Basal Insulin Dosage

[JoeJOns]

Hey guys,

Just wondering, how many units of Basal insulin do you take a day? And how do you feel it benefits you?

Kind regards

 

[rebrascora]

I have just upped my basal (Levemir) to 14 units and been given the green light to split the dose last week, so 7units in the morning and 7 at night. I am at last getting some stable readings in the normal range after several months of being mostly in the 10s with occasional hypos. The basal insulin mops up slow releasing glucose from proteins and fats I believe whilst the bolus deals with the readily digested carbohydrates which hit the blood stream quite quickly after being eaten. If you didn't take basal insulin, your BG would probably rise overnight and you might require more small bolus insulin doses through the day to try to keep your BG steady, but it would be much more difficult to balance it.

 

[Robin]

The basal insulin mops up slow releasing glucose from proteins and fats I believe whilst the bolus deals with the readily digested carbohydrates which hit the blood stream quite quickly after being eaten.

Basal also deals with the trickle of glucose that is put out by the liver 24 hours a day, to keep your vital organs (especially your brain) supplied with consistent fuel. So if you didn’t take basal, your levels would rise, irrespective of whether you ate or not.

 

[JoeJOns]

I have just upped my basal (Levemir) to 14 units and been given the green light to split the dose last week, so 7units in the morning and 7 at night. I am at last getting some stable readings in the normal range after several months of being mostly in the 10s with occasional hypos. The basal insulin mops up slow releasing glucose from proteins and fats I believe whilst the bolus deals with the readily digested carbohydrates which hit the blood stream quite quickly after being eaten. If you didn't take basal insulin, your BG would probably rise overnight and you might require more small bolus insulin doses through the day to try to keep your BG steady, but it would be much more difficult to balance it.

Oh nice. That's much the same as what I am on. I take 13 units a day except I take it all in the morning! It seems to be keeping me relatively stable at the moment throughout the day and night. Although my sugars go up a tiny bit during the night between 3-6am. I was diagnosed a month ago so I'm just getting used to everything! Hope you are happy and managing everything well 🙂

 

[rebrascora]

Basal also deals with the trickle of glucose that is put out by the liver 24 hours a day, to keep your vital organs (especially your brain) supplied with consistent fuel. So if you didn’t take basal, your levels would rise, irrespective of whether you ate or not.

Thanks Robin for including that very important info that I left out!

 

[JoeJOns]

Basal also deals with the trickle of glucose that is put out by the liver 24 hours a day, to keep your vital organs (especially your brain) supplied with consistent fuel. So if you didn’t take basal, your levels would rise, irrespective of whether you ate or not.

That's interesting. I wasn't actually aware that this happens! I have to say, I have learned more about diabetes on this forum than from anywhere else!

 

[Deleted member 25429]

I only take 6 units but still in the honeymoon period . I take very little fast acting as I am on a very low carb diet

 

[JoeJOns]

I only take 6 units but still in the honeymoon period . I take very little fast acting as I am on a very low carb diet

I'm also in the honeymoon period at the moment but I decided to opt for a kind of higher dose of basal because my sugars were quite high initially. I'm interested in looking into a low carb diet for the future, just at the moment I have to put on some weight so I'm taking in quite a bit of carbs, fats and protein. How are you finding the low carb diet?

 

[rebrascora]

I love my low carb diet and I just increase my fat intake if I need to put on weight or decrease it and do a bit more exercise if I need to lose a bit.
It does take a bit of getting your head around because we have spent our whole lives piling our plate with carbs like bread and potatoes and pasta at every meal but once you grasp the basic principles of low carb and develop a shopping list and have a few menu ideas it is pretty easy and I am starting to experiment more with my cooking/food than I ever did before and it is really tasty.

 

[Kaylz]

but I decided to opt for a kind of higher dose of basal

you make it sound like it's a choice of how much basal you use which isn't the case at all, it should keep you level and that's what you need, you don't really choose a dose

 

[Deleted member 25429]

I'm also in the honeymoon period at the moment but I decided to opt for a kind of higher dose of basal because my sugars were quite high initially. I'm interested in looking into a low carb diet for the future, just at the moment I have to put on some weight so I'm taking in quite a bit of carbs, fats and protein. How are you finding the low carb diet?

I had been on a diet before I had a DKA and was diagnosed as type 1, so I haven’t had to adjust my eating habits . Still managing to loose weight and bring my hba1c down to 41 . I can tolerate rice , but potatoes are a no no for me . I always have low fat cheese with any carbs. It’s all a learning curve and it appears that everyone is different. Good luck

 

[JoeJOns]

you make it sound like it's a choice of how much basal you use which isn't the case at all, it should keep you level and that's what you need, you don't really choose a dose

I understand that it isn't a choice, it's probably just the way I am coming across through typing. I'm still getting used to things hence I'm probably asking some stupid questions and saying stupid things

 

[KARNAK]

I had DKA and a HbA1c of 156 on DX, I was put on Insulin of 14 units in the morning and the same in the evening. The D nurses came into my home after being released from hospital and couldn't get my meter to read anything but high for ten days, eventually managed too get a reading🙄 but the dosage had gone up dramatically. Got called in by the Consultant and ended up on 56 units of Basal in the morning and 34 in the evening,😱 I am now two years later on 18 AM and 5 PM plus NovoRapid with food. I managed to get my HbA1c down from 156 to 48 in 3 months, thankyou forum, now at a steady 38/9, the only real problem I have is to take Creon made from a pigs pancreas as an Enzyme, stay near a loo. My Basal gets corrected nearly every other day, personal choice but the DSN & Consultant approves. Just a little insight into big D management @JoeJOns, take on board as much as your brain can handle, you are doing well and mixing in with our community, we look forward to more positive posts or negative but we are here for you and each other, take my friend.

 

[leonS]

Kaylz is absolutely right. The condition at diagnosis has very little to do with the dose needs, and more to do with such factors as how soon were you treated after the on set and what your life style had been, and many other things that have nothing to do with the treatment required.

It VERY important to get the basal dose right as NOTHING else will work as it should otherwise. If the base dose is too high or low you will have to compensate by using a very low or high bolus, and this will lead to large swings in BG.

As a guide (from the internet) the total insulin dose should be your weight in Kg multiplied by a factor, which is between 0.5 and 0.7. Half of this should be basal insulin. I take no responsibility for this, it came from various web sites - I would be interested to know how this compares with actual doses needed.

i use 30 units/day long acting insulin.

 

[everydayupsanddowns]

The easiest way I found to check whether my basal was doing it’s job properly (which I only discovered after almost 20 YEARS of T1D) is to undertake a series of fasting basal checks through 24 hours.

Once i’d got my head around the way my basal needs ebbed and flowed, rising and falling through the year, my diabetes became a lot less ‘random’.

There’s a good write-up about basal insulin and how to tweak your dose here: https://www.diabetes-support.org.uk/info/?page_id=120

 

[leonS]

The disturbing part is "I only discovered...". Why is this not part of the instructions given by the HCT? I too "only discovered" after a few years of struggle to get base-bolus working.

There are a few sites that give this sort of information

 

[everydayupsanddowns]

The disturbing part is "I only discovered...". Why is this not part of the instructions given by the HCT? I too "only discovered" after a few years of struggle to get base-bolus working.

There are a few sites that give this sort of information

It’s a regular part of pump induction, but rarely seems to get mentioned for people on MDI outside of forums. 🙄

 

[trophywench]

The disturbing part is "I only discovered...". Why is this not part of the instructions given by the HCT? I too "only discovered" after a few years of struggle to get base-bolus working.

There are a few sites that give this sort of information

Which was precisely why the founder members decided we needed an article about basal testing (as mentioned by everydayupsanddowns above) when we launched the www.diabetes-support.org.uk website & forum all those years ago ! Terry G and I wrote it - he'd recently had a pump & been on DAFNE at his hospital in the home counties and I was on MDI and recently been on the UHCW 'CARBS 4 1' course (very much based on BERTIE) and received very very similar advice which we were constantly explaining to forum members; hence it was a lot easier to bung it on the website and respond with the link.

With such a large proportion of insulin users of all types not getting regular advice from EXPERT SPECIALIST medical personnel these days - and even those of us that do, being asked whether we really need to see them twice a year still - this lack of Really Useful medical advice is getting more widespread. It's worrying to me!

 

[Ljc]

I first heard of basal testing on here, to date no DN at my practice has even heard of it .