Basal Testing Explained: Finding the Right Insulin Settings for Stability
The time has come. I must put the basal settings to the test.
Basal insulin is the silent backbone of glucose stability. It is supposed to maintain glucose levels when no other factors—food, boluses, or external chaos—are in play. If basal insulin is incorrect, every other insulin decision becomes an exercise in futility. Boluses work too hard to compensate, corrections become necessary too often, and stability remains an illusion. This cannot stand.
Recent events indicate that the current basal rates may be too aggressive in some time blocks, leading to unexpected lows, or too weak in others, allowing for creeping highs. The most recent theater incident provided irrefutable proof that instability exists. I do not accept instability. I will find and eliminate these weak points.
Starting March 2nd, I will execute a full basal testing protocol to determine whether the programmed rates are providing the correct background insulin—or if they are setting up failures that I must later correct.
How This Test Will Work
Each test requires controlled conditions. There can be no outside interference, no meal boluses to mask the results, and no unnecessary variables introduced. The protocol is as follows:
No food for 5+ hours during the test window.
No boluses except for documented corrections after the test window.
Minimal movement. Unplanned physical exertion will introduce unnecessary confusion.
The testing will be divided into four critical time blocks: 1️⃣ Overnight (12 AM - 8 AM) – Determines if fasting stability is maintained through the night. Waking high or low indicates an imbalance. 2️⃣ Morning (8 AM - 12 PM) – Tests the effect of morning basal rates in a fasting state. 3️⃣ Afternoon (12 PM - 6 PM) – Verifies mid-day stability without meal interference. 4️⃣ Evening (6 PM - 12 AM) – Identifies any pre-sleep imbalances that may contribute to overnight fluctuations.
Each block will be isolated to ensure clear, undeniable data patterns.
Metrics for Success
A drop greater than 30 mg/dL = Basal insulin is too strong and must be reduced.
A rise greater than 30 mg/dL = Basal insulin is too weak and must be increased.
A stable reading within ±10 mg/dL = The basal setting is correct.
Adjustments That May Follow
Basal Rates: If instability is detected, I will adjust the hourly insulin delivery to eliminate unnecessary fluctuations. The current basal rates range from 1.1 to 1.4 units per hour, with the highest rates programmed in the late morning (9 AM - 12 PM). If fasting trends reveal consistent drops, I will lower basal rates at those times. If glucose levels drift upward in the absence of food, I will increase the basal rate for that block. The goal is a seamless, flat glucose line—no unexpected dips, no unnecessary rises, just stability.
Insulin Sensitivity (Correction Factor): The current correction factor is 1:40 mg/dL across all time blocks. If testing reveals that corrections are too aggressive, I will adjust to 1:45 mg/dL or higher. If corrections are insufficient to bring glucose into range, I will reduce the factor to 1:35 mg/dL, ensuring more insulin is delivered per correction.
Carb Ratios: The current carb ratio is 1:14 g throughout the day. If basal testing shows that glucose rises after fasting periods, indicating that meals are carrying too much of the workload, I will adjust to 1:13 g for tighter post-meal control. If frequent lows after eating suggest over-bolusing, I will increase to 1:15 g, allowing less insulin per gram of carbohydrate.
Non-Negotiable Rules of the Test
1️⃣ If hypoglycemia occurs, testing ceases immediately. I do not collect data at the expense of safety. 2️⃣ If hyperglycemia occurs, data is recorded, but no corrections are made until the test window is complete. 3️⃣ Decisions will not be made based on a single day. I require patterns, not isolated incidents.
What Comes Next
I will monitor Dexcom data relentlessly, analyze every fluctuation, and refine settings with precision. There will be no guesswork. Only data. Only improvement.
This is the path to stability. The mission is clear. The test will be executed flawlessly.
End transmission.
