Basal testing - much needed advice

[Lauren8443]

hi, I'm currently trying to work out my Levemir basal split doses, since moving from 1 lantus injection last week. I think I have cracked the before bed does at 10 units at 10 am.... today I tried 12 units this morning and fasted from 6am to 12pm, my BS rose from 4.6 to 8.... do I just keep adjusting until my morning BS stays stable from 6 to 12?? Then I know I have the correct dosage.

Surely I don't need to fast from 12pm to 6pm if I am just basing it on the two spilt doses?

I seem to really spike in the morning with carbs at the moment since being on Levemir, never used to on lantus. Is this just because my basal rate isn't correct yet???

Help and advice much needed

 

[Ginny03]

Increasing your morning basal might have a limited effect on the morning rise in your sugars, as it takes Levemir a good few hours to act. I never have breakfast and have a very similar morning rise to you (sometimes even bigger!) The only way I've been able to combat it is with a dose of humulin s in the morning - (not humalog because that acts too quickly, but also not for long enough). Really I'd need to increase my night dose to get the morning down, but I can't do that because then my sugars too much when I'm asleep. With the humulin, I've got good level control.

If you can get the morning sugars correct by just adjusting the levemir, it would be worth doing a fasting from noon til 6pm, as if you're anything like me you might find your sugars then falling during that time... I really have found this insulin a bit of a nightmare. Hope you get yours sorted!

 

[Lauren8443]

I was on lantus before and was pleased with how it worked, but my blood sugars were dropping during the night, so I have moved to Levemir in order to get more control with two split does. It doesn't seem to be working that great for me though.

I might give it a couple more days and move back to lantus but move it to the morning instead of before bedtime, see if that works .

Not sure what it is with Levemir, it just seems sluggish to me?!

 

[Ginny03]

4 hours ish for it to get up and running, so yes, it is sluggish. I'm sorry to say that I still get that low with it at night as well - usually 3am - so bedtime snacks are a must.

 

[Lauren8443]

Have you ever been on lantus? Do you think moving it to the morning would be a good move to try and avoid night time Lows?

 

[trophywench]

Well definitely would Lauren since Lantus ALWAYS peaks at around 4.5 to 5 hours later whenever you take it but if you took it at 10pm it would absolutely coincide peaking with the body's natural lowest BG - which absolutely isn't the Best Plan for almost anyone!

I found the opposite with Levemir, that it responded far far quicker than Lantus for me - but we are all different. So having it in the am at 6am you'd most likely have to have your lunch at 1.00pm at the very latest to avoid lunchtime hypos instead - I had to change to permanent 'early' lunch - 12 - 1.00 when I was on it, and lower my lunchtime carb ratio and go high late afternoon instead, till they invented Levemir. What a breath of fresh air!

Anyway - Basal testing is the only way with any basal insulin, whatever it is - and you are supposed to do it in roughly 6 hour blocks - but only one block at a time - here's a link to the way to do it as taught to not only me but most of us attending either DAFNE or BERTIE type courses. Scroll down the page to 'How to discover ...' http://www.diabetes-support.org.uk/info/?page_id=120

Happy testing!

 

[Ginny03]

Have you ever been on lantus? Do you think moving it to the morning would be a good move to try and avoid night time Lows?

Nope - though I'm tempted to give it a try!

 

[sunny sanghera]

I may be changing my lantus to levemir also due to night time hypos which have almost killed me and I have lowered my lantus dose and still get hypos so it's abit of a nuisance

 

[everydayupsanddowns]

Have you ever been on lantus? Do you think moving it to the morning would be a good move to try and avoid night time Lows?

I was considering switching to Levemir before I started on a pump. Lantus at breakfast was far better for me in terms of overnight hypos (used to have lots on Lantus when taken at night) but I did find that I had more problems with spikes after breakfast as Lantus took a while to get going and the previous dose was tailing off while I had breakfast and early morning hormones kicking off!