to get more conclusive results.
Yesterday was my second dinner time test since before Christmas. On my first attempts, I decided to try gluten free meals for both tests I took. Bad idea. Apparently gluten free meals don’t hold the same carb breakdown as non-GF meals, so my insulin dosage at lunch sent my sugars plummeting around 3:00 pm. I was advised to eat “real” food at lunch and try the test again. (Or just food I would typically eat, rather than stuff I was experimenting with.)
On these last two tests, I tried two variations: first day was quinoa and some Indian spinach curry and cheese, second day was a plain ol’ PB sandwich on wheat. I survived my 2:00 pm and 4:00 pm checks, which means my lunch dosage is as it should be. On both days, however, precisely at 6:15 pm, my blood sugar dropped to 63 and 65 mg/dl, respectively.
A pattern! (And the test is over… I can have dinner after all.)
Not only did this tell me something was wrong with the basal rate at this time, but it also explained all of the strange issues I was having in November and December. During those months, I’d get off work at 5:00ish, go grab a Subway sandwich, and eat dinner before my 6:30 pm dance lesson. Shortly after eating my sandwich or during the lesson itself, I would plummet down to hypoglycemiaville. (Which made spinning and learning choreography that much more complicated.)
My CDE and I were trying to adjust my dinner bolus rates to account for my activity levels in the evening. Hmm. Maybe we fixed the wrong thing.
Now that we have a pattern, we’ll probably adjust. Which will then lead to another round of testing to see if the adjustments succeed.
These tests aren’t for people with active calendars. During these tests, you are supposed to keep activity, stress, high fat foods, (life), to a minimum because, as all PWDs know, anything can have an effect on blood glucose control. Never mind that you aren’t eating anything for about 8 hours straight. (Or trying to.) Since I have a lot of evening plans, explaining that I need to skip dinner three nights in a row is impossible (which is why I didn’t test during the holidays). Not doing any exercise for three nights in a row is also impossible. If you are female, you can pretty much forget testing one week out of the month.
I am still struggling with my morning rates, so there are a couple of skipped breakfasts in my future. Possibly even an overnight test because I’m not quite sure if that’s effecting my mornings. (Which equates to getting up at midnight, 2 am, and 4 am.) All in the name of science, I suppose.
As much as I hate starving myself repeatedly and the wrenches that get thrown into plans when I can’t pass, the results are quite enlightening. I just wish there was an easier way to see if you were administering the correct doses.