Test days 1 to 4

Your healthcare team will let you know how they want you to optimise your pump. One method is described here, using a total of 4 test days that you should complete. On each test day, you will skip a meal and see how your blood glucose reacts.

We have put together some monitoring sheets which explain what you should do on each test day and when you should record your blood glucose. The monitoring sheets are available to download and print here. Before starting this, check the requirements with your healthcare team.

These monitoring sheets are designed to help you to see how well your background or basal insulin is working, how well matched the insulin is to your meal, and also how long your mealtime bolus of insulin lasts.

Basal insulin

If your background or basal insulin is working effectively your blood glucose levels should remain stable when you miss a meal. A rise suggests not enough insulin, a fall suggests too much insulin. Your diabetes team can help you to make appropriate adjustments.

Post-meal

When these levels are stable, you can look at the pattern of blood glucose for 4 hours or more after the last meal to tell you how long that mealtime insulin bolus is working (this is the shaded area for each test day).

You should only miss one meal on any day. If you find it too difficult to miss meals, you can try the test by having carbohydrate-free meals or snacks such as plain meat, fish, or eggs with green vegetables or salad. Avoid fish or meat with pastry or breadcrumbs/batter.

The test days should not be consecutive – perhaps stagger them over 2 weeks.

If you have blood glucose below 4 mmol/L during the fast you need to stop and treat the low blood sugar. Abandon the test for that day. Don’t choose a day where you are being more active than normal or are unwell.