Are you taking too much basal insulin?
Doing a basal test is the best way to test if the basal insulin dose is right. It involves testing the glucose levels for a set period of time where the patient fasts and when only the basal insulin is working.
How does it help?
If the basal insulin dose is right, diabetes is much easier to manage. If the dose is too high, your patient will be having hypos and eating a lot more. If it is too low, your patient will be having high glucose levels and adding extra doses of rapid insulin to keep the glucose levels in range.
How is a basal test performed?
Doing a basal test involves fasting for a section of the day when only the basal insulin is working. After a meal, it takes 4 hours for the rapid-acting insulin (or a bolus in the pump) to wear off, so the basal test starts then. Your patient needs to check their glucose levels every 1 or 2 hours for the period (4 – 6 hours) and then decide if the basal insulin dose needs to be changed. If your glucose levels drop by more than 2 mmol/L, you know that the basal insulin dose is too high and needs to be decreased.
The different sections are:
It’s best to test one section per day and consider doing two tests before you decide to change the insulin dose. After you’ve made any change to the insulin dose, it’s a good idea to re-test each section of the day to make sure the changes to the dose improved the glucose levels.
How to prepare for the test
Basal testing worksheet
(PDF for download and printing) see Appendix.