Basal Insulin Doses

[pawprint91]

After initially stopping my evening basal insulin (I was down to one unit), I noticed my morning readings were slowly yet consistently on the slight rise (up from the 6s into the 7s and 8s), so decided to bring it back (just one unit), I now seem to be back at the 7s, but I've got a weekend that's a bit out of the ordinary so perhaps going to leave this as it is for now and consider 2 units if this is still the case next week.

However, my morning basal is puzzling me slightly. I was down at 4 units and this survived no carb basal testing pretty well. BUT again, my pre-meal readings now seem to be higher (7/8) as opposed to the 5/6 I was getting - does this mean I may need to increase my basal by a unit? However, whilst my mornings go well, sometimes I find if I am particularly active, I can go a bit low (4s) before dinner - would increasing my basal increase the likelihood of this, or would I just be better taking less novorapid with lunch if I know the afternoon might be a busy one? I have noticed these higher readings since I increased my use of novorapid to all meals, not just dinner and I'm having less of a fixed dose and moving more towards finding a ratio that works for me - but I think novorapid is okay as the DSN said if it's done it's job then really you just return to the number you started at (e.g. 6) when it's worn off, which is mostly happening for me, I just seem to have a higher starting number than I used to. These questions seem to have come more in the past two weeks, which has coincided with me getting my first libre so maybe I'm just overthinking it and micromanaging my diabetes, even though I understand it's an ever changing thing, particularly at this early stage for me!

I ask all these questions as a teacher who is back in the classroom next week (without children, they're the week after) and I haven't been back to work since my diagnosis due to how it affected my eyesight, so this will probably have to all change again.

 

[rebrascora]

It sounds like your thinking is right about increasing basal.
Your own insulin production may be waning a little bit and needing progressively more help. Probably a way off the honeymoon period coming to an end, but the start of that process.... the end can take years to get to! 🙄
I would find that my levels would drift up to 8-10 and stick there and I was repeatedly having to add corrections to bring them down and then it would drift straight back up again after the NovoRapid wore off. That was the signal that my basal needed increasing. Usually I would end up getting frustrated with it and injecting too much NR and then hypoing and then levels going back up to 10 and it would be the frustration which would eventually trigger me to increase basal and then the lovely relief of levels behaving themselves for a few weeks.
If your levels are dropping lower after a busy afternoon then you have the option to reduce bolus in advance or have an afternoon snack to keep levels topped up. Having the Libre to keep an eye on things really helps with this.

 

[SB2015]

ask all these questions as a teacher who is back in the classroom next week (without children, they're the week after) and I haven't been back to work since my diagnosis due to how it affected my eyesight, so this will probably have to all change again

Hi @pawprint91 , I was teaching when I was diagnosed.

Being in your feet all day led me to need less insulin for my basal and bolus, so keep a watch on your levels. It is also good to have stashes of JBs everywher. I was in a secondary school, so had some in offices at both ends of the school, just in case I forgot to pick up my bag.

You mention changing doses by a whole unit. I would recommend getting a half unit pen. As you are on low doses it makes it possible to do finer adjustments, and helps to avoid yo-yo ing.

Do come up with a plan with your school about managing hypos and hypers. Lots of different strategies are used And others on here can advise. I had a member of staff who a child would go to if I had a hypo and needed help. This person wouod cover for me if necessary, but I found that the students were great at picking up my hypos and happily got on with what they were doing whilst I sorted myself out.

let us know how you get on.

 

[pawprint91]

I would find that my levels would drift up to 8-10 and stick there and I was repeatedly having to add corrections to bring them down and then it would drift straight back up again after the NovoRapid wore off. That was the signal that my basal needed increasing. Usually I would end up getting frustrated with it and injecting too much NR and then hypoing and then levels going back up to 10.

This is exactly what happened to me last night, so frustrating! Thank you 🙂

Hi @pawprint91 , I was teaching when I was diagnosed.

Being in your feet all day led me to need less insulin for my basal and bolus, so keep a watch on your levels. It is also good to have stashes of JBs everywher. I was in a secondary school, so had some in offices at both ends of the school, just in case I forgot to pick up my bag.

You mention changing doses by a whole unit. I would recommend getting a half unit pen. As you are on low doses it makes it possible to do finer adjustments, and helps to avoid yo-yo ing.

Do come up with a plan with your school about managing hypos and hypers. Lots of different strategies are used And others on here can advise. I had a member of staff who a child would go to if I had a hypo and needed help. This person wouod cover for me if necessary, but I found that the students were great at picking up my hypos and happily got on with what they were doing whilst I sorted myself out.

let us know how you get on.

Thanks @SB2015. I am anticipating a drop maybe needed when I return to work for sure - I have a busy weekend too, so maybe just going to handle being up by 1 m/mol to where I would ideally like to be for the next few days - I am happy being a 7/8 for now, would rather that than risk hypos when out and about!

My school have been really supportive since I was diagnosed, which is lovely. Thanks for your reply, as it's nice to hear from other teachers with diabetes, too!

Edit to say: I just had a letter with my next appointment come through in a months time, so think I will ask about half dose pens then, thank you for the tip!