{"id":1911,"date":"2018-12-06T13:00:03","date_gmt":"2018-12-06T12:00:03","guid":{"rendered":"http:\/\/samjwatkins.com\/blog\/?p=1911"},"modified":"2018-12-06T13:51:02","modified_gmt":"2018-12-06T12:51:02","slug":"working-on-basal-rate-2","status":"publish","type":"post","link":"https:\/\/samjwatkins.com\/blog\/?p=1911","title":{"rendered":"Working on basal rate 2"},"content":{"rendered":"<p>As I come to the end of my sabatical, I&#8217;ve had an infection that drove up my glucose rates and plumented them just as quickly at the end.\u00a0 The past three days have seen me hypo from 2am in the morning.<\/p>\n<p>Which makes it a good time to review Basal Rate 2.<\/p>\n<h2>Hit me one more time, baby<\/h2>\n<p>\ud83d\ude2e OK.<\/p>\n<p>Excel is a brilliant tool for comparing two graphs and I use it for tracking my changes.<\/p>\n<p>First I enter in my old basal rate as:<\/p>\n<table style=\"height: 796px;\" width=\"816\">\n<tbody>\n<tr>\n<td width=\"49\">Time<\/td>\n<td width=\"46\">Old Basal rate 2<\/td>\n<\/tr>\n<tr>\n<td>0<\/td>\n<td>1.5<\/td>\n<\/tr>\n<tr>\n<td>1<\/td>\n<td>1.5<\/td>\n<\/tr>\n<tr>\n<td>2<\/td>\n<td>0.76<\/td>\n<\/tr>\n<tr>\n<td>3<\/td>\n<td>0.86<\/td>\n<\/tr>\n<tr>\n<td>4<\/td>\n<td>1.25<\/td>\n<\/tr>\n<tr>\n<td>5<\/td>\n<td>1.5<\/td>\n<\/tr>\n<tr>\n<td>6<\/td>\n<td>1.75<\/td>\n<\/tr>\n<tr>\n<td>7<\/td>\n<td>0.78<\/td>\n<\/tr>\n<tr>\n<td>8<\/td>\n<td>1.5<\/td>\n<\/tr>\n<tr>\n<td>9<\/td>\n<td>0.8<\/td>\n<\/tr>\n<tr>\n<td>10<\/td>\n<td>0.77<\/td>\n<\/tr>\n<tr>\n<td>11<\/td>\n<td>0.7<\/td>\n<\/tr>\n<tr>\n<td>12<\/td>\n<td>0.69<\/td>\n<\/tr>\n<tr>\n<td>13<\/td>\n<td>1.15<\/td>\n<\/tr>\n<tr>\n<td>14<\/td>\n<td>1.1<\/td>\n<\/tr>\n<tr>\n<td>15<\/td>\n<td>0.99<\/td>\n<\/tr>\n<tr>\n<td>16<\/td>\n<td>1<\/td>\n<\/tr>\n<tr>\n<td>17<\/td>\n<td>1<\/td>\n<\/tr>\n<tr>\n<td>18<\/td>\n<td>1.4<\/td>\n<\/tr>\n<tr>\n<td>19<\/td>\n<td>1.4<\/td>\n<\/tr>\n<tr>\n<td>20<\/td>\n<td>1.6<\/td>\n<\/tr>\n<tr>\n<td>21<\/td>\n<td>1.7<\/td>\n<\/tr>\n<tr>\n<td>22<\/td>\n<td>1.3<\/td>\n<\/tr>\n<tr>\n<td>23<\/td>\n<td>1.55<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>You will notice the time is actually the hourly rate in question: my pump allows me to have a different rate per hour which is great for tuning.\u00a0 But it is not a format accepted by the <a href=\"http:\/\/www.insulin-pumpers.org\/howto\/basal.cgi\" target=\"_blank\" rel=\"noopener\">Basal Rate Estimator<\/a> but we&#8217;ll come on to that in a moment.<\/p>\n<p>I then take my interstitial glucose readings for the period I want to tune:<\/p>\n<table style=\"height: 349px;\" width=\"509\">\n<tbody>\n<tr>\n<td width=\"49\">Time<\/td>\n<td width=\"46\">Old Basal rate 2<\/td>\n<td width=\"85\">Interstitial blood sugar<\/td>\n<\/tr>\n<tr>\n<td>0<\/td>\n<td>1.5<\/td>\n<td>4.5<\/td>\n<\/tr>\n<tr>\n<td>1<\/td>\n<td>1.5<\/td>\n<td>4<\/td>\n<\/tr>\n<tr>\n<td>2<\/td>\n<td>0.76<\/td>\n<td>3<\/td>\n<\/tr>\n<tr>\n<td>3<\/td>\n<td>0.86<\/td>\n<td>3.2<\/td>\n<\/tr>\n<tr>\n<td>4<\/td>\n<td>1.25<\/td>\n<td>2.2<\/td>\n<\/tr>\n<tr>\n<td>5<\/td>\n<td>1.5<\/td>\n<td>2.2<\/td>\n<\/tr>\n<tr>\n<td>6<\/td>\n<td>1.75<\/td>\n<td>2.2<\/td>\n<\/tr>\n<tr>\n<td>7<\/td>\n<td>0.78<\/td>\n<td>2.2<\/td>\n<\/tr>\n<tr>\n<td>8<\/td>\n<td>1.5<\/td>\n<td>2.1<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>You can see here why I am tuning &#8211; I have a drop from 1am, my goal is to flatten out the curve :D.<\/p>\n<p>Because the <a href=\"http:\/\/www.insulin-pumpers.org\/howto\/basal.cgi\" target=\"_blank\" rel=\"noopener\">Basal Rate Estimator<\/a> needs the information in a very specific format, I am going make some changes to the data.\u00a0 I don&#8217;t do this in Excel because that would be very hard to make useable for any period in question.<\/p>\n<p>I&#8217;ve written a short script to do the job for me:<\/p>\n<p style=\"padding-left: 30px;\">In powershell script&#8230;<br \/>\nOpen excel spreadsheet<br \/>\nOpen sheet<br \/>\nWork through the blood glucose (converting time to 12 hour clock and add :00 to each hour)<br \/>\nWork through the old basal rate (converting time to 12 hour clock and add :00 to each hour)<br \/>\nWork through the new basal rate (converting time to 12 hour clock and add :00 to each hour)<\/p>\n<p>The output looks something like this:<\/p>\n<p>Doing blood sugar<br \/>\n0:00 4.5<br \/>\n1:00 4<br \/>\n2:00 3<br \/>\n3:00 3.2<br \/>\n4:00 2.2<br \/>\n5:00 2.2<br \/>\n6:00 2.2<br \/>\n7:00 2.2<br \/>\n8:00 2.1<br \/>\nDoing old BR<br \/>\n0:00 1.5<br \/>\n1:00 1.5<br \/>\n2:00 0.76<br \/>\n3:00 0.86<br \/>\n4:00 1.25<br \/>\n5:00 1.5<br \/>\n6:00 1.75<br \/>\n7:00 0.78<br \/>\n8:00 1.5<br \/>\n&#8230;<br \/>\n10:00 1.3<br \/>\n11:00 1.55<br \/>\nDoing New BR<br \/>\nFirst guess is to use exactly the same values as the old basal rate as that will allow us to fine tune<\/p>\n<p>We&#8217;re nearly there, I run the <a href=\"http:\/\/www.insulin-pumpers.org\/howto\/basal.cgi\" target=\"_blank\" rel=\"noopener\">Basal Rate Estimator<\/a> entering in the &#8220;BG&#8221; or my institial values: this is a simple cut and paste from the powershell output.<\/p>\n<p>I use humalog, so I select that and enter in my insulin ratio (that needs to be the same units as my readings, as I work in mmol\/l my value is 2.5).<\/p>\n<p>Now, in this case, my first blood glucose reading is midnight and the last is 9am.\u00a0 I copy in my basal values between midnight and 9am but go to the bottom of the column and grab between 10pm and 11pm.\u00a0 If I don&#8217;t do that, the tool complains as it hasn&#8217;t got a starting value for insulin kinetics (how much insulin is in your system at midnight affecting your blood sugar).<\/p>\n<h2>Sounds fiddly!<\/h2>\n<p>Bear with me.\u00a0 I&#8217;ve put in the input into the right boxes, in the right format, so let&#8217;s have a look at the output.\u00a0 First screen the graphs (real and simulated) overlay one another.\u00a0 We need to change the &#8220;new basal&#8221; to see a difference.<\/p>\n<p><a href=\"https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/basalRateEstimator1.png\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-1915 size-medium\" src=\"https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/basalRateEstimator1-269x300.png\" alt=\"\" width=\"269\" height=\"300\" srcset=\"https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/basalRateEstimator1-269x300.png 269w, https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/basalRateEstimator1-768x856.png 768w, https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/basalRateEstimator1-918x1024.png 918w, https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/basalRateEstimator1.png 1260w\" sizes=\"auto, (max-width: 269px) 100vw, 269px\" \/><\/a> So lets do that &#8211; I actually go through 4 iterations, but I&#8217;m guessing you&#8217;d like to see the final one.<\/p>\n<p><a href=\"https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/basalRateEstimator.png\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-1916 size-medium\" src=\"https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/basalRateEstimator-267x300.png\" alt=\"\" width=\"267\" height=\"300\" srcset=\"https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/basalRateEstimator-267x300.png 267w, https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/basalRateEstimator-768x863.png 768w, https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/basalRateEstimator-911x1024.png 911w, https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/basalRateEstimator.png 1251w\" sizes=\"auto, (max-width: 267px) 100vw, 267px\" \/><\/a> I can then copy that to my pump as day 2 of the basal run and back to the Excel Sheet, where I can then plot the graph.<\/p>\n<div id=\"attachment_1917\" style=\"width: 310px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/output.png\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-1917\" class=\"wp-image-1917 size-medium\" src=\"https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/output-300x181.png\" alt=\"\" width=\"300\" height=\"181\" srcset=\"https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/output-300x181.png 300w, https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/output-768x464.png 768w, https:\/\/samjwatkins.com\/blog\/wp-content\/uploads\/2018\/12\/output.png 1009w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-1917\" class=\"wp-caption-text\">Adjusted basal<\/p><\/div>\n<h2>Hang on a minute&#8230; the blood sugars look different<\/h2>\n<p>Ah, because I was hypo last night, the basal rate estimator tells me I&#8217;m hypo and refuses to work, so I add two to each value of the blood sugars to allow me to do the simulated run.<\/p>\n<h2>This all sounds like wet pieces of string and sticky tape&#8230;<\/h2>\n<p>I was doubtful the first time I used this methodology.\u00a0 The user interface is crude on the basal rate estimator however this is so much quicker than guessing which rate needs to be trimmed and by how much.<\/p>\n<p>The 4am reading is still a dip.\u00a0 I&#8217;ve taken more than 1iu off my basal and that&#8217;s a huge change, so I will try that tonight and do a second estimation run tomorrow morning then move on to breakfast and lunch and tea.\u00a0 In five days, I normally get pretty close to having a flat line all day if I don&#8217;t eat which is a great place to be.<\/p>\n<h2>You talk about a script, can I have it?<\/h2>\n<p>Powershell scripts can be run on any Windows PC machine from Windows 7 onwards.\u00a0 I am very happy to share &#8211; here it is &#8211; but it&#8217;s very rough and ready at the moment.<\/p>\n<p>Give me a couple of days to knock it into better shape and I will share on this page \ud83d\ude42<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As I come to the end of my sabatical, I&#8217;ve had an infection that drove up my glucose rates and plumented them just as quickly at the end.\u00a0 The past three days have seen me hypo from 2am in the morning. Which makes it a good time to review Basal Rate 2. Hit me one [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[5,9],"tags":[],"class_list":["post-1911","post","type-post","status-publish","format-standard","hentry","category-forty-two","category-type-1-diabetes"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Working on basal rate 2 - Finding the chase and cutting to it<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/samjwatkins.com\/blog\/?p=1911\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Working on basal rate 2 - Finding the chase and cutting to it\" \/>\n<meta property=\"og:description\" content=\"As I come to the end of my sabatical, I&#8217;ve had an infection that drove up my glucose rates and plumented them just as quickly at the end.\u00a0 The past three days have seen me hypo from 2am in the morning. Which makes it a good time to review Basal Rate 2. 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Which makes it a good time to review Basal Rate 2. 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