Abasaglar dosing

[Lucyr]

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

I’m not following what you mean sorry? I’d take a correction when I wake up then bolus for breakfast out when it was in front of me.

 

[Annette Arundell]

I’m not following what you mean sorry? I’d take a correction when I wake up then bolus for breakfast out when it was in front of me.

Hi Lucy I tried that but I keep rising once I'm up and moving around, I tried a unit correction this am and got back to bed for an hour it still rose when I got up, and I then have to do another 8 units of NovoRapid for 36 g carb, as I just keep rising for few hrs, like I said nightmare,

 

[rebrascora]

Hi Lucy I tried that but I keep rising once I'm up and moving around, I tried a unit correction this am and got back to bed for an hour it still rose when I got up, and I then have to do another 8 units of NovoRapid for 36 g carb, as I just keep rising for few hrs, like I said nightmare,

Clearly one unit is not enough correction then. You need to experiment and find what works for you, so increase it by another unit or half a unit and try again and see what happens and then increase it again if that is still not enough. I need 1.5-2 units and I am reasonably insulin sensitive but everyone is different. You need to find what works for you and with diabetes trial and improvement is the way to good management. It is important to do lots of testing when you are experimenting like this though so keep a close eye on your Libre if you have one or plenty of finger pricking. Don't just jab quick acting insulin and go back to sleep or if you do, set and alarm to check it. You need to monitor it until you know how it is working for you and then once you are confident you have found the right dose that works, then you can be less vigilant of your levels.

 

[everydayupsanddowns]

I tried splitting Lantus because of overnight lows when I was taking it in the evening as I had been recommended, but it would never play nicely.

My best strategy was taking when I woke up, or at breakfast time.

That would make the mini-peak happen during the day, when it’s easier to workaround, and it should be tailing off at night when it looks like you need less?

 

[Robin]

I tried splitting Lantus because of overnight lows when I was taking it in the evening as I had been recommended, but it would never play nicely.

My best strategy was taking when I woke up, or at breakfast time.

That would make the mini-peak happen during the day, when it’s easier to workaround, and it should be tailing off at night when it looks like you need less?

When I was on Lantus, taking it in the morning meant that it tailed off from 4am, just when I needed an insulin boost to cover the dawn rise. I finally worked out that theoretically the only good time to take it would be 3am...at which point I decided Levemir would be a better bet!

 

[everydayupsanddowns]

When I was on Lantus, taking it in the morning meant that it tailed off from 4am, just when I needed an insulin boost to cover the dawn rise. I finally worked out that theoretically the only good time to take it would be 3am...at which point I decided Levemir would be a better bet!

Haha! Yes! I am lucky(?!) in that my rise is only triggered when i get up!

 

[Annette Arundell]

I tried splitting Lantus because of overnight lows when I was taking it in the evening as I had been recommended, but it would never play nicely.

My best strategy was taking when I woke up, or at breakfast time.

That would make the mini-peak happen during the day, when it’s easier to workaround, and it should be tailing off at night when it looks like you need less?

Hi trouble is I go hypo in early hours, as abasaglar is peaking, so treat it, but go high few hrs later, as its worn off and continue to rise really high on getting up that then keeps me high through first part of day, I have to take 8 units of NovoRapid for 40 carbs at least every morning, then might need correction few hours later, so I just can't get it right, I feel i want to increase night dose to stop early morning rise but cant because when it peaks i go hypo, so its not working, hope they let me come off it. Thanks for reply, my diabetes is a total nightmare.

 

[PattiEvans]

Hi, @Annette Arundell sorry I didn’t get back to you earlier, am on holiday and the internet is very flaky here. If you want a pump, which would solve all the problems you are currently having, you need to ask for one. I didn’t think I stood a chance, but @trophywench encouraged me to ask and I got one. I kept a diary of times I took insulin and amounts plus what I ate and hypos etc. It proved that twice daily basal just didn’t work for me.

 

[Annette Arundell]

Hi, @Annette Arundell sorry I didn’t get back to you earlier, am on holiday and the internet is very flaky here. If you want a pump, which would solve all the problems you are currently having, you need to ask for one. I didn’t think I stood a chance, but @trophywench encouraged me to ask and I got one. I kept a diary of times I took insulin and amounts plus what I ate and hypos etc. It proved that twice daily basal just didn’t work for me.

Hi Pattidevans thanks for reply im hopeing to be admitted to hospital today regarding diabetes problems, im hoping to come off basal abasaglar that they put me on as it peaks and gives hypos then higher in morning on getting up, but they don't really listen, they act like its my fault, but as you know we know our body’s, so will hopefully get something sorted but I'm so down with all this as going on so long, and huge weight loss, anyway enjoy your holiday, and again thanks for reply.

 

[Lucyr]

Hi Pattidevans thanks for reply im hopeing to be admitted to hospital today regarding diabetes problems, im hoping to come off basal abasaglar that they put me on as it peaks and gives hypos then higher in morning on getting up, but they don't really listen, they act like its my fault, but as you know we know our body’s, so will hopefully get something sorted but I'm so down with all this as going on so long, and huge weight loss, anyway enjoy your holiday, and again thanks for reply.

I’m sorry to hear of your hospital admission, is this to stabilise your blood sugars? I haven’t heard of that being done as an inpatient other than for DKA before, I hope it helps you.

 

[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!

I meant to ask, if you are not getting a roughly flat line during fasting, how do you know your basal amount is correct?

I asked this of some else on another thread and it reminded me of your post.

 

[Robin]

With a lot of experimentation! Flat fasting line during daylight hours, no problem when I’m on split Levemir. When I was taking Lantus in the morning, dip before lunch. when I took Lantus at lunchtime, dip late afternoon.
It’s night time when the fun really starts, though. Imagine a slack washing line, higher at both ends and curved downwards towards the middle. That’s what I achieve with x units of basal. Increase basal, x + 1 and the curve gets much steeper on the way down, then flattens out and remains flat for the second half of the night, (as if you’ve tilted the curve one way). Decrease basal, x-1, and the overnight trace stays flat for the first half of the night, then steeply rises for the second half, as if you’ve tilted the whole curve the other way. Conclusion. It’s my body that produces the dip overnight, not the basal.
I need to start off in the 7s at bedtime to avoid going below 4 at 3am, and I need to whack in 2 units of Novorapid when I wake up, irrespective of breakfast bolus, to counteract the rise. If I was on a pump, this would be built in with my basal pattern).
I used to really struggle working out patterns before I started using the Libre. Once I could see the whole 24hrs, it became obvious. I assume my own hormones (cortisol?) must reduce glucose output as soon as my head hits the pillow, and then tell my liver to fire up again in the wee small hours. My consultant also assumes I'm still producing a bit of endogenous insulin, because my basal needs are fairly low, but I need an average amount of bolus. (There’s some research, which has been mentioned on the forum from time to time, that found most Type 1s even if they developed diabetes quite young, still produce a bit of their own).
Sorry, that ended up more long winded than I was expecting!

 

[Annette Arundell]

With a lot of experimentation! Flat fasting line during daylight hours, no problem when I’m on split Levemir. When I was taking Lantus in the morning, dip before lunch. when I took Lantus at lunchtime, dip late afternoon.
It’s night time when the fun really starts, though. Imagine a slack washing line, higher at both ends and curved downwards towards the middle. That’s what I achieve with x units of basal. Increase basal, x + 1 and the curve gets much steeper on the way down, then flattens out and remains flat for the second half of the night, (as if you’ve tilted the curve one way). Decrease basal, x-1, and the overnight trace stays flat for the first half of the night, then steeply rises for the second half, as if you’ve tilted the whole curve the other way. Conclusion. It’s my body that produces the dip overnight, not the basal.
I need to start off in the 7s at bedtime to avoid going below 4 at 3am, and I need to whack in 2 units of Novorapid when I wake up, irrespective of breakfast bolus, to counteract the rise. If I was on a pump, this would be built in with my basal pattern).
I used to really struggle working out patterns before I started using the Libre. Once I could see the whole 24hrs, it became obvious. I assume my own hormones (cortisol?) must reduce glucose output as soon as my head hits the pillow, and then tell my liver to fire up again in the wee small hours. My consultant also assumes I'm still producing a bit of endogenous insulin, because my basal needs are fairly low, but I need an average amount of bolus. (There’s some research, which has been mentioned on the forum from time to time, that found most Type 1s even if they developed diabetes quite young, still produce a bit of their own).
Sorry, that ended up more long winded than I was expecting!

Thanks that's interesting I might ask to go back to levemir, as you said Abasaglar/lantus gives 2 peaks when taking x 2 aday, im in hospital at moment as all out of control and made me feel really ill .

 

[trophywench]

Between 2.30am ish and 3.30am ish - the time when all human bodies experience their lowest BG, as borne out by those on permanent nights at both the BL plant at Longbridge and the Jag one in Coventry when almost every man working there, got an attack of the munchies and also by it being known by A&E staff throughout the UK (when we could all call a spade a shovel without fear of criticism) as the suicide hour .......