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Anyone here who uses only Bolus & no Basal or very less basal?

D

db270

Member
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11
My basal (long acting - NPH, Lantus etc) insulin needs seem to be very less as compared my bolus (fast acting) needs.

I was wondering if there was anyone else (T2s obviously) here who takes no basal or less basal as compared to bolus? And has their blood sugar under control. How much basal & how much bolus units do you take per day?
 
Everyone is different and other peoples doses won't help you.

As a T2 why are you on insulin rather than diet controlled?
 
@xfieldok This member is simply looking for suggestions from other members - questioning why they are on insulin is irrelevant. If you don’t have anything supportive to offer then please don’t respond.
 
Another T1 but I was wondering if you take metformin too? That acts to block liver dumps so may reduce basal need?
 
At one point (pre pump) I was allergic to all available basal insulins. I was taking high doses of bolus, and spreading meals over 24hrs to try to mitigate having no basal, but I still felt lousy. Every single day felt like I was just recovering from flu. So, I survived no basal, but really don't want to try that again.
 
Diakat said:
Another T1 but I was wondering if you take metformin too? That acts to block liver dumps so may reduce basal need?
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Yes. I do take Metformin & I know that it blocks liver dumps. But most T2 on insulin also take metformin, so I was just curious to know if there are others who have very reduced or no external basal needs
 
helensaramay said:
A starting point for basal bolus insulin is that basal is about the same as total bolus.
However, this will depend on things like what you eat. how much exercise you do and how stressed you are.

The purpose of basal is to work with the glucose which is constantly dripped from our livers.
As this is constant, I believe it is not unusual to dose only basal, especially when starting insulin.

I have not read about anyone needing bolus but not basal.
However, my experience is from a T1 perspective.
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I take only Bolus (Fast acting) twice a day with meals (11&12 units).
I have not been prescribed basal.

I think this is because I’ve dropped my HBA1C from 10 something to 7.4 in 3 months.

So just so people don’t freak out, you can be prescribed bolus without basal.
 
Juicyj said:
@xfieldok This member is simply looking for suggestions from other members - questioning why they are on insulin is irrelevant. If you don’t have anything supportive to offer then please don’t respond.
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I am sorry. I was genuinely interested. When I was dx, I was offered insulin with no mention of lifestyle/diet changes. Fortunately I found this place first.

My current use of insulin is soley to beat the steroids into submission and makes little sense to anyone that isn't me, least of all to the nurses at the surgery who are baffled....
 
NaijaChick said:
I take only Bolus (Fast acting) twice a day with meals (11&12 units).
I have not been prescribed basal.

I think this is because I’ve dropped my HBA1C from 10 something to 7.4 in 3 months.

So just so people don’t freak out, you can be prescribed bolus without basal.
Click to expand...

Thank you. I have a few more questions if you don't mind.

- Have you done a "basal test" to figure out if you need basal additional to whatever your pancreas provides?
- How long since you have been diagnosed with T2?
 
I expect your body is still making a lot of inslin, but due to high inslin resistance it is not enough to control your BG after your meals. It is possible the inslin level your body is making is higher then someone without diabetes, but as your pancreas is working "full out" all the time the inslin level may change little over the day. A cpeptrade test would comfirm this, but hard to get for T2 on NHS.

In a person without diabetes the background level of inslin is very low, then when they eat a meal their pancreas very quickly releases a short burst of high level of inslin - this is called "first inslin responce" and is often stated in research papers as an increase in rate, not obsolete level. This short lived high level of inslin is responsible for removing the glocose that gets added to the blood from the digestion of carbs in the meal. Mostly this high inslin level gets used by the liver, and never get to the rest of the body - very different from injecting inslin.

In type2 diabetes the "first inslin responce" mostly stops working, hence resulting in high BG increase if a meal contrains more carbs then there is enough inslin to convert into fat. (The glycogen stores are normally nearly 100% filled in a person with type2 diabetes unless they are eating a lowcarb diet)

The level of carbs in the meal mostly determines how much the meal will increase BG however protein also increased BG a little, so even if a meal has no carbs an increased level of inslin is needed by the body to control BG. It is not possible to predict if your body can provide the level of inslin needed for a carb free meal, without you doing careful experiments, monitor your BG and being very aware of the risk of hypos.

It is even possible that your meal time inslin reduced how much inslin your pancreas makes over the few our after the meal to below the level the pancreas makes while you are not eating.
 
NaijaChick said:
I take only Bolus (Fast acting) twice a day with meals (11&12 units).
I have not been prescribed basal.
Click to expand...

I have also moved to something similar now. I started with 70% basal & 30% bolus, then to 50-50 & then 30-70. But now I take only bolus (old style Insulin R). Not taking basal affects me a bit only before breakfast & before dinner. My sugar levels are 15-20 points higher before breakfast & before dinner than they were when I was taking basal (NPH). And the amount of basal I needed for just those twenty points was something 7 units twice a day. So my doctor advised me to stop basal & increase my bolus just a little bit. I now have 10 & 12 units of bolus before breakfast & dinner respectively.
 
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db270 said:
I have also moved to something similar now. I started with 70% basal & 30% bolus, then to 50-50 & then 30-70. But now I take only bolus (old style Insulin R). Not taking basal affects me a bit only before breakfast & before dinner. My sugar levels are 15-20 points higher before breakfast & before dinner than they were when I was taking basal (NPH). And the amount of basal I needed for just those twenty points was something 7 units twice a day. So my doctor advised me to top basal & increase my basal just a little bit. I now have 10 & 12 units of bolus before breakfast & dinner respectively.
Click to expand...

How weird that we are both on such similar doses. *****Sugar Free Hugs*****
 
db270 said:
Yes. I do take Metformin & I know that it blocks liver dumps. But most T2 on insulin also take metformin, so I was just curious to know if there are others who have very reduced or no external basal needs
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I'm reducing my insulin units and found Metformin greatly helps with how much basal I need. I hv tried without basal but I range just a bit higher than my consultant advises. I hv nerve problems in my legs and one foot/toes worse than the other so don't want to risk more damage or loss of sight.
My main aim in reducing units is to improve my weight loss after bariatric surgery.
Only a few days ago I had to stop reducing my basal but in doing so I needed less bolus. I'm currently on holiday so haven't weighed myself to see if my stalled weight loss has been rebooted. I've lost 5st on insulin but know type2s have high/severe insulin resistance so part and parcel is needing extra insulin to keep excellent control.
I'd say if you hv good control on no or less basal monitor heavily just incase that changes unexpectedly. Inform your team at your next opportunity. Monitor monitor monitor and if your bgs creep up don't feel bad about reintroducing or increasing safely under medical advice.
I'm very confident changing my units but not everyone is so always take medical guidance when making important changes to your insulin routine.
What are your fbgs looking like for pass 2wks? Also in comparison to days with less/no basal?
 
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