Temporary Basal setting, How much is too much before you reset your basal rates? Options

[susanhs]

I have had very good control with my present basal settings, but as soon as I go shopiing, take a walk, do housework (not even to mention some cardio workouts I try every once in a while) I have to set a temporary basal rate of 70-85% to keep from going too low.
I do not have a CGM.

I just looked at the Carelink daily reports which showed I used temp basal for the past 10 days from a low of 171 minutes per day to a high of 462 minutes per day. These were around the time of "movement", exercise and shopping. The highest usage was on an all-day shopping excursion, so you know it is not extreme exertion! ).
As I don't do this extended shopping sort of thing very often, I wonder how I can set my basal to use less of the temp basal..... or do some of you pumpers out there use it like I do? Is this normal?

Sometimes, though, I trend low toward bedtime, so I cut back on basal, so I can go to sleep in peace. then I eat my piece of low carb bread with cheese or ham, mostly do not bolus since my BG is ok, but do if it is high (170 or higher


I would love to do some heavy exercising on treadmill, weights, elliptical, etc, but have had a reaction to giong very low (59) afterwards, even tho I keep the temp basal for 2 hr's after exercise. My Medtronic lead person said to do this.

[Linda B]

There is no right or wrong way to do temp basals - it is completely dependent on how your body handles exercise and how it responds to the basal setting.

If what you are doing works well for you when you are shopping, and you are avoiding lows, then keep it up!

If what you are doing for heavy exercise does not work, then you need to adjust it. For some people it is important to set the temp basal one to two hours BEFORE you start exercising and then continue it for two hours after. Why not try that and see if it helps. It also may be that you need to use a lower percentage for heavy exercise.

You should be able to find a setting and timing that allows you to exercise.

Linda B.

[Marty]

I usually exercise in the afternoon after lunch. Instead of adjusting my basal rate down, I subtract 2 units from my lunch bolus for a 1-hour workout that includes cardiovascular (elliptical) and resistance training (Pilates, free weights). I make a similar adjustment to my breakfast bolus when I plan above-average exertion (hiking, shopping, gardening) after breakfast. Over the years, I've learned what kind of adjustment works for different activities. Another strategy to consider.

Marty

[GA Hiker]

For my Tuesday morning 2-hour hikes I reduce my basal by 50% beginning 2 hours before hiking until the end of the hike, I reduce my breakfast bolus, and I have a snack (usually half an apple, 15g carb) just as we start out. Even with all that, I am likely to go low during the hike unless I have some hard candies along the way.

[Dave1958]

The wide range of strategies above for accounting for exercise is interesting.
I find that walking and pulling clubs while playing 27 holes of golf requires that I reduce my basal to 40% of normal 4 hours before starting, and maintaining that rate for about 21 hours total. I can still get a little low along the way if I don't drink about 3 liters of some kind of sport drink containing a total of 168 grams of carbohydrate with no additional insulin. The same strategy works for me when I go to a gym and exercise hard for one to one and a half hours, except no carb drinks at the gym--just water. As long as I start with my blood glucose measuring above 140, I can finish between 60 and 120.
Experience is the only way I know of to zero in on my ideal correction strategy for exercise, since it won't always be the same energy usage, prior food, or digestion rate. You need to keep track of what you're doing while you're doing it.

John Walsh's book, Pumping Insulin has a good presentation of how the body reacts to exercise and how it varies with the condition of the muscles.

Dave

[TPower]

you could set a second basel pattern to use if you know your going shopping and exercising. If you do it the same time you would just set the pattern for that day and and at the end you would change it back to normal settings

[JohnG]

I have my basal set for my standard day which includes driving to work and walking short distances from my desk to the plant and other offices.

If I add and extra activity like walk 2-3 miles with my dog or wash a car then I could need to set a temp but it just really depends on what my BG level is when I start and how long the activity will last, it's not a simple decision....every day is a new opportunity that's why I use a pump and CGMS. I have tried diffrent patterns especially on weekends when I have less stress, more activity, and lower insulin requirements but nothing has worked better than just making adjustments on the fly....

This post has been edited by JohnG: Feb 23 2013, 12:12 PM

[susanhs]

I have my basal set for my standard day which includes driving to work and walking short distances from my desk to the plant and other offices.

If I add and extra activity like walk 2-3 miles with my dog or wash a car then I could need to set a temp but it just really depends on what my BG level is when I start and how long the activity will last, it's not a simple decision....every day is a new opportunity that's why I use a pump and CGMS. I have tried diffrent patterns especially on weekends when I have less stress, more activity, and lower insulin requirements but nothing has worked better than just making adjustments on the fly....

Thanks, John and everyone who has written to let me know how they handle their basals and temp basals.
I really did not know what was "normal" and will continue to do "by the hour" temp basals, (actually lasting as long as the activity last plus more for strenuous exercise).
It is my goal to set the temp basal, instead of eating to keep my BG up. I think I feel more comfortable now that I have heard from you-all.