Changed basal now big spikes

[Lauren8443]

Hi, I've been playing around with my basal injection and amounts over the past couple of months. I think I have it Sussed at 15.5 units before bed, and stay relatively level through the night.

I have noticed that I am getting much bigger spikes after eating though???? Upto 15! Then panicking and over correcting to bring them down.

If the basal is correct throughout the night, is it just down to bolus ratios now?? And if lantus isn't lasting 24hrs (which I think it's definitely not) then do I increase the bolus I:c ratios through the day??

Any advice would be appreciated

 

[khskel]

Can't help you with the lantus duration as I've never used it. Sounds as though it could well be your bolus ratios. Have you done any daytime basal testing to see what happens without food/insulin?

 

[Lauren8443]

I've only ever focus on night time basal testing.... if I test basal testing in day, this presumably effects my bolus ratios if it naturally goes up/down, as can't inject more basal at different times??

 

[trophywench]

Well you use the basal testing to adjust your basal insulin so you don't go 'up and down' - it may mean splitting your basal dose - but if you can't get a fairly flat BG throughout the whole 24 hours with one jab of Lantus - you can always try a different basal. For instance Levemir - that is designed to have 2 jabs daily and because you're injecting less insulin in each jab, neither of them lasts the full 24 hours (or longer) - a lot of us found 2 jabs of Levemir matched our bodies far better than one of Lantus and ironed out quite a lot of the ups and downs throughout each 24 hrs that we'd had with one jab of basal insulin.

It's true you shouldn't have extra jabs of any basal insulin - however say your BG starts rising in a morning before lunch, so when you test then you're nowhere near as low as you'd want to be - you can add a 'correction' amount of insulin to the bolus for the meal you are about to eat. However - this is NOT a long-term solution - you shouldn't need - and wouldn't want - to need to do it all the while.

If I were you I'd do the daytime basal testing - and then look at that to see where any highs and lows are (you need to do them all over a period, so you then consider what's happening the whole day, not just bits of it. If you want second opinions where others can suggest what they'd do if the results were theirs, post the results and we will. In any event - this is a good thing to do and take the results to your DSN specifically and get their advice - since that's where you'd ask (if you thought it might solve it) about changing brands of insulin, splitting doses, or whatever. I presume you do see a DSN at your hospital diabetes clinic fairly regulary ?

 

[SB2015]

I too switched to Levemir in order to split my basal, as I did not have a flat profile during the full 24 hours. It was well worth it as I was also able to adjust my morning basal depending on what I had planned for the day ahead, which with Levemir was impossible and the night before I would have not known what the plans were, as life is now so flexible.

 

[mikeyB]

Ditto, switching from Lantus to split dose Levemir solved my varying profile. It's pointless splitting Lantus, it makes no difference. It's not the Lantus wearing off that's the problem, it's your body's varying requirements.

 

[malturn]

I split my Lantus 22 units at 7.30am and 22 units at 7.30pm this in conjunction with my humalog bolus seems to keep me pretty level most of the time. my wake up average is between 5 and 6 every day, and I very rarely go higher than 9 even after a misscalculation on my carbs.

 

[Ref]

I wouldn't say it is pointless splitting Lantus - it might work. It does for me - and it is worth giving that a go before changing to Levemir. Despite the supposed flat profile I found Lantus peaked with me and I would hypo. Consultant suggested splitting the dose and that works fine for me and goes some way to accommodating my body's varying requirements. I currently take 6 in the morning and 5 in the evening but the other way round has my BGs all over the place.