Suggestions

[Emmaathome]

Hi All

I know you can't give me medical advice, but I would appreciate suggestions - I am seeing the DSN on 23 July.

I am currently taking 16u Lantus on an evening, along with 10u Novorapid with my evening meal. Waking BG levels are usually between 9-12.

My daytime levels are usually not too bad - from lunchtime through to evening meal, they are usually quite good - between 5.5 and 8 (I know a little higher than they should be, but i'm grading on a curve!).

I think the Lantus must be "peaking" during this time then - so I think a split dose of Lantus would help to reduce evening / nighttime levels. I understand Lantus isn't designed to split from what I've read - but i could be wrong (usually am!). I am wondering if I would be better with a split of the Lantus (or a.n.other long acting insulin).

I just want to try something to get my levels down and rather than just keep increasing the medication, I wonder if the timing of it might help me? What do you guys think? Any suggestions gratefully received!

 

[bigpurpleduck]

Do you test before bed? If not it might be that 10u Novarapid isn't enough for your evening meal and the high BG is running on into the morning.

If yes and it is the Lantus that needs looking at I'm unsure whether or not this can be split - I know Levemir can but not certain on Lantus. Hopefully someone else can help with that one!

I'd also like to add that numbers between 5.5 and 8 sound pretty damn fantastic to me if you're not long diagnosed! Even 9-12 is an achievement. Heck, 9-12 would be an achievement for me some days and I've been at this for nearly 20 years! Keep up the good work 🙂

 

[Flutterby]

I was going to ask what your pre-bed reading is. Lantus can be split - I was told that yesterday at the X-pert insulin course but they might decide to switch you to Levemir - that's what happened to me and I like Levemir better. The other question is "if your prebed levels are lowish - are you hypo-ing in the night?" that would give a rebound high in the morning. I'd start by checking pre-bed levels to establish if they are ok and if they are then check during the night and see what's going on. Best of luck.

 

[Emmaathome]

Bedtime levels are usually same or a couple of "points" higher but not miles higher.

I haven't been told how to work out how much novorapid to take based on food intake - just a "wild guess" by the doc - we started on 6u and now we're on 10u. Can you advise how many units is usual to take per g of carbs? I can then have a look at the carbs and cals app, to try to match insulin to food

thanks

 

[Flutterby]

Unfortunately it varies from person to person so there's no hard and fast "rule" they start by saying assume one unit of rapid insulin to 10g of carbs and then with testing and practice you will work out whether you need more or less. I don't think you should alter anything at this early stage, I would just do plenty of testing so that you have lots to show the DSN and perhaps keep a food diary when you can showing what you ate, what insulin you had and what your results were. That's the best advice I can give and I've noticed that you are type 2 - I had missed that before so it may be a little different. Do the tests, keep the food diary and let the DSN help you further.