Forgetting background insulin

[bigboi]

Hey guys im not 100% sure if i done my lantus background insulin or not im sitting quite high right now but i had a carby tea and have took correction units.. Any advice on what to do through the night? Thank you!

 

[Jason_Avoneg]

Take your fast acting insulin to lower your blood sugars, then take the right amount of Lantus.

 

[bigboi]

Take your fast acting insulin to lower your blood sugars, then take the right amount of Lantus.

I cant take any lantus because if it turns out i have done it already im screwed

 

[claire1991]

It's been a long time since I took injections (I'm on a pump) but I'd be inclined to do half a dose now and set an alarm in the night to test and if no hypos occur during the night you can be pretty certain you haven't done it so do the other half in the morning and then you're good to do the full dose tomorrow night.
I'm not 100% sure this is the right think to do but it's what I'd do.

 

[Jason_Avoneg]

Ok, so measure your blood sugar and take insulin to reduce it and happy days?

 

[claire1991]

I'd be concerned about getting ketones during the night from not having any back ground at all.

 

[bigboi]

It's been a long time since I took injections (I'm on a pump) but I'd be inclined to do half a dose now and set an alarm in the night to test and if no hypos occur during the night you can be pretty certain you haven't done it so do the other half in the morning and then you're good to do the full dose tomorrow night.
I'm not 100% sure this is the right think to do but it's what I'd do.

Thank u claire!

 

[claire1991]

Thank u claire!

Good luck! Hope you have a hypo/hyper free night!

 

[Jason_Avoneg]

Right, say you go to sleep with your sugars at 5mmol and you haven't taken any background insulin, it'll creep over night, and it'll go high when your body decides it's time to wake up (liver dump), where as over shooting background insulin will lead you to hypos, not sure if you have good hypo awareness and etc but personally I'd rather just have elevated levels for a few hours then risk a coma or worse in case it dips to some silly levels.

But then again, hey what do I know? I'm just a Chi-town ***** with a Nas flow.

 

[claire1991]

Right, say you go to sleep with your sugars at 5mmol and you haven't taken any background insulin, it'll creep over night, and it'll go high when your body decides it's time to wake up (liver dump), where as over shooting background insulin will lead you to hypos, not sure if you have good hypo awareness and etc but personally I'd rather just have elevated levels for a few hours then risk a coma or worse in case it dips to some silly levels.

But then again, hey what do I know? I'm just a Chi-town ***** with a Nas flow.

Not having any background insulin at all puts you at an immense risk of developing DKA very quickly. Half a dose of long acting will prevent this from happening and if long acting has already been given than one and a half doses is better than a double dose, which of corse will lead to hypos.

 

[Jason_Avoneg]

Not having any background insulin at all puts you at an immense risk of developing DKA very quickly. Half a dose of long acting will prevent this from happening and if long acting has already been given than one and a half doses is better than a double dose, which of corse will lead to hypos.

Cool story.

 

[claire1991]

Cool story.

Thank you very much

 

[Jason_Avoneg]

Np

 

[TheBigNewt]

Not having any background insulin at all puts you at an immense risk of developing DKA very quickly. Half a dose of long acting will prevent this from happening and if long acting has already been given than one and a half doses is better than a double dose, which of corse will lead to hypos.

Fake news. It takes a while without insulin to get to the DKA stage. Look up all the metabolic steps/transformations that have to occur in order for ketone bodies to be produced as a compensatory mechanism for no glucose. Half dose isn't a bad idea though.

 

[claire1991]

Fake news. It takes a while without insulin to get to the DKA stage. Look up all the metabolic steps/transformations that have to occur in order for ketone bodies to be produced as a compensatory mechanism for no glucose. Half dose isn't a bad idea though.

Oh, how come you can get DKA within hours if a pump fails then? Is it because it's fast acting insulin in a pump instead of slow release?

 

[Jason_Avoneg]

Oh, how come you can get DKA within hours if a pump fails then? Is it because it's fast acting insulin in a pump instead of slow release?

Is this based on published evidence or anecdotal evidence?

My response of cool story probably wasn't the best way forward, but nor is scaremongering people about DKA (which doesn't kill instantly, where a severe enough hypo can or leave you as a potato...)

Not disputing the half Lantus idea, but the OP can't even remember if he took his insulin...what if he forgets to set his alarm or to test or something else and ends up as a potato...

 

[claire1991]

Is this based on published evidence or anecdotal evidence?

My response of cool story probably wasn't the best way forward, but nor is scaremongering people about DKA (which doesn't kill instantly, where a severe enough hypo can or leave you as a potato...)

Not disputing the half Lantus idea, but the OP can't even remember if he took his insulin...what if he forgets to set his alarm or to test or something else and ends up as a potato...

Published evidence. Look it up, people on pumps are more likely to end up with DKA because their basal is fast acting insulin instead of slow release.

I wasn't scaremongering at all, at least not intentionally. I did say that it's been a long time since I've been on injections and that I wasn't 100% sure I was right it's just what I would have done.

 

[Grumpy ole thing]

Hey guys im not 100% sure if i done my lantus background insulin or not im sitting quite high right now but i had a carby tea and have took correction units.. Any advice on what to do through the night? Thank you!

Id probably test bs 4 hours after eating and correct if necessary with fast acting, then set the alarm and test every 2 hours, again correcting if required with fast acting until its time for the next background/basal dose whenever you would usually take it. You might find at some point that all is well and you don't need that many tests. Take care x

 

[TheBigNewt]

Back before insulin I've read people would live a pretty long time with Type 1. Sure, they'd lose weight and get sick and stuff but they didn't die in 2-3 days. The OP said he was actually taking insulin to correct high sugars, so he has/had some on board. Look up what happens in your metabolism during true DKA. That stuff can't happen overnight. Sure it will happen quicker to a pumper, they run out quicker. But if they bolus they won't go into it very quick.

 

[SimonCrox]

Yes, this is a problem. The real problem is not knowing if you have forgotten or not.
The Lantus doesn't just stop at 24 hours, it will go on a bit longer (varies from person to person)
I would, if in your shoes, check my glucose level at 3.00 am; if going up, take the Lantus.
Probably want to avoid this situation in the future; I beleive that there are some pencaps which tell when last dose taken.
https://timesulin.com/
Good luck.
best wishes