Basal Insulin Doses

[LauraC27]

Hello,

It has been a while since I posted on here! I was diagnosed Type 1 coming up to 4 years ago.
Almost one year ago now I switched to Tresiba Degludec - (I was on Levemir split dose morning/evening before that).
The reason I changed was due to a few factors, but one being lifestyle, taking one dose of basal each day was going to be better for me than having to remember the evening dose etc. I have much better control now.
However, I came across somebody the other day who has also just switched to Tresiba Degludec from Levemir, and I was shocked to find out that this person takes a lot less units of Tresiba than I do. Her dose to cover her for 24 hours was only 9 units. I inject 30 units in the morning to cover me for 24 hours. I am wondering why this is? I don't have a particularly carb heavy diet... Is there a reason why some people require more basal insulin than others?
My bolus insulin is Novorapid for my meals.
Just interested to find out!

Thank you,
Laura.

 

[Rokaab]

It's probably just that everyone is different, I also read that some people who changed to taking Tresiba (from a number of others) often end up taking less, I didn't when I changed - mine stayed about the same as it had been before using when Lantus.
Also remember that some people do just need more than others, just because
Do not worry about what other people use, worry about what you need/use

 

[EllieM]

Some T1s can manage on 15 units a day (basal plus bolus) others need more than 100. There's absolutely no point in comparing your needs with those of someone else.

 

[LauraC27]

Thank you Ellie for your response, it wasn't so much that I was comparing, it was just more that I have not come across that before, and I didn't realise people's basal doses could vary so much person to person that's all. I was just interested to find out if there was a reason for the wide variation, but I do understand that everybody is different of course.

 

[UK T1]

Hi, if I'm understanding your question properly I think it might be based around why some people are more sensitive to insulin than others. Loads of things can affect this including (but almost certainly forgetting lots of things):

Age, hormones, metabolism, exercise levels, body fat% but also composition and location of fat, other medical conditions (and so possibly also other medication taken, as there are well known medications that decrease sensitivity to insulin) - these can affect everyone diabetic or not.

If you're injecting insulin then also things like injection site condition and injection technique, as better rotation of sites and better technique can help sensitivity. Similarly, I've said age can be a factor as it is common to become more (even if it is just slightly) resistant to insulin when you're older, but also possibly duration of diabetes. It might also be that some are taking more basal and less bolus, or vice versa, so aside from the reasons listed above for why one diabetic might need different insulin doses compared to another, it is also usual to compare total insulin rather than just basal. It could be that someone else is still producing low levels of insulin so needs to inject less. Usually height and mass will affect requirements. So often you're given initial doses based on your body mass before these are tweaked based on how you've responded (based on any of the other factors listed above). This includes what proportion of the total insulin is basal vs bolus. Lifestyle and usual diet will influence this and mean it also has to change greatly throughout the year for some people. For example, I'm still a little confused why, upon lockdown, my insulin requirements greatly decreased. I'm definitely less active, now my job is computer based and not on my feet all day, but wonder if decreased stress played a part?

It could also be that these things don't affect you, and you might find yourself not fitting usual trends too! As said, ultimately it doesn't matter about your insulin requirements as long as you're keeping good blood glucose stability and control. There will be way more reasons than I've quickly listed above as to why one person needs less insulin than another too. It shouldn't matter unless you're struggling to inject large doses, in which case your diabetes team might be able to work through some suggestions of what you can try to reduce your need. We can't control everything but might be able to influence some factors.

I don't know or think any of these things necessarily count for you, but if I understood your question properly thing you were just curious as to the possible factors at play, so I hope this helps a little, or helps others reading this thread. Have a lovely rest of your weekend!

 

[searley]

Hello,

It has been a while since I posted on here! I was diagnosed Type 1 coming up to 4 years ago.
Almost one year ago now I switched to Tresiba Degludec - (I was on Levemir split dose morning/evening before that).
The reason I changed was due to a few factors, but one being lifestyle, taking one dose of basal each day was going to be better for me than having to remember the evening dose etc. I have much better control now.
However, I came across somebody the other day who has also just switched to Tresiba Degludec from Levemir, and I was shocked to find out that this person takes a lot less units of Tresiba than I do. Her dose to cover her for 24 hours was only 9 units. I inject 30 units in the morning to cover me for 24 hours. I am wondering why this is? I don't have a particularly carb heavy diet... Is there a reason why some people require more basal insulin than others?
My bolus insulin is Novorapid for my meals.
Just interested to find out!

Thank you,
Laura.

Firstly deluded lasts in your system for about 3 days so if you miss 1 dose it should not really affect you... tresiba is also slightly more tolerant if you take a couple of units too much certainly more so than levemir or lantus

But every one is different so not only will their body react differently to varying qualities of insulin but also everyone has different activity levels etc..

In fact I regularly have to change my dose.. if I know I have a very active week coming up I only take about 25 units if I have an easy week coming up I need about 30 units

Don’t worry too much about what others need todo just concentrate on what is good for you

 

[Stevec189]

If it helps I take 42 units of Tresiba. I have bought mine down since I have lost 1St in weight this calendar year. As others have said we are all different.

 

[LooperCat]

My Tresiba doses ranged from 17u a day to 36u depending on the way of eating I choose.

 

[CelalDari]

Hello,

It has been a while since I posted on here! I was diagnosed Type 1 coming up to 4 years ago.
Almost one year ago now I switched to Tresiba Degludec - (I was on Levemir split dose morning/evening before that).
The reason I changed was due to a few factors, but one being lifestyle, taking one dose of basal each day was going to be better for me than having to remember the evening dose etc. I have much better control now.
However, I came across somebody the other day who has also just switched to Tresiba Degludec from Levemir, and I was shocked to find out that this person takes a lot less units of Tresiba than I do. Her dose to cover her for 24 hours was only 9 units. I inject 30 units in the morning to cover me for 24 hours. I am wondering why this is? I don't have a particularly carb heavy diet... Is there a reason why some people require more basal insulin than others?
My bolus insulin is Novorapid for my meals.
Just interested to find out!

Thank you,
Laura.

Your basal insulin is mostly linked with your body weight and based on that the diabetes team make a prediction of how much you need as well as observing how much insulin you needed in hospital to lower your blood sugar when first diagnosed.

However I have found this not to be the case. I take 14 units of Lantus and find it a bit much sometimes. I’m a slim person with a BMI of 18.6 (barely in the healthy range). Conversely a 12 year old girl in my family takes 26 units of Lantus a day. So it just depends from person to person. I’m pretty sure my liver is larger since I’m an adult so it should produce more glucose but I suppose not because my basal is significantly lower.

Although I am newly diagnosed so I might have retained some pancreatic beta cell function— just not sure how much

 

[ArtemisBow]

When I attended my DAFNE course a few years ago the variance between people was huge - I was on 7-8 units of Lantus a day, the guy next to me was on 70. A bit younger than me, roughly same weight, very fit with a physically demanding job. Everyone is different.

 

[Rylando88]

I’m on 10 units of tresiba every morning, I started on 12 but was having hypos through the day. I think it varies from person to person as others have said xx