Any basal detectives out there?

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aymes

aymes

Senior Member
Relationship to Diabetes
Type 1
I mentioned in the lasagne thread that I have been having some basal issues overnight recently, pretty stumped, although have a few things still to try, so figured I'd post it up here in the hope that a fresh pair of eyes might be able to spot something I've missed.

I currently take my lantus at night, around 10pm, for a while now I've been having hypos quite regularly at around 1-2am. I usually eat at around 6pm and go to bed around 11pm so I'm confident that it's the lantus not the novorapid that's the problem. If I have a snack before bed it is usually ok but I don't want to have to do that as routine.

I've been doing a lot of basal testing recently. I'm really reluctant to decrease the dosage as it is spot on at all other times, when tested I've not drifted up or down by more than one unit the whole day.

Splitting the dose could be an option but I'm pretty sure (through basal tests and experience) that I'm one of the 'lucky' few where lantus pretty much lasts the full 24 hours so I don't think splitting will help as even if it's injected in two lots they will fully 'cross over'.

Although lantus is meant to be 'peakless' I am aware that some people do experience a slight peak with it so my current thinking is that this could be the issue, as I'm dropping at around 3hrs after injecting that could tally. So I think my next move is going to be to shift the timings around, maybe to early evening then possibly reduce my evening ratio a little to compensate for the peak if necessary.

When I saw my consultant last week we did discuss me moving on to levimir as an option to cope with it which is a possibility. I'm just quite reluctant to change insulins if I can help it though as lantus seems to work well for me about from this particular flashpoint. And of course I'm working on getting a pump which could really help here.

So, have a couple of things left to try but if anyone else fancies taking a stab at suggesting some possibilities feel free to suggest.
 
yo aymes, I had the same issues on lantus. no matter what I did with it I was having nighttime hypos, waking up high etc etc,

the move to levemir has been excellent though. Have found a dose that works and more 😎

good luck!
 
PUMP!:D
I dont know much about lantus - but i would have thought a split dose might be one answer. The other could be to bring it forward to maybe 7pm - this way if you were going to drop you would know about it before you went to bed or your evening meal might help you keep things level.

Alex used to be on levemir and we split his dose and got his level near perfect on waking etc - just weeks before the pump start! But now we have 8 or 9 basals now and can have more if needed.

PUMP!🙂Bev x
 
Hi aymes,
I'm sure i can't come up with anything you haven't already tried or thought of.
It's just another example of how different we all are.

If i was having the same trouble i would definitely reduce my Lantus a tiny bit. I'm not a great lover of having my Lantus 'make me eat' during any part of the day - i'd much rather let my Novorapid be used for that. For me, if your long acting is 'demanding' you raise your levels with carbs, at any time of the day - that would signal to me that i was taking just a bit too much.

Trouble is, once you start changing doses, sometimes you end up worse off than when you started. Best of luck .
Do let us know what you decide and how it works out for you.
 
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I think moving it to early evening is a good start, then your evening meal can meet the peak as you say. I would move the basal and then see if you need to reduce your bolus ratio; Rather than changing both at once for an anticipated decrease. You might find you don't need to change the ratio.
Other thought is if you experience increased insulin resisitance in the morning, if you took the lantus in the morning then the peak might help with the post breakfast blood sugar peak.

I think having a play with the lantus is a good idea before swapping to levemir, if you can't get it right then it's worth changing.
 
Hey, just spotted your thread. Ill chip in I think lol
I take my lantus in the morning as of last year because of the lows i had through the night kind of like you actually, I find that because my blood sugar wants to be higher in the morning anyway that the hypo thing doesnt affect me if I take it in the morning.
by the next morning my blood is on 5.5 or something in that area so my guess is that the lantus is working better if you know what I mean 🙄
 
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