Basal doses

[Munjeeta]

Last night i woke myself up in the night to test my evening Levemir dose... I went to bed with a blood sugar of 7, when I tested it at 3 am it was 11 then when I woke up it was 9...

I'm not really sure what this means, as i did wake up with a blood sugar only 2units higher than the one I went to sleep which would suggest my basal dose is ok, but the random nocturnal reading of 11 has confused me somewhat...

Does my levemir need to be bumped up a unit or 2? I will try again tonight to see what happens...

 

[tracey w]

Last night i woke myself up in the night to test my evening Levemir dose... I went to bed with a blood sugar of 7, when I tested it at 3 am it was 11 then when I woke up it was 9...

I'm not really sure what this means, as i did wake up with a blood sugar only 2units higher than the one I went to sleep which would suggest my basal dose is ok, but the random nocturnal reading of 11 has confused me somewhat...

Does my levemir need to be bumped up a unit or 2? I will try again tonight to see what happens...

as always, speak to your team, but if this happened to me i would check again incase it was a one off, it it was higher on rising for 2 days this would be classed as a pattern on dafne and need to change basal. You should wake same or similar to number you go to bed on if basal is right, it should keep you steady. hope this helps. As you are going to bed within range it would definately suggest that basal not right.

 

[aymes]

I'd definately agree you need to do the 3am readings a couple more times to check if it is a pattern or a one off.

How long after your last fast acting inslin was the reading of 7? On the basis of going from 11 to 9 (presumably with no fast acting insulin circulating) it would look like the basal may need tweaking, either dosage or timing. The increase from 7 to 11 is more confusing, potentially something to do with your evening ratio if it wasn't too long after.

 

[Munjeeta]

as always, speak to your team, but if this happened to me i would check again incase it was a one off, it it was higher on rising for 2 days this would be classed as a pattern on dafne and need to change basal. You should wake same or similar to number you go to bed on if basal is right, it should keep you steady. hope this helps. As you are going to bed within range it would definately suggest that basal not right.

Thank you - I will wake myself up again tonight, and see what's a happenin'!

I'd definately agree you need to do the 3am readings a couple more times to check if it is a pattern or a one off.

How long after your last fast acting inslin was the reading of 7? On the basis of going from 11 to 9 (presumably with no fast acting insulin circulating) it would look like the basal may need tweaking, either dosage or timing. The increase from 7 to 11 is more confusing, potentially something to do with your evening ratio if it wasn't too long after.

Right... Well my basal dose was taken at 7, my bolus dose at about half 6. The reading of 7 was taken at about 10, so no short acting should really have been in my system. However, I did just remember that I had a hypo mid-evening, so although I was 7 when I went to bed, the long acting carbs from that were probaby still acting, hence the rise to 11...

Trouble is, I've had a hypo tonight too (obv need to change my evening meal ratios too... 😛 ) so same effect will prob be seen... Oh joy! Nothing seems to work for long

 

[aymes]

it's really difficult to try and spot patterns when you've been having hypos (frustrating if the problem is hypos!) as there are so many variations in what's happening, hypo treatments working, potential rebound effect etc...

Keep goin with it, you'll get there!

 

[Munjeeta]

Thanks 🙂 I will keep going. It's just frustrating. I can't seem to stop the hypos. It's constant swinging between highs, lows then back to hypo bounce-back highs...

 

[Munjeeta]

Ok, so this morning I have not eaten breakfast and tested every hour.

9am - 8.5
10 am - 8.1
11 am - 9.3
12 pm - 8.8
1 pm - 7.6

I know these aren't perfect readings by any stretch of the imagination but am I right in thinking that the 14 units of levemir I give myself in the morning is correct?

I need to work on my evening dose to bring the morning reading down within range I know...

 

[Adrienne]

Wow they are great readings in as much as they are on an even keel. They need to be slightly lower but I think you will get there if your waking level was lower. I personally think you are right and you need to sort out the nighttime and get the waking one lower then the whole day will be lower on the levemir you are already on in the morning.

 

[aymes]

That looks like your basal is pretty much spot on then and it's kept you really steady (the rule of thumb i've been told to work to is that you remain +/- 1 unit. As you say your ratios etc may need some tweaking to get you on target but that's so much easier to do once you're confident your basal is right.

 

[Northerner]

There's nothing to beat being confident in your basal doses! Well...there probably are some things, I admit! I have pretty much sorted out mine after several months of nightly lows and sleeping hypos. Last night I went to bed on 5.7 and woke this morning to...5.7! I just had a biscuit before bed, as I knew this was enough to get me through the little peak of lantus that I get.

I did a bit of basal testing last week and found that my levels rise slightly - maybe up to 2 mmol/l - but still staying within range (for example, woke at 4.8, rose to 6.4 five hours later). I accept this rise as it means I no longer have to worry about nighttime hypos, and that in turn is good because I no longer feel I have to go to bed high to prevent them (if you see what I mean!)

Good luck!

 

[Munjeeta]

Thanks for your replies.

Wow they are great readings in as much as they are on an even keel. They need to be slightly lower but I think you will get there if your waking level was lower. I personally think you are right and you need to sort out the nighttime and get the waking one lower then the whole day will be lower on the levemir you are already on in the morning.

Yes, good morning readings are something I have struggled with since I was diagnised, I've never managed to crack them! I am trying to do nighttime waking tests, but unfortuntely seem to have had a spate of evening hypos which have sent everything a bit haywire. Today's goal: no hypo!

That looks like your basal is pretty much spot on then and it's kept you really steady (the rule of thumb i've been told to work to is that you remain +/- 1 unit. As you say your ratios etc may need some tweaking to get you on target but that's so much easier to do once you're confident your basal is right.

It's good to think that maybe it's finally right... Thanks for your help! 🙂

There's nothing to beat being confident in your basal doses! Well...there probably are some things, I admit! I have pretty much sorted out mine after several months of nightly lows and sleeping hypos. Last night I went to bed on 5.7 and woke this morning to...5.7! I just had a biscuit before bed, as I knew this was enough to get me through the little peak of lantus that I get.

I did a bit of basal testing last week and found that my levels rise slightly - maybe up to 2 mmol/l - but still staying within range (for example, woke at 4.8, rose to 6.4 five hours later). I accept this rise as it means I no longer have to worry about nighttime hypos, and that in turn is good because I no longer feel I have to go to bed high to prevent them (if you see what I mean!)

Good luck!

I've been following your basal journey, Northerner, it's good to see that I'm not alone! And it's also good that you seem to be getting there with it! I can't believe that I've been diabetic for so long and not actually been given the guidance from my various diabetes teams that I have got on here... However, I do have to come back to my state of mind... Half the battle is accepting it and, after 14 years, I think I've only actually done that in the last few months 😱