Too much basal or bolus

E

ellevee

Member
Relationship to Diabetes
Type 1
Hi some of you were kind enough to respond to me before . Yesterday I tried a basal test . I’ve attached the graph
I’m having problems working out when my bolus ends. I always assumed my bolus took six hours on work but I ate my breakfast yesterday and continued downward till
Five pm when I gave up . I’m on levemir twice daily 2 units in morning and two at night and novorapid for meals . Any thoughts appreciated thanks you in advance ‍ so confused by it all
 

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I will start with the caveat that I have no medical training and my analysis is based on my own experience.

Looking at your graphs, if you ate at 8am (and took some bolus) but your BG was still falling at 5pm, this suggests your basal is too high.
Your dose is low which means a reduction will be a large portion. Do you have a half unit pen? This will make it easier.
The other thing to remember is that your morning and night doses do not have to be the same - this is the huge advantage of Levemir over single dose basals such as Tresiba.
 
I did wonder when you said your NR was lasting 6 hours in your other post that it was likely your basal, because generally NR doesn't last longer than 5 and the last hour has minimal impact, especially if you are on low doses, so I agree with @helli, that graph looks to me like your morning Levemir is too much for now.
A half unit pen will be really useful to you, both for Levemir and NR.
 
Thank you both I’d been struggling with higher numbers recently with foot to floor and team said to up levemir . It made me feel
Awful so I cut it back again but I’m so surprised by this graph how much it’s dropping . I have an appointment on Tuesday with nurse and will ask for half unit pens . I’ve only been diagnosed 6 months so appreciate the support I’ve found here ❤️
 
I use my fast acting insulin to deal with "foot on the floor" because it is too rapid a rise (usually about 6mmols in an hour but relatively short lived) for Levemir to deal with it, so I inject 1.5-2units of my fast acting insulin as soon as I wake up and before I get out of bed to deal with it, which works great for me. I also usually include my breakfast bolus at the same time if I am having breakfast.
Of course you are likely to be more sensitive to insulin than me so you might only need 0.5 or 1 unit of fast acting to deal with it. We are all different and you have to find what works for you as an individual and be prepared to adjust that if/when your needs change, as they almost certainly will, particularly during the honeymoon period, but even after that, the goal posts change from time to time with diabetes and we need to learn new strategies or adjust the old ones to fit, when that happens.
I find exercise the previous evening can also help prevent foot on the floor if you don't feel confident to use your NR to deal with it, especially if you don't have half unit pens yet.
 
Yes, that looks like too much basal to me too @ellevee Definitely get half unit pens for both your Levemir and your Novorapid. It really irritates me when they don’t give them automatically to people on small doses (not that they don’t benefit people on higher doses too, but it’s blatantly obvious someone on small doses would need one).
 
I'm definitely no medical expert but agree your basal may be a bit high in the morning - the Novorapid seems to be lingering a bit too - maybe a change to a faster and quicker-ending fast acting insulin would help - I'm on Fiasp which only lasts about 3hrs and have found it easier to control going too low (I was changed from Novorapid after one day on DAFNE Course) - and definitely ask about a 1/2 unit pen (Echo Plus) as they really help you to fine tune things - I'm just coming out of honeymoon period (have doubled my insulin needs in the past 6 months) and found them very useful to make small adjustments as and when needed - hope any changes you make will work @ellevee
 
helli said:
How can you tell this from the graphs

That's 3 hours for you. I find it lasts as long as NovoRapid but starts sooner. This is reflected in the profile graphs
But we are all different.
Click to expand...
Very true - and exactly that - we are all different (it only lasts 3hrs for me but does the job perfectly)
 
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