Mostly (at least in my mind), the day revolved around this:
Sunday was our annual holiday open house at the homestead, with nearly 40 guests, a kitchen helper, and a piano player all crammed into our little house. With all of this bolus-worthy goodness in front of me, I decided before the start that I would set a temporary basal rate to help me manage the BG’sus out of my glucose.
Sometimes, I know just enough to be dangerous.
I’ve set temp basals dozens of times in the last couple of years. They always worked out well too. Set for just the right amount of insulin, just the right amount of time. Mostly for workouts, where I set the rate for an hour or an hour and a half at 0.575 units per hour. That’s a little less than half my average basal. Once in a great while, I’ll set one that’s higher than my normal basal rate because I know I’ll be eating a bit more than usual over an extended period of time. This was one of those times.
The problem is, when you’re hosting your own party, you don’t get much of a chance to graze at the buffet. And that’s where my trouble started.
Instead of eating my way through the afternoon and being helped along by my over-basalness, I was greeting people, taking coats, taking out trash, refilling drinks, but not eating. A couple of hours in, I realized I had made a mistake.
I realized I was going a bit low (spoiler alert: nothing to worry about in the long run), and I had to cancel the temporary basal rate then get something to eat. Only… all of my temporary basals had worked great before, and I never had to cancel one early. So I didn’t know how! Never even had thought about it before.
Fortunately, I found it rather quickly, right next to the option to set the temp basal. Crisis averted.
Don’t try this at home, folks. Read up on your pump settings before you start to freelance.
Comments
Eek! I use a lot of temporary basal reductions (which is part of why my endo has me reducing my overnight basal rates) and a 1 day monthly basal increase for hormones (damn girl stuff). I think it never occurred to me to use a temp basal increase for “grazzing” since there is no way I’d be able to figure out the math for my bolus. This is one of the few times my not trusting my math skills is actually beneficial! Glad you are OK & sounds like a fun. albeit busy, party!
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I have never used a temporary basal to cover food “grazing”. I’ve heard of it done before, and use temp basals to cover times of more-than or less-than normal activity, but for some reason, I can’t convince myself to use basal for food – that’s what bolus is for. Yes, a unit of insulin is a unit of insulin, no matter what you call it, but the bolus gets counted in “active” insulin (or Insulin-on-board) so you can get an idea of how much more insulin I’ve got working, so I find it a bit more useful that way — set a two-hour (or whatever) square/extended bolus for 20-30 carbs (or my best guess, which is wrong anyway), and let ‘er rip. Unfortunately, cancelling a square-wave on a Medtronic is a little more complicated than cancelling a temporary basal. (Also unfortunately, I *never* get it right with this approach).
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Scott, I haven’t read enough to feel comfortable with doing a square or extended bolus, or a dual-wave either. But you make a good point. Thanks!
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The way you wrote this was quite comical. In light of going low at least!
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