Basal Rate Worksheets

v09/06/05
Pump Setup: Fine-Tuning Basal Rates
This worksheet will assist you in testing your pump settings and making small adjustments to ensure that you are getting the most from your insulin pump. Wait to begin these tasks until you are comfortable wearing the pump and performing all of the functions associated with it. Accomplishing the goals in this worksheet takes quite a bit of effort, so choose a time when you have several days in a row to dedicate to strict blood sugar testing and meal schedules. In order to test your basal rates, follow the steps in the following three sections. The goal is for your blood sugar to stay within 30 mg/dl (1.7 mmol/L) of your target blood sugar over the period of each test. Be patient with the process, it may take quite a number of days to determine the basal rates that are right for you. To test your basal rates it will be important that you keep all other variables as constant as possible during the days you are performing the tests. Choose a time to do these tests when you can do the following: Eat meals for which you can easily determine the correct bolus. Do not eat high fat foods, as the correct bolus is more difficult to determine since those foods may have an extended effect on your blood sugar. Do not participate in strenuous exercise on the days you are performing the basal rate tests unless it is exercise that you do everyday. If you have an illness or infection, do not perform these tests. Write down all blood sugar values and keep very good notes so that we can evaluate the results of the tests with you, if you need help.
YOU
ARE WELCOME TO HAVE US REVIEW YOUR RESULTS WITH YOU. CONFIDENCE, FEEL FREE TO MAKE THESE ADJUSTMENTS ON YOUR OWN.
HOWEVER, IF YOU HAVE THE Basal rates should be checked at least a couple of times per year, and more often when your blood sugars seem to be unstable. While we will not go into specifics here, you may need to set and verify different basal rates depending on what shift you are working, whether you exercise or not, and for the ladies based on the phase of the menstrual cycle. If you can go without eating two meals in a row, for instance the bedtime snack and breakfast, you can do two steps of the basal checks together. Thus, for instance, you can merge the overnight and morning basal rate checks. Most of you will, however, want to take one step at a time.
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Copyright CMSA 2005
v09/06/05
THE OVERNIGHT BASAL RATE. The first basal rate to check is the overnight rate. When this basal rate is set correctly, the pump will compensate for any increase in the early morning blood sugar or Dawn Phenomenon. It is best to check the morning, afternoon and evening basal rates after the overnight basal rate is set correctly. Perform this test when your blood sugar before your evening meal is between 70 and 200 mg/dl (3.9 11.2 mmol/L). Follow these instructions. A worksheet is provided on the following page to assist you in performing this test. 1. Record your current basal rates in the spaces provided. 2. Eat a dinner with a known number of grams of carbohydrate. Try to eat at least 4 hours before you plan to go to bed. Give a meal bolus that matches the grams of carbohydrate you are eating AND use your correction factor if your blood sugar is out of your range. 3. DO NOT EAT AFTER DINNER AND DO NOT EAT A BEDTIME SNACK, EVEN IF YOU USUALLY LIKE TO HAVE ONE. 4. Test at bedtime. If your blood sugar is between 100 and 250 mg/dl (5.6 13.9 mmol/L), continue the test. The goal is to observe your blood sugar values to determine where your basal rate needs adjusting. If your blood sugar is lower than 100 mg/dl (5.6 mmol/L), stop the test and treat the low blood sugar and / or eat a snack. If your blood sugar is higher than 250 mg/dl (13.9 mmol/L), stop the test and follow high blood sugar guidelines. If you have to stop here, try again another day, but if you dont get past this point in 2 4 tries, get in contact with us so we can help you. 5. Test again about 4 5 hours after going to sleep, around 2 - 3 AM for most people. As long as your blood sugar is between 90 and 250 mg/dl (5 - 13.9 mmol/L), continue the test. If your blood sugar is lower than 90 mg/dl (5 mmol/L), stop the test and treat the low blood sugar / eat a snack. If your blood sugar is higher than 250 mg/dl (13.9 mmol/L), stop the test and follow high blood sugar guidelines. If you have to stop here, get in contact with us about an adjustment in your basal rate based on this information. IF YOU OVERNIGHT BASAL RATE PROVES PARTICULARLY DIFFICULT TO ADJUST, WE MAY ASK YOU TO CHECK TWO OR EVEN THREE TIMES DURING THE OVERNIGHT PERIOD FOLLOWING THESE SAME RULES, BUT THIS IS UNCOMMON. 6. Test when you wake up, take your breakfast bolus plus any necessary correction bolus and eat breakfast. This concludes the overnight basal rate check. 7. Get in contact with us to discuss your blood sugar values and make adjustments in your basal rate. Record the basal rate adjustment in the space provided in the table. 8. Repeat the overnight basal rate test again until your blood sugar values do not fluctuate more than 30 mg/dl (1.7 mmol/L) during the test and then repeat it one more time to confirm the results. Because you are not a machine, it may NOT be possible to achieve this ideal overnight sugar pattern. Do not let that frustrate you, we will together come close!
Copyright CMSA 2005
v09/06/05
Overnight Basal Rate Worksheet

Test 1 Date ________ Before Dinner
Check your blood sugar. If outside the range 70 200 mg/dl (3.9 11.2 mmol/L), stop the test and try again another night. If in range, take your carbohydrate based insulin and correction, and eat your dinner. Do not eat again after dinner.
Test 2 Date ________
BLOOD SUGAR Test 3 Test 4 Date Date ________ ________
Bedtime (Do not eat a bedtime snack!)

Under 100 mg/dl (5.6 mmol/L)? Stop test and treat low / eat a snack. Over 250 mg/dl (13.9 mmol/L)? Stop test and follow high blood sugar guidelines. If you stop here, try test again another night.
Overnight 1 (usually 2-3 AM: _______)

Under 90 mg/dl (5 mmol/L)? Stop test and treat low / eat a snack. Repeat test again tomorrow night with an adjusted basal rate. Over 250 mg/dl (13.9 mmol/L)? Stop test and follow high blood sugar guidelines. Repeat test again tomorrow night with adjusted basal rate.
Overnight 2 (time _______)

Overnight 3 (time _______)

Before Breakfast (Eat breakfast!)

The test ends here. Take breakfast bolus and any necessary correction bolus. Contact your healthcare provider for your basal rate adjustment.
Current
BASAL RATE ADJUSTMENTS (units / hour) After Test After Test After Test 1 2 3
_______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______
After Test 4
_______ _______ _______ _______ _______ _______ _______ _______ _______
After Test 5
_______ _______ _______ _______ _______ _______ _______ _______ _______
Basal Rate #1: Start Time: 12AM u/hr____ Basal Rate #2: Start Time: _____ u/hr____ Basal Rate #3: Start Time: _____ u/hr____ Basal Rate #4: Start Time: _____ u/hr____ Basal Rate #5: Start Time: _____ u/hr____ Basal Rate #6: Start Time: _____ u/hr____ Basal Rate #7: Start Time: _____ u/hr____ Basal Rate #8: Start Time: _____ u/hr____ Basal Rate #9: Start Time: _____ u/hr____
Copyright CMSA 2005
v09/06/05
THE MORNING BASAL RATE Perform this test when your blood sugar before your evening snack is between 70 and 200 mg/dl (3.9 11.2 mmol/L). 1. Record your current basal rates in the space provided. 2. Test at bedtime and eat a bedtime snack with a known number of grams of carbohydrate. Give a meal bolus that matches the grams of carbohydrate you are eating AND use your correction factor if your blood sugar is out of your range. Eat a bedtime snack even if you do not usually do so you will be missing breakfast! 3. Test again about 4 5 hours after going to sleep, around 2 - 3 AM for most people. As long as your blood sugar is between 90 and 250 mg/dl (5 - 13.9 mmol/L), continue the test. If your blood sugar is lower than 90 mg/dl (5 mmol/L), stop the test and treat the low blood sugar / eat a snack. If your blood sugar is higher than 250 mg/dl (13.9 mmol/L), stop the test and follow high blood sugar guidelines. If you have to stop here, try again another day, but if you dont get past this point in 2 4 tries, get in contact with us for help. 4. Test in the morning. If your blood sugar is between 70 and 250 mg/dl (3.9-13.9 mmol/L) continue the test and DO NOT EAT BREAKFAST! If your blood sugar is lower than 70 mg/dl (3.9 mmol/L), treat the low and stop the test. If your blood sugar is higher than 250 mg/dl (13.9 mmol/L), stop the test and follow high blood sugar guidelines. If you have to stop here, you may eat breakfast. You should try the test again another day, but if you dont get past this point in 2 4 tries, get in contact with us so we can help you. 5. Test every two hours until lunchtime. If your blood sugar is between 70 and 250 mg/dl (3.913.9 mmol/L) continue the test. The goal is to observe your blood sugar values to determine where your basal rate needs adjusting. If your blood sugar is lower than 70 mg/dl (3.9 mmol/L), treat the low and stop the test. If your blood sugar is higher than 250 mg/dl (13.9 mmol/L), stop the test and follow high blood sugar guidelines. If you have to stop, get in contact with us about an adjustment in your basal rate based on this information. 6. At lunchtime, test your blood sugar, take your lunch bolus plus any necessary correction bolus and eat lunch. This concludes the morning basal rate check. 7. Get in contact with us to discuss your blood sugar values and make adjustments in your basal rate. Record the basal rate adjustment in the space provided. 8. Repeat the morning basal rate test again until your blood sugar values do not fluctuate more than 30 mg/dl (1.7 mmol/L) during the test and then repeat it one more time to confirm the results. Because you are not a machine, it may NOT be possible to achieve this ideal overnight sugar pattern. Do not let that frustrate you, we will together come close!
Copyright CMSA 2005
v09/06/05
Morning Basal Rate Worksheet

Test 1 Date ________ Before Bedtime
Check your blood sugar. If outside the range 70 200 mg/dl (3.9 11.2 mmol/L), stop the test and try again another night. If in range, take your carbohydrate based insulin and correction, and eat your bedtime snack.
Overnight (usually 2-3 AM: _______)

Under 90 mg/dl (5 mmol/L)? Stop test and treat low / eat a snack. Start test again tomorrow night with an adjusted basal rate. Over 250 mg/dl (13.9 mmol/L)? Stop test and follow high blood sugar guidelines. If you stop here, try test again another day.
Upon Waking Up (Do not eat breakfast!) Under 70 mg/dl (3.9mmol/L)? Treat
low and stop test. Over 250 mg/dl (13.9 mmol/L)? Stop test and follow high blood sugar guidelines. If you stop here, try test again another day.
2 Hours After Waking Up

Under 70 mg/dl (3.9mmol/L)? Treat low and stop test. Over 250 mg/dl (13.9 mmol/L)? Stop test and follow high blood sugar guidelines. Repeat test again tomorrow with adjusted basal rate.

Same instructions as at 2 hours.

Before Lunch (Eat Lunch!)

The test ends here. Take dinner bolus and any necessary correction bolus. Contact your healthcare provider for your basal rate adjustment.
Current
_______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______
After Test 4
_______ _______ _______ _______ _______ _______ _______ _______ _______
After Test 5
_______ _______ _______ _______ _______ _______ _______ _______ _______
Copyright CMSA 2005
v09/06/05
THE AFTERNOON BASAL RATE Perform this test when your blood sugar before your breakfast is between 70 and 200 mg/dl (3.9 11.2 mmol/L). 1. Record your current basal rates in the space provided. 2. Eat a breakfast with a known number of grams of carbohydrate. Give a meal bolus that matches the grams of carbohydrate you are eating and use your correction factor if your blood sugar is out of your range. 3. Test at lunchtime. If your blood sugar is between 70 and 250 mg/dl (3.9-13.9 mmol/L) continue the test and DO NOT EAT LUNCH! If your blood sugar is lower than 70 mg/dl (3.9 mmol/L), treat the low and stop the test. If your blood sugar is higher than 250 mg/dl (13.9 mmol/L), stop the test and follow high blood sugar guidelines. If you have to stop here, you may eat lunch. You should try the test again another day, but if you dont get past this point in 2 4 tries, get in contact with us so we can help. 4. Test every two hours until dinnertime. If your blood sugar is between 70 and 250 mg/dl (3.913.9 mmol/L) continue the test. The goal is to observe your blood sugar values to determine where your basal rate needs adjusting. If your blood sugar is lower than 70 mg/dl (3.9 mmol/L), treat the low and stop the test. If your blood sugar is higher than 250 mg/dl (13.9 mmol/L), stop the test and follow high blood sugar guidelines. If you have to stop, get in contact with us about an adjustment in your basal rate based on this information. 5. At dinnertime, test your blood sugar, take your dinner bolus plus any necessary correction bolus and eat dinner. This concludes the afternoon basal rate check. 6. Get in contact with us to discuss your blood sugar values and make adjustments in your basal rate. Record the basal rate adjustment in the space provided. 7. Repeat the afternoon basal rate test again until your blood sugar values do not fluctuate more than 30 mg/dl (1.7 mmol/L) during the test and then repeat it one more time to confirm the results. Because you are not a machine, it may NOT be possible to achieve this ideal overnight sugar pattern. Do not let that frustrate you, we will together come close!
Copyright CMSA 2005
v09/06/05
Afternoon Basal Rate Worksheet

Test 1 Date ________ Before Breakfast
Check your blood sugar. If outside the range 70 200 mg/dl (3.9 11.2 mmol/L), stop the test and try again another day. If in range, take your carbohydrate based insulin and correction, and eat your breakfast.
Lunchtime (Do not eat lunch!)

Under 70 mg/dl (3.9mmol/L)? Treat low and stop test. Over 250 mg/dl (13.9 mmol/L)? Stop test and follow high blood sugar guidelines. If you stop here, try test again another day.
2 Hours After Lunchtime

Under 70 mg/dl (3.9mmol/L)? Treat low and stop test. Over 250 mg/dl (13.9 mmol/L)? Stop test and follow high blood sugar guidelines. Repeat test again tomorrow with adjusted basal rate.


Before Dinner (Eat Dinner!)

The test ends here. Take dinner bolus and any necessary correction bolus. Contact your healthcare provider for your basal rate adjustment.
Current
BASAL RATE ADJUSTMENTS (units / hour) After Test After Test 2 After Test 1 3
_______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______
After Test 4
_______ _______ _______ _______ _______ _______ _______ _______ _______
After Test 5
_______ _______ _______ _______ _______ _______ _______ _______ _______
Copyright CMSA 2005
v09/06/05
EVENING BASAL RATE Perform this test when your blood sugar before your lunch is between 70 and 200 mg/dl (3.9 11.2 mmol/L). 1. Record your current basal rates in the space provided. 2. Eat a lunch with a known number of grams of carbohydrate. Give a meal bolus that matches the grams of carbohydrate you are eating and use your correction factor if your blood sugar is out of your range. 3. Test at dinnertime. If your blood sugar is between 70 and 250 mg/dl (3.9-13.9 mmol/L) continue the test and DO NOT EAT DINNER! If your blood sugar is lower than 70 mg/dl (3.9 mmol/L), treat the low and stop the test. If your blood sugar is higher than 250 mg/dl (13.9 mmol/L), stop the test and follow high blood sugar guidelines. If you have to stop here, you may eat dinner. You should try the test again another day, but if you dont get past this point in 2 4 tries, get in contact with us so we can help. 4. Test every two hours until bedtime. If your blood sugar is between 70 and 250 mg/dl (3.9-13.9 mmol/L) continue the test. The goal is to observe your blood sugar values to determine where your basal rate needs adjusting. If your blood sugar is lower than 70 mg/dl (3.9 mmol/L), treat the low and stop the test. If your blood sugar is higher than 250 mg/dl (13.9 mmol/L), stop the test and follow high blood sugar guidelines. If you have to stop, get in contact with us about an adjustment in your basal rate based on this information. 5. At bedtime, test your blood sugar, take your bedtime snack bolus plus any necessary correction bolus and eat your bedtime snack. This concludes the evening basal rate check. 6. Get in contact with us to discuss your blood sugar values and make adjustments in your basal rate. Record the basal rate adjustment in the space provided. 7. Repeat the evening basal rate test again until your blood sugar values do not fluctuate more than 30 mg/dl (1.7 mmol/L) during the test and then repeat it one more time to confirm the results. Because you are not a machine, it may NOT be possible to achieve this ideal overnight sugar pattern. Do not let that frustrate you, we will together come close!
Copyright CMSA 2005
v09/06/05
Evening Basal Rate Worksheet

Test 1 Date ________ Before Lunch
Check your blood sugar. If outside the range 70 200 mg/dl (3.9 11.2 mmol/L), stop the test and try again another night. If in range, take your carbohydrate based insulin and correction, and eat your lunch.
Dinnertime (Do not eat dinner!)

Under 70 mg/dl (3.9mmol/L)? Treat low and stop test. Over 250 mg/dl (13.9 mmol/L)? Stop test and follow high blood sugar guidelines. If you stop here, try test again another night.
2 Hours After Dinnertime

Under 70 mg/dl (3.9mmol/L)? Treat low and stop test. Over 250 mg/dl (13.9 mmol/L)? Stop test and follow high blood sugar guidelines. Repeat test again tomorrow night with adjusted basal rate.


Bedtime
The test ends here. If you would like a snack, take a snack bolus and any necessary correction bolus. Call your healthcare provider for your basal rate adjustment.
Current
_______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______ _______
After Test 4
_______ _______ _______ _______ _______ _______ _______ _______ _______
After Test 5
_______ _______ _______ _______ _______ _______ _______ _______ _______
Copyright CMSA 2005

Basal Rate Worksheets

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v09/06/05

Pump Setup: Fine-Tuning Basal Rates

Copyright CMSA 2005

Copyright CMSA 2005

Overnight Basal Rate Worksheet

Test 2 Date ________

BLOOD SUGAR Test 3 Test 4 Date Date ________ ________

Test 5 Date ________

Bedtime (Do not eat a bedtime snack!)

Overnight 1 (usually 2-3 AM: _______)

Overnight 2 (time _______)

Overnight 3 (time _______)

Before Breakfast (Eat breakfast!)

Copyright CMSA 2005

Copyright CMSA 2005

Morning Basal Rate Worksheet

Test 2 Date ________

BLOOD SUGAR Test 3 Test 4 Date Date ________ ________

Test 5 Date ________

Overnight (usually 2-3 AM: _______)

2 Hours After Waking Up

4 Hours After Waking Up

6 Hours After Waking Up

Before Lunch (Eat Lunch!)

Copyright CMSA 2005

Copyright CMSA 2005

Afternoon Basal Rate Worksheet

Test 2 Date ________

BLOOD SUGAR Test 3 Test 4 Date Date ________ ________

Test 5 Date ________

Lunchtime (Do not eat lunch!)

2 Hours After Lunchtime

4 Hours After Lunchtime

6 Hours After Lunchtime

Before Dinner (Eat Dinner!)

Copyright CMSA 2005

Copyright CMSA 2005

Evening Basal Rate Worksheet

Test 2 Date ________

BLOOD SUGAR Test 3 Test 4 Date Date ________ ________

Test 5 Date ________

Dinnertime (Do not eat dinner!)

2 Hours After Dinnertime

4 Hours After Dinnertime

6 Hours After Dinnertime

Copyright CMSA 2005

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