On Monday I decided to go the Ghandi route and use civil disobedience to test my basal rates; ok I wasn’t making a political statement but I did need to know if my basal rates were in the right ballpark to control my base glucose levels. One of the most difficult things to manage as a juvenile diabetic is the relationship between basal rate insulin and bolus ratios. Too often the wrong bolus ratio can make one think that their basal rate is either too high or too low around meal time. The temptation to change the wrong input for the bs management system is pretty high here as altering the bolus ratio is in a lot of ways easier than adjusting the basal rate. Basal rates have two factors, time of day and units of insulin per hour, Bolus ratios only have one factor units of insulin per grams of carbohydrates at a given meal. It’s always easier to adjust a one variable function than a two variable function.
Because both basal rates and bolus ratios affect the level of my blood sugars I knew I needed to eliminate the variability one factor introduces to the system. Therefore, to remove bolus ratios from clouding my test for the accuracy of my basal rates I didn’t eat a thing on Monday until 7pm. Essentially I checked my blood sugars every half hour so I could see any movements in my glucose levels throughout the course of the day. The results of the test were actually great, I was able to identify 3 points of the day where my basal rates were off, at 2 of those points my basal rate was too low and at 1 of those points my basal rate was too high. Going forward I hope this test helps move me back to more stable glucose levels allowing me to avoid the weird high/ low flip I’ve often encountered from 3pm to 5:30 pm.
The test itself was not fun! I sat through a day of class with my stomach growling and grew more cranky by the minute. During my last class of the day my friend bet me I would be too hungry to swim that evening; by the time I got home at 6:30 pm, she was right, I was starving and had absolutely no energy to swim. I would have liked to run the basal rate test for 24 hours, but was worried that starving myself for a day would have introduced a different variable (my body releasing glucose reserves to make up for lost food) so once my tummy really started to grumble I filled it up with some black beans and chicken sausage. Although my Monday was an unpleasant experience that turned me into a hungry, hungry, hippo it was necessary to figure out what was going on with my blood sugars. Over the past two days my glucose levels have been a lot more stable and the headache I’ve had for the past two weeks has disappeared. Sometimes a little discomfort is needed to control this disease.