Anyone fancy a bit of basal detective work??

[aymes]

As many of you will know I?ve generally been quite lucky in that I?m satisfied with my basal insulin, never had too many problems with it and it has, in the past at least, always seemed to last at least (and at times more than) 24 hours.

Well, in the past couple of weeks something has definitely shifted and something needs to be changed, just need to work out what?

Recently my night-time and morning readings have been off so I?ve been testing (eating early to do so) and at 5 hours (about 10pm) after my evening meal my blood sugars are well within target. I take my lantus at 10pm; however by about midnight when I go to bed they are usually about 3 above what they were at 10pm. If I don?t correct this they stay absolutely steady throughout the night, often not even changing at all, so I?m fairly confident the dosage of the lantus is right. I?ve also basal tested during the day and it?s pretty much spot on. So, I?m wondering if it?s a timing issue. Maybe that it isn?t lasting the full 24 hours and so in the two hours between taking the lantus and going to bed the new dose hasn?t ?kicked in? yet meaning I rise over that time.

Given that theory I think my options are either to have the lantus earlier, or to split the dose. My thoughts with having the injection earlier is that all it?s likely to do is shift when I have this rise to a different time. Sure that will mean it may be easier to correct as I?m more likely to catch it if I go to bed earlier but I?d rather not have the rise at all. So that leaves me with splitting the dose, something I?d rather avoid if possible as my waking up time can vary so wildly and I?d like to keep that flexibility of possible, but of course if it has to be done it has to be done!

So, does anyone have any thoughts or suggestions, I know it?s often easier to spot something if you?re more removed from the situation!

(Sorry for the essay length post)

 

[bev]

My very limited experience with A is that splitting the dose seems to be the best answer.
However, i didnt experiment with changing the timing as the levemir was just running out after about 18 hours - so we started by splitting his dose down the middle - but very soon realised that the overnight dose needed to be two thirds of the total and the morning dose a third. So he has 7.5 units at night and then 3 in the morning and it has him covered nicely for the whole 24 hours and his basal is pretty much spot on.🙂
Sorry if this isnt what you want to hear - i know for A having another injection to remember in the morning is a pain - but he at least will be pumping soon so wont have to worry about that.Bev

 

[sofaraway]

I agree it sounds like a timing issue, I think taking it a few hours earlier would help. If you move the gap earlier to maybe 6-7ish then you can cover the gap woth your evening meal novorapid. so you coudl take your lantus at the same time as your evening meal.

I used to find that my lantus ran out it only lasted properly about 20 hours or so. I took it at 10pm and my pre-dinner and before bed results were high so had to add some to my evening novopraid dose to cover the gap.

I now split my dose and find it gives me great basal coverage. my evening lantus is at 9pm and my morning anywhere between 6-9am so liek you have variable time of getting up.my iniital reluctance at splitting was that my morning dose would be difficult to get consistent, which has proved the case but at the moment I am getting away with it.

 

[tracey w]

Know what you mean aymes, i often cant see the wood for the trees when it comes to working things outfor me, wheras others see it straight away.

Agree with Bev and Nikki, sounds like lantus running out and I was told that lantus does not start to work for at least two hours, (know can be different for everyone though). sounds like splitting or taking earlier may help. the only other thing could be if you are eating foods with a late spike?? Sure your not but just a thought 🙄 good luck

 

[Freddie99]

Ah basals. This split levemir is causing me pain but I'm close to cracking whether I actually need the morning one or not. Take today, at about midday my blood was 4.4 mmol/L. If I hadn't had something to nibble on I reckon I would have hypo'd. I think that's caused by the morning levemir. I'll reduce that to two units tomorrow and test at around midday to see how things go. If it's low I think I'll abandon the morning levemir.

Tom