Oh bother this bloomin' basal!

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Northerner

Northerner

Admin (Retired)
Relationship to Diabetes
Type 1
A few weeks ago I thought I'd got my basal cracked - 20 units lantus. Then I started getting lots of low readings, adjusted both bolus and basal, lantus down to 18. Again, thought this had stabilised with good fasting readings in the 4.x - 5.x area. However, a few days ago, my waking sugars were in the 3.x area, so I reduced lantus to 17 units.

But, lo and behold! Yesterday morning I woke to 2.6 and last night I woke up at 2:15 and tested - I was 2.5! I had gone to bed without a snack on 7.7. I had some jelly babies and a cereal bar and woke to 4.4. I'm thinking I might drop down to 15 lantus to see what happens - if I get high readings I guess I can live with that for a day. The slightly odd thing is that I missed lunch yesterday - first meal I've missed since diagnosis! - took a reading at around 3:30 pm and it was 4.9, suggesting that the basal was OK.

Anyone else experience this? I hadn't done anything out of the ordinary over the past few days to make me more sensitive. :confused::confused:
 
can I hit you with some Q's?!

when you changed your basal did you alter your ratio?
have you changed your injection site of the lantus?
are you doing one dose of lantus or spliting and what time do you take it?

so many questions I know, but lantus is a friend of mine, I know him well, and he likes to play up....
 
Sounds nuts - but mine is suddenly going haywire too - I have had to reduce mine just recently - after having to put it up last week! - Don't laugh - but it could be the weather - it is getting warmer - and I know heat affects your insulin absorbtion. When I was travelling - at one point I thought I was going to have to drop my lantus completely! At the mo that is the only thing I can think of - I have been hot at night (need to get summer duvet out!) and have been going low over night despite going to bed at 7's or so. Usually your bs should only reduce by 2 overnight! So same as. At the end of the day I don't try to rationalise it - have been at it so long realsied there is no rationalisation!

Not a lot of help - but you aren't on your own! :D
 
Sugarbum said:
but lantus is a friend of mine, I know him well, and he likes to play up....
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Hehe

How long after your evening meal is your bedtime reading? Is it possible that your n'rapid is still working when you go to bed? So that at 7.7 you are still heading downwards.

I have found out one of my old diaries and I can see that I was using 22 units for weeks then I woke up 3 days in the 3.x range dropped to 20 units which worked for 4 days then started waking up 3.x again so dropped to 18 units and then stayed on 18units for the remainder of the diary- about 5 pages

I think lowering your basal by 1-2 units each time is a sensible approach as it does seem like a basal issue. Have you tried any formal basal testing during the day?

I agree with Admin and have suggested it before that the weather and seasons could be having an affect. I've had the opposite effect i am now taking double the amount of basal insulin I was in December, and have recently split the dose, which is working well for me.
 
Sugarbum said:
can I hit you with some Q's?!

when you changed your basal did you alter your ratio?
have you changed your injection site of the lantus?
are you doing one dose of lantus or spliting and what time do you take it?

so many questions I know, but lantus is a friend of mine, I know him well, and he likes to play up....
Click to expand...

I have always injected lantus in my tummy, alternating sides. Have thought about splitting the dose as I have long suspected that I'm getting an early peak after injecting. I take it around 10:30 pm which, in answer to nikki's question, is probably only around 3.5 - 4 hours after my evening meal so there is a possibility that the novorapid is still at play - although this is countered by the fact that I think my lantus has been depleted before the full 24 hours are up (have read somewhere that it is effective over between 18-24 hours, rather than actually 24 hours). My bedtime readings are lower than they were as I've got more accurate in my NR calculations, and I have been to bed at levels of 7.x before with no adverse effects. I haven't had a double figure bedtime reading since January.

I have felt warmer recently, and my mood improves tremendously when the sunshine and longer days appear, so it may be this that is affecting my metabolism in some way. I was wondering, actually, if there is in fact a fairly constant rate at which the liver releases glucose, or if this can vary (maybe also seasonally). Certainly warmer at night - got very hot last night so might switch to 'Spring' duvet from 'Winter' - also, didn't need a hot water bottle last night for the first time in months. Plus, the chilblains on my toes are healing, suggesting that I am warmer generally. It's my first experience of Spring with diabetes, so have no previous knowledge of how it might affect me!
 
FYI - I moved pregnancy news to a different thread - didn't want to detract Northerner!
Admin x
 
sofaraway said:
I agree with Admin and have suggested it before that the weather and seasons could be having an affect. I've had the opposite effect i am now taking double the amount of basal insulin I was in December, and have recently split the dose, which is working well for me.
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Me too, I find changes in the weather have quite an effect on me.
 
Hi Northerner

Just a suggestion but has anyone ever said maybe you should try Lantus in the morning instead of evening, before you try splitting the dose. Again I speak only from experience with my daughter and also others I know who have done this but have been children.

You are right Lantus lasts between 18 and 22 hours tops. Levemir even less at about 16 to 20 (complete tops) which is why Levemir generally ends up being split more than Lantus.

The theory of why Lantus is always suggested in the evening is that it was not given to small children to begin with, only teens and adults and of course they can have lie ins in the morning so would miss the injection time. So when they started young children on it ie my daughter she was injected at teatime. She was always hypo in the morning or too low so we changed it quite quickly to 8 am. We found that it worked well for the first 12 hours much better than the 2nd lot of 12 hours.

Might be worth a try but obviously as others say, speak to your team.

Just a thought.
 
my lantus is working great now and i aint had a double figure reading at all in weeks!!!!! i dont split dose as i find this has a bad effect on my levels and also i was told if you adjust your lantus it takes 3 days for it to change in your system. got my a1c done the other day and it has been bad for the last 2 (last bad on was 13%) and we couldnt figure out what was causing the high levels i was getting. new a1c is down to 7.2% so im made up!!!!! found out i had become resistant to insulatard and needed to be swapped to lantus as my basal.
 
mikep1979 said:
my lantus is working great now and i aint had a double figure reading at all in weeks!!!!! i dont split dose as i find this has a bad effect on my levels and also i was told if you adjust your lantus it takes 3 days for it to change in your system. got my a1c done the other day and it has been bad for the last 2 (last bad on was 13%) and we couldnt figure out what was causing the high levels i was getting. new a1c is down to 7.2% so im made up!!!!! found out i had become resistant to insulatard and needed to be swapped to lantus as my basal.
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Excellent Mike - clearly heading in the right direction, and good to hear that they tracked down the cause of those earlier highs. I'd prefer not to start messing about too much with my routine - it's convenient for me as it is and I think it's just a case of getting the best out of it - although Adrienne's suggestion of moving the injection to the morning is something I have been considering. My concern with that would be that I might be 'running on empty' for a few hours before waking if the lantus doesn't last 24 hours. Currently, I have novorapid circulating in the evening, even if the lantus has all gone.

Last night reduced to 16 units and woke this morning at 5.2, so I'm happy with that🙂
 
yeah i am well chuffed that they are coming down really well. just hope i stay ok on the lantus now lol.

i got switched to split dose and then morning dose on my insulatard before they swapped me over to lantus and i must say both times it made me feel worse. started lantus on a morning schedule and felt like it wasnt running right, so my dsn swapped it over to night time and it has worked better ever since. looking at the reading you got today northerner it may be you need to reduce it a lil, but like everyone on here has said ask your dsn what they think first.
 
Hi Mike

That is a great HbA1c.

Northerner, you are right of course and you could end up running on empty. With my daughter that worked out ok (ish) as she always dipped early hours anyway and ended up staying down there so she woke up generally under 8.0 (I know that is high ish to wake up on but for a child that's not too bad on injections). Pumping I like 5.0 and 6.0 on waking.
 
Still not quite getting it right. After my reduction to 16 lantus I've had readings of 5.2, 4.7 and 3.6 today on waking. Going to try another unit reduction tonight! I must be saving the NHS a fortune with my reduced insulin usage - I'll probably save at least a pint over the next 30 years if I continue like this!🙂
 
Northerner said:
Still not quite getting it right. After my reduction to 16 lantus I've had readings of 5.2, 4.7 and 3.6 today on waking. Going to try another unit reduction tonight! I must be saving the NHS a fortune with my reduced insulin usage - I'll probably save at least a pint over the next 30 years if I continue like this!🙂
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Perhaps theres some kind of exchange negiotion you could enter into? Crack some kind of deal for more test strips?!
 
Sugarbum said:
Perhaps theres some kind of exchange negiotion you could enter into? Crack some kind of deal for more test strips?!
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Perhaps they could pay for my next pair of running shoes? 🙂 I'm now saving them even more, as I have reduced to 15 lantus over the past couple of nights, waking to 5.5 yesterday and 5.1 today...
 
Northerner said:
Perhaps they could pay for my next pair of running shoes? 🙂 I'm now saving them even more, as I have reduced to 15 lantus over the past couple of nights, waking to 5.5 yesterday and 5.1 today...
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...and 4.0 this morning, so going to try 14 units tonight. Seems that the more I reduce my lantus by, the lower my numbers get - something doesn't seem quite right with that!:confused:
 
Northerner said:
...and 4.0 this morning, so going to try 14 units tonight. Seems that the more I reduce my lantus by, the lower my numbers get - something doesn't seem quite right with that!:confused:
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Hmmm, have you tried some tests during the night ( pain I know) to get some idea of what is happening during the night? I'm not sure where I'm going with this but it could show if you're steadily dropping or if the lantus is having some sort of peak just before you wake up? What sort of numbers are you going to bed with?
 
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