Abasaglar dosing

[Annette Arundell]

Hi I'm now on Abasaglar insulin, I was told to take it x 2 aday, but I find im having hypos at night, ive read up about this insulin, and it is supposed to be taken once aday, well I would like to try that but confused how to start it, as if I take one larger dose would I not overdose? As the dose from 12 hrs before would be in my system still, can anyone answer this please, how to do this safely.

 

[SweetGuy]

I used to take it once a day. But the amount that I needed to make any impact on the BG was so large I switched to mixed twice a day. I didn't think slow acting insulin on its own was a type 1 sort of thing.

 

[Annette Arundell]

I used to take it once a day. But the amount that I needed to make any impact on the BG was so large I switched to mixed twice a day. I didn't think slow acting insulin on its own was a type 1 sort of thing.

I take novorapid as well for meals but cant seem to sort background one, I was on levemir, which didn't last even when split then tresiba, which made me very unwell, put back on levemir, now Abasaglar which not really working at moment, thanks for reply

 

[Becka]

I do not think taking it once a day will make any difference. I went in the opposite direction by splitting it to take 12 hours apart — just so I could have the option of lowering it in the evening based on whether it felt needed or in the morning for the day I was expecting — but have not noticed any difference.

I would think the safest way to combing into a single dose would be to gradually increase one dose while reducing the other. For example take one less unit in the morning and then one more at night. That way you will spend half the day on one less unit until it is combined, which is better than doing it in one go and spending a half day on either a half dose or 50% too much. And you can also monitor the effects as you go, as maybe you will find it works better to split it 25% and 75%.

 

[pm133]

Hi I'm now on Abasaglar insulin, I was told to take it x 2 aday, but I find im having hypos at night, ive read up about this insulin, and it is supposed to be taken once aday, well I would like to try that but confused how to start it, as if I take one larger dose would I not overdose? As the dose from 12 hrs before would be in my system still, can anyone answer this please, how to do this safely.

You should phone whoever told you to split the dose and talk this through with them.
They'll be best placed to guide you.

Following well-intentioned advice on here could get you in some trouble if you're not careful.

 

[Annette Arundell]

Thanks for reply will try it and see as on two doses I get two peaks where it makes sugar lower, I didn't think it was supposed to peak as much, so should only get one peak .

 

[Annette Arundell]

I do not think taking it once a day will make any difference. I went in the opposite direction by splitting it to take 12 hours apart — just so I could have the option of lowering it in the evening based on whether it felt needed or in the morning for the day I was expecting — but have not noticed any difference.

I would think the safest way to combing into a single dose would be to gradually increase one dose while reducing the other. For example take one less unit in the morning and then one more at night. That way you will spend half the day on one less unit until it is combined, which is better than doing it in one go and spending a half day on either a half dose or 50% too much. And you can also monitor the effects as you go, as maybe you will find it works better to split it 25% and 75%.

Thanks for reply will try it and see as on two doses I get two peaks where it makes sugar lower, I didn't think it was supposed to peak as much, so should only get one peak .

 

[pm133]

Thanks for reply will try it and see as on two doses I get two peaks where it makes sugar lower, I didn't think it was supposed to peak as much, so should only get one peak .

I might be misunderstanding but you shouldn't be getting peaks at all as a result of your basal.

Your basal is designed to keep your background blood glucose levels steady when you are not eating - you'll see this for example on overnight readings or fasting periods during the day.

The idea is to tweak your basal until you get a nice steady line during those fasting periods. If you have a look at basal testing it'll explain a bit better than I'm doing.
Here's an example of a couple of my own overnight readings to give you a feel for the sort of background reading you are looking for. I tend to eat something late at night which is why there's a bit of a decline after midnight but then it settles quite nicely. Not all my graphs look like this but these are two examples. They both settle at about 4.5 to 5.0 overnight.
Hope this helps.

 

[Robin]

I might be misunderstanding but you shouldn't be getting peaks at all as a result of your basal.

This rather assumes that both the basal and your BG has read the instruction book. I don’t know how large a dose you take, nor what @Annette Arundell is on, but Lantus (and presumably it’s Biosimilar Abasaglar) seems to produce less of a flat line the smaller the dose. I couldn’t get it to work for me on 6 or 7 units a day, it always produced a peak after around 5 hours, enough to send me hypo in the middle of the night if I took it at bedtime, and taking it in the morning meant a hypo before lunch, and it running out in the wee small hours, before Dawn Phenomenon kicked in. Splitting the dose made it worse, with two peaks, as Annette is saying. I ended up taking it at midday which was just inconvenient, but in the end I found that Levemir suited me much better.
Some people’s glucose production obviously plays ball, and produces a nice flat line, others doesn’t!

 

[pm133]

This rather assumes that both the basal and your BG has read the instruction book. I don’t know how large a dose you take, nor what @Annette Arundell is on, but Lantus (and presumably it’s Biosimilar Abasaglar) seems to produce less of a flat line the smaller the dose. I couldn’t get it to work for me on 6 or 7 units a day, it always produced a peak after around 5 hours, enough to send me hypo in the middle of the night if I took it at bedtime, and taking it in the morning meant a hypo before lunch, and it running out in the wee small hours, before Dawn Phenomenon kicked in. Splitting the dose made it worse, with two peaks, as Annette is saying. I ended up taking it at midday which was just inconvenient, but in the end I found that Levemir suited me much better.
Some people’s glucose production obviously plays ball, and produces a nice flat line, others doesn’t!

Fair enough.
I think Annette is on the same basal as me.

 

[Robin]

I think Annette is on the same basal as me.

Oops, sorry, the wording in my post was as clear as mud, she said she's on Abasaglar in the thread title, I meant how many units she was on.( I wondered if it was a small dose)

 

[Annette Arundell]

Oops, sorry, the wording in my post was as clear as mud, she said she's on Abasaglar in the thread title, I meant how many units she was on.( I wondered if it was a small dose)

I'm on 10 units 9 am and 6 units 11pm and I do have hypo in early hours as you said after around 5 hrs, then I get high sugars when getting up at 8.00am, would it help if I took bit larger dose at night to alter peak which it defiantly dose, I have two peaks a day, but one in day not so bad, so maybe smaller dose giving me problem, thanks for reply.

 

[Robin]

I'm on 10 units 9 am and 6 units 11pm and I do have hypo in early hours as you said after around 5 hrs, then I get high sugars when getting up at 8.00am, would it help if I took bit larger dose at night to alter peak which it defiantly dose, I have two peaks a day, but one in day not so bad, so maybe smaller dose giving me problem, thanks for reply.

I don’t think you could be sure of a larger dose at night altering the peak. I think if you decide to experiment, you need to enlist the help of your DSN. They need to see your readings, though, else they may not believe it’s having such a profound effect, so keep a record. My natural pattern of overnight blood glucose is to drop steeply as soon as my head hits the pillow, until around 4am, when I rise steadily until after breakfast, and I needed a basal regime that didn’t make that worse. Levemir worked for me, but I know you’ve tried that.

 

[Lucyr]

I'm on 10 units 9 am and 6 units 11pm and I do have hypo in early hours as you said after around 5 hrs, then I get high sugars when getting up at 8.00am, would it help if I took bit larger dose at night to alter peak which it defiantly dose, I have two peaks a day, but one in day not so bad, so maybe smaller dose giving me problem, thanks for reply.

If you go hypo overnight with your current dose then you need a smaller dose not a larger one

 

[Annette Arundell]

If you go hypo overnight with your current dose then you need a smaller dose not a larger one

Hi Lucy I understand that, but it made me wonder about the peak timings, as morning one peaks later as its bigger dose, so I wondered if the peak time would be later, and help with morning highs when I get up as they are awful, thanks for reply

 

[pm133]

Oops, sorry, the wording in my post was as clear as mud, she said she's on Abasaglar in the thread title, I meant how many units she was on.( I wondered if it was a small dose)

At 18 units, I am on a slightly larger dose than her 16 which I take as a single hit at dinner time.

It took a fair bit of playing around to get a smooth line overnight.
I think at diagnosis I was put on 6 to start with and got as high as 22 at one point.

 

[Lucyr]

Hi Lucy I understand that, but it made me wonder about the peak timings, as morning one peaks later as its bigger dose, so I wondered if the peak time would be later, and help with morning highs when I get up as they are awful, thanks for reply

If you increased the dose significantly enough to delay the peak by several hours, I imagine you’d have passed out from the hypo before you got to the morning. Don’t forget it would be doing more all night and it’s already doing too much. Taking rapid insulin as soon as you wake up for the morning bg rise would be a safer strategy

 

[PattiEvans]

You sound like an ideal candidate for a pump. With a pump you can have a different level of insulin every hour, which means you can achieve a completely flat line overnight. Is it something you have thought abut @Annette Arundell ?

 

[Annette Arundell]

You sound like an ideal candidate for a pump. With a pump you can have a different level of insulin every hour, which means you can achieve a completely flat line overnight. Is it something you have thought abut @Annette Arundell ?

Hi they have never mentioned this to me, so maybe bring it up to them , thanks for reply.

 

[Annette Arundell]

If you increased the dose significantly enough to delay the peak by several hours, I imagine you’d have passed out from the hypo before you got to the morning. Don’t forget it would be doing more all night and it’s already doing too much. Taking rapid insulin as soon as you wake up for the morning bg rise would be a safer strategy

Thats what I do now, but its a nightmare if you wanted to go out for breakfast, as I cant do this anymore.