Type 1 Struggling To Get Basal Rate Right - Advice Please.

Chestnut24

Member
Messages
5
Type of diabetes
Type 1
Hello, I have had T1D for over two years now and have been using Toujeo in place of Lantus for about 9 months.

The dose I thought was right was 11 units, but I have come to realise that I am often having to snack once the 4 hours of bolus wears off. I was also dropping about 4mmol overnight so needed to snack before bed to avoid night hypos.

I decided to try dropping from 11 units to 10 and after 3 days I have steadied to a 10mmol fasting base rate, which I know is too high but I feel so much more in control with it being balanced and steady. (I had a no carb breakfast today and was still at 10mmol at 1pm)

I know 10mmol is too high as a fasting bsg but do not want to go back to constantly having to snack to avoid lows. Really don't know what to do and would be grateful for any advice.
 
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Antje77

Oracle
Retired Moderator
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19,284
Type of diabetes
LADA
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Insulin
Why did you switch from Lantus to Toujeo? It seems to be the same insulin, just more concentrated, but I could be mistaken here. For Lantus, you could get a half unit pen.
 
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Chestnut24

Member
Messages
5
Type of diabetes
Type 1
Why did you switch from Lantus to Toujeo? It seems to be the same insulin, just more concentrated, but I could be mistaken here. For Lantus, you could get a half unit pen.
Thanks for the reply. I was switched onto Toujeo because I was getting very lathargic and running very high blood sugars after my evening meal, and my endocrinologist put this down to the Lantus not lasting a full 24 hours. (I inject basal at 9pm.) Toujeo is meant to have a 3 day 'wraparound' and a much more steady profile.

I am considering 10 units one night and 11 the next, but am worried this might make things even more unpredictable..
 

alphabeta

Well-Known Member
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615
Type of diabetes
Type 1
Treatment type
Insulin
Thanks for the reply. I was switched onto Toujeo because I was getting very lathargic and running very high blood sugars after my evening meal, and my endocrinologist put this down to the Lantus not lasting a full 24 hours. (I inject basal at 9pm.) Toujeo is meant to have a 3 day 'wraparound' and a much more steady profile.

I am considering 10 units one night and 11 the next, but am worried this might make things even more unpredictable..
Well to be honest you can simply play along the timing of your Lantus, same problem but got around it by playing around timings!
 
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Chestnut24

Member
Messages
5
Type of diabetes
Type 1
Well to be honest you can simply play along the timing of your Lantus, same problem but got around it by playing around timings!
I have read about having split doses. So go back onto lantus, get a half unit pen and split it? Does sound like I would have better control... I have a half unit pen for novorapid which helps me a lot. Thanks!
 

alphabeta

Well-Known Member
Messages
615
Type of diabetes
Type 1
Treatment type
Insulin
I have read about having split doses. So go back onto lantus, get a half unit pen and split it? Does sound like I would have better control... I have a half unit pen for novorapid which helps me a lot. Thanks!
Well I personally did a split dose before, but I only injected 1 unit at around 12 pm i guess and it went smooth. I can't advise you but a lot of diabetics do so.
 
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Chestnut24

Member
Messages
5
Type of diabetes
Type 1
Well I personally did a split dose before, but I only injected 1 unit at around 12 pm i guess and it went smooth. I can't advise you but a lot of diabetics do so.
Thank you. Diabetes Centre will be closed tomorrow for bank holiday I assume, but I will call on Tuesday and ask to discuss going back onto Lantus and trying this.
 

alphabeta

Well-Known Member
Messages
615
Type of diabetes
Type 1
Treatment type
Insulin
Thank you. Diabetes Centre will be closed tomorrow for bank holiday I assume, but I will call on Tuesday and ask to discuss going back onto Lantus and trying this.
It really seems a better choice to stay on Lantus since you are on such low doses
 
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Cookiekeri

Member
Messages
8
Is toujeo a better insulin than lantus ?? Am having this problem myself am currently on 20iu of lantus glargine and still having high bms through the night to the morning .. I’ve tried everything like stop eating at a certain time or increasing doses.. no carbs everything !! I think I need a stronger basal insulin .. is toujeo better ?? X
 

Chestnut24

Member
Messages
5
Type of diabetes
Type 1
Is toujeo a better insulin than lantus ?? Am having this problem myself am currently on 20iu of lantus glargine and still having high bms through the night to the morning .. I’ve tried everything like stop eating at a certain time or increasing doses.. no carbs everything !! I think I need a stronger basal insulin .. is toujeo better ?? X
Hi, yes! After a week of feeling really awful trying to find the right dose (I was signed off work for a week as my numbers were so high and it could only be tweaked every three days) it really levels out. It is not stronger though... well, it is more concentrated but the numbers on the pen are the same as lantus if that makes sense. If you need stronger insulin, could it just be that you need more lantus? Though you did say you tried that... Have you tried to split the dose to avoid the night time highs? Also, I know it's not always so easy, but my doc recommended a walk after my evening meal to stop the numbers running so high... Good luck!
 

alphabeta

Well-Known Member
Messages
615
Type of diabetes
Type 1
Treatment type
Insulin
Is toujeo a better insulin than lantus ?? Am having this problem myself am currently on 20iu of lantus glargine and still having high bms through the night to the morning .. I’ve tried everything like stop eating at a certain time or increasing doses.. no carbs everything !! I think I need a stronger basal insulin .. is toujeo better ?? X
Lantus is stronger very slightly
 

becca59

Well-Known Member
Messages
2,856
Type of diabetes
Type 1
Treatment type
Insulin
Was switched to Toujeo from Lantus two years ago. I was told it will eventually be phased out and they were switching all Lantus users. I too am on 10 units was on 11 during the heatwave. Have done the 10 one day and 11 another( consultant on board with it ) but didn’t find it better overall.
I personally couldn’t be doing with going back to splitting the Lantus.