Oh bother this bloomin' basal!

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aymes said:
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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I did do a test in the night a few days ago and I was 2.5, which is one of the things that convinced me to lower the lantus. I've been going to bed around 5.5-7.5 over the past few nights, but with a snack of bread and peanut butter. My daytime (pre-meal) readings have also been dropping low, despite being similarly cautious with the novorapid, so I've assumed a reduction in basal is needed too. I'm not overly anxious about things because I do seem to be just about staying 'ahead of the game' and my levels are actually pretty good on the whole, just a little perplexed!🙂
 
Reduced the lantus to 14 units last night...and woke to 3.9 this morning! At this rate, I'll be cured by the end of the month😉
 
Northerner said:
Reduced the lantus to 14 units last night...and woke to 3.9 this morning! At this rate, I'll be cured by the end of the month😉
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Aaah thats so funny! If only eh :D

Suppose you will just have to keep dropping. my dsn told me that when i started on lantus (couple of weeks ago), i probably woould find i would need to reduce my fast acting? havent needed to, just wondering if you have reduced your fast acting and if so to what effect?? Or have you just been dropping the lantus?
 
tracey w said:
Aaah thats so funny! If only eh :D

Suppose you will just have to keep dropping. my dsn told me that when i started on lantus (couple of weeks ago), i probably woould find i would need to reduce my fast acting? havent needed to, just wondering if you have reduced your fast acting and if so to what effect?? Or have you just been dropping the lantus?
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Hi tracey! No, I've been dropping the novorapid, although not quite so much recently. I've been dropping the lantus because my fasting levels have been too low. So, I was giving the correct bolus for a meal, but once the quick acting had dissipated I was still hypoing. Both my NR and lantus are now around 30% lower than a couple of weeks ago. It's interesting because a few months ago I dropped my lantus by one unit and my fasting levels came up 2-3 mmol. Now I drop by one unit and the levels either stay the same or drop, so it seems to be a progressive change in requirements that I'm just about keeping under control!😱

Not planning on any further reduction tonight, so will see how things are tomorrow!
 
good luck, hope it stabalises soon! sometimes we just dont know why things happen and then suddenly all back on track, lets hope so 🙂
 
Reduced the lantus to 12 last night, and woke to 4.6 this morning. It will be interesting to see how things are in a week's time. My total insulin yesterday was 42 units, down from 60 units a couple of weeks ago.:confused:
 
a rough equation that can be used is that people with type 1 would use 0.5 units per kg of weight.

So if someone weighed 60kg then they would use in region of 30 units a day.

how does that fit with you?
 
sofaraway said:
a rough equation that can be used is that people with type 1 would use 0.5 units per kg of weight.

So if someone weighed 60kg then they would use in region of 30 units a day.

how does that fit with you?
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That's total insulin? Hmmm...rather stands the argument on its head! Before Christmas I weighed 55 kg, but my weight has now increased to 65 kg - yet I'm using nearly a third less insulin! I've been thinking that maybe part of this is down to the fact that I was extremely ill and I've been gradually recovering. Even though I may have felt OK for a couple of months, maybe there have been some unseen little recovery stages going on that I'm unaware of, but that have had some impact on my insulin usage and I'm gradually heading towards that equation.
 
We just had a meeting with our DSN last week because our son's insulin needs have gone up by 50% since diagnosis 5 months ago. She told me this: at diagnosis, people normally start on .5 units per kg of weight. In some children and in some adolescents in particular, the insulin needs settle to 1.0 units per kg of weight (which is exactly where he is now, amazingly) -- with the proviso that with growth and changes through adolescence, the needs can rise to 1.2 or 1.5 or even, with some girls, to nearly 2 units per kg of weight.

She then said that insulin requirements tend to settle again after adolescence to about .75 units per kg. By my calculations, you are at about .7 units per kg right now! Don't know if this helps at all, but it may help with reassurance or ball park figures!
 
Slight blip yesterday as I woke to 6.8 which is unusual for me, but stuck to the 12 units of lantus and woke to 4.6 this morning. Contemplating a reduction to 11 units tonight...
 
Reduced my lantus to 11 units last night and woke up to...3.3 this morning! Goodness knows what would be happening to me if I was still on 20 lantus!😱
 
not long and you really will be cured!

I wonder if you can get on a CGMS so you can see whats going on overnight,
 
Patricia said:
Northerner, you are really fighting some battles here -- the unpredictability is so hard and wearing! I feel for you.
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Hi Northerner

Have you thought about changing to give it in the morning for a while and see what effect that has? You could always change it back if you didn't think it worked.
 
Patricia said:
Northerner, you are really fighting some battles here -- the unpredictability is so hard and wearing! I feel for you.
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Actually, it isn't that unpredictable - if I reduce my lantus I can predict that my requirements for lantus will reduce! lol!:D

I reduced to 10 units last night and woke this morning to...3.9! I'm wondering whether to reduce to 9 tonight, because if my requirements are still dropping 10 might give me lows during the night.

Adrienne - I've thought about giving the lantus in the morning, but it is more convenient at night. I don't appear to be having night hypos at the moment, although I undoubtedly would be if I wasn't keeping on top of the dose reductions. I wouldn't know how to change to a morning dose - do you just not take it the night before and risk going high that night?:confused:
 
Like anything I don't think you can use the insulin/weight ratio for everyone and it should only be used as a guide. My insulin requirements are way under this due to my healthy diet and small portions. I do not follow DUK advise on high carb/starchy meals - hence their insulin ratios are waaaay out for me!

Northerner - I know you are very athletic and full of muscle which use up more energy, so again you will be very different.

Out of interest Northerner - you are hypoing over night - but what are your levels like during the day? Are you having to eat more? Are they going low inbetween meals?
 
Northerner said:
I wouldn't know how to change to a morning dose - do you just not take it the night before and risk going high that night?:confused:
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That's how I was advised to go about it, and just be prepared for a correction in the morning. Or I guess you could split it first and then move it entirely to lessen the 'jump'...?
 
Maybe you are in some kind of weird, nether-region self-fulfilling prophecy place, where when you move toward something, it moves further away and so on, a big cycle... Nah.

Might it be worth reducing more than one unit at a time? We had the opposite with E, and increased by 20% each time rather than the recommended 10%, because the situation was so clearly extreme. My understanding is that for levermir anyway, a 1 unit increases more or less should equal a 1mmol adjustment... This has turned out to kinda be the case once the change beds in...
 
Patricia said:
Maybe you are in some kind of weird, nether-region self-fulfilling prophecy place, where when you move toward something, it moves further away and so on, a big cycle... Nah....
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Exactly like the Greek myth of Tantalus! Which spookily contains the word 'lantus'!😱😱
 
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