However one monitors and regulates their blood sugar levels and basal rates, it is important to make changes gradually. An initial lowering in basal rate should be no more than 10% of the original. After the initial lowering point, one must note the factor by which one's blood sugar changes. If blood sugar levels decreased, one should lower their basal rate by 20% next time. If their blood sugar levels increased, a lowering of 10% was too great, and one should not lower their basal rate at all next time. If blood sugar levels remained relatively constant, a drop in basal rate of 10% was sufficient. Just as the action to change basal rate should be gradual in nature, the actual response from changing basal rate does not happen instantly. A change in basal rate is felt around two hours after the action is done. This is especially important for those with diabetes to note, as it affects when they should act to monitor their basal rates. For example, if there is a particular time in the day when one notices a problem with blood glucose levels, they should act to change their basal rate accordingly two hours prior to when the problem was previously experienced. Causes of Basal Rate The liver is the primary contributing organ which produces glucose continuously even when nothing is being eaten. The liver will supply glucose either from fats or from previously eaten foods. Therefore, the basal rate can be thought of as a sort of "second bolus" after the initial bolus intake of insulin. Modelling the Basal Rate Most adult diabetics (over the age of 21) will have a fairly constant ratio of bolus:basal of 60%:40%, where 60% of all insulin intake in a single 24-hour period will be attributed to meals (bolus) and 40% should then be attributed to the basal rate. This ratio will fluctuate from person to person depending on their size, activity level, and caloric intake as well but is a good baseline for determining the correct basal rate for an adult diabetic. Thus, the basal rate could theoretically be set based on an averaged bolus insulin intake of several days. Averaging the total bolus, and then dividing this number by 36 would then give the required hourly basal rate intake for any individual with a 60:40 ratio established. References External links Insulin Pump Terminology: Basal Rates Information on