Timing of basal on MDI

[lizdeluz]

Could anyone tell me what the rules are for timing basal?
Currently I take my basal at breakfast time alongside my first bolus of the day.
Recently I've been having higher bs readings on waking than I would like: not always but quite often (sigh).
If I injected my basal at, say 21:00h, I could treat any highs before going to bed with a correction bolus.

Does this seem logical or nonsense?

 

[tim2000s]

Could anyone tell me what the rules are for timing basal?
Currently I take my basal at breakfast time alongside my first bolus of the day.
Recently I've been having higher bs readings on waking than I would like: not always but quite often (sigh).
If I injected my basal at, say 21:00h, I could treat any highs before going to bed with a correction bolus.

Does this seem logical or nonsense?

The issue you may face with Lantus is that it may absorb irregularly overnight and you may suffer nocturnal hypos. The NICE recommendations now are for 2x Levemir daily as it seems to give better coverage and is less likely to result in nocturnal hypos. Of course you may not want to change, and you can also split dose Lantus.

It's all a bit trial and error really. Whatever you choose to do you have to test a lot when you do it to observe the outcomes properly.

 

[robert72]

The rules are that there aren't any rules - only what works for you. Most of the time I was on Lantus I took it in the evening. I also tried morning but, for me, it never lasted the full 24 hours. You could also try a split dose if you think it's not lasting for you.

 

[noblehead]

Prior to pumping I was taking my lantus early evening @lizdeluz, if you don't fancy taking a split-dose or trying levemir then why don't you ask to try Tresiba, it lasts up to 42 hours but is injected once a day, Rob above uses this basal insulin.

 

[lizdeluz]

Many thanks for these suggestions. I will try to galvanize myself into making changes instead of looking at them for months!

 

[staffsmatt]

Another vote here for tresiba, just been changed into it and feel a lot better on it already..

 

[novorapidboi26]

before the pump I was on twice a day Levemir, but before that and doing DAFNE I was on a single Lantus dose before bed.....

I haven't looked at any guidance but it was always most common amongst my DAFNE brothers and sisters to take the Lantus before bed, this allowed the morning rise to be dealt with better than it would be having a diminished, if not expired dose of Lantus to do the job from the previous morning...

Definitely worth trying it in the evening though....

Or as others have suggested and many Lantus users are doing now, split it....

best of luck.....

 

[lizdeluz]

before the pump I was on twice a day Levemir, but before that and doing DAFNE I was on a single Lantus dose before bed.....

I haven't looked at any guidance but it was always most common amongst my DAFNE brothers and sisters to take the Lantus before bed, this allowed the morning rise to be dealt with better than it would be having a diminished, if not expired dose of Lantus to do the job from the previous morning...

Definitely worth trying it in the evening though....

Or as others have suggested and many Lantus users are doing now, split it....

best of luck.....

Thank you! I was originally on an evening Lantus injection and my consultant advised me to try taking it at breakfast because I was getting early morning hypos, just as I was trying to go off to work.

Now I'm dealing with more highs in the morning. Not this morning though, only 5.8

I'm going to have to become more confident about deciding and changing!

 

[novorapidboi26]

On a single dose of Lantus, an ideal scenario for me would be to take it before bed, adjust it so that I am held steady till morning, then compensate for any surplus/deficit the rest of the day with Novorapid.....

This in the end wasn't good enough, hence the Levemir split....

 

[lizdeluz]

On a single dose of Lantus, an ideal scenario for me would be to take it before bed, adjust it so that I am held steady till morning, then compensate for any surplus/deficit the rest of the day with Novorapid.....

This in the end wasn't good enough, hence the Levemir split....

Interesting. All grist to the mill. Thank you, I'll bear this in mind as I do testing over the next couple of weeks.

 

[RuthW]

There's a thread about typical problems with Lantus somewhere on the forum. You might like to look at it.

 

[tim2000s]

My thread, here http://www.diabetes.co.uk/forum/threads/lantus-users.67760/ . I also wrote this blog about it because I have strong opinions.