Basal insulin

[EK297]

Hi everyone,

I’ve been struggling with my background insulin for a little while - just doesn’t feel that it’s right. My diabetes team are about as much use as a chocolate teapot and I’ve just been left to it to “experiment” with what works.

I’ve tried adjusting it but it still doesn’t feel right. Is there a good place to start to know how much basal you should be giving? I’m on Levemir.

Thanks!
Em

 

[Lisa69free]

Hi there, when was you diagnosed and what did they advise you? I had a similar experience being sent home and being told to pretty much use my own initiative but have spoken to diabetic clinic since and now I'm equipped to deal.

Are you just on a daily basal or are you on bolus insulin too? I have found it's my bolus I needed to find tune. We are all different so there is no 1 fits all I'm afraid

 

[EK297]

Hi there, when was you diagnosed and what did they advise you? I had a similar experience being sent home and being told to pretty much use my own initiative but have spoken to diabetic clinic since and now I'm equipped to deal.

Are you just on a daily basal or are you on bolus insulin too? I have found it's my bolus I needed to find tune. We are all different so there is no 1 fits all I'm afraid

I was diagnosed 30 years ago. Switched into Levemir about 18 months ago. They told me to try x units. Didn’t suit so I adjusted but I’m really struggling to get it right. Not sure how much is down to the amount I am taking, or how I am splitting the dose

 

[StewM]

Hi everyone,

I’ve been struggling with my background insulin for a little while - just doesn’t feel that it’s right. My diabetes team are about as much use as a chocolate teapot and I’ve just been left to it to “experiment” with what works.

I’ve tried adjusting it but it still doesn’t feel right. Is there a good place to start to know how much basal you should be giving? I’m on Levemir.

Thanks!
Em

You can make an estimate based on your weight. There’s tables available online that’ll give you a dose suggestion based on your weight. This has a low likelihood of giving you the precise dose you need but should hopefully get you in the right general area.

Basal Testing is probably your best bet. Again you can Google guidelines on how to do this. You basically fast for a little while to get a sense of what your Basal is doing without the variables of food/Bolus to spoil your data.

 

[StewM]

Typically splits tend to be lopsided. This is because of our Basal doses varying throughout the day. Typically, the morning dose is larger than the later dose because we need less whilst sleeping.

However this will vary a lot depending on your particular needs, which you can only really assess through trends in your readings.

 

[ROE100]

Be carful with the suggestion of looking online for table based on weight - if I was given this I would be on 4 times more basal than what I am currently on and even what I am currently on is on the tad high side for certain times of the day.

Basal testing is a good starting point but it isn't always the full answer, as weather hot or cold can have effect on our requirements.

 

[StewM]

Be carful with the suggestion of looking online for table based on weight - if I was given this I would be on 4 times more basal than what I am currently on and even what I am currently on is on the tad high side for certain times of the day.

Basal testing is a good starting point but it isn't always the full answer, as weather hot or cold can have effect on our requirements.

What would you do instead?

 

[Fairygodmother]

Have you basal tested? Doing this helps you to work out how you’re responding to the amount of basal you use and shows where adjustments to dosing may be needed. It can take time, and repeated basal testing, to arrive at a better dose so you need to be patient. Like all things T1, an individual approach seems to be the best as we’re all different. I never expect perfection but I try to keep blood sugars between 4.8 and 8.2 even if the correction doses and/or carb corrections vary every day.
https://www.mysugr.com/en/blog/basal-rate-testing/

 

[Daibell]

Hi. You do need to split Levemir and as another poster has said it may need to be 'lopsided'. For example I take 8 to 10 units at night and 18 for the day. That's based on my Libre 2 graphs. Try to have 12 hours between the split doses if you can as Levemir really only lasts 12 hours or less before it runs down. The night-time split is fairly easy to get right as your reading at the start should be roughly the same at the end as you won't be eating or exercising. It may be slightly higher in the morning due to the dawn phenomenon

 

[NicoleC1971]

Basal is key so I am surprised you are not getting more help but would suggest, as previous post, basal test.
1) ideally get or buy a Freestyle Libre to easily check your blood sugars day and night.
3) pick a day when you are going to be averagely active or a typical working day.
2) eat only fat and drink water (fat fast) - basically no protein or carbs for a day. For example cream in coffee, unsweetened nut butters (not cashews though) but no proteins which can produce glucose in these circumstances.
3) Test or scan every 4 hours (more if you have fsl).

If you basal test whilst still eating your results will be confounded by your bolus dosing regime.
Start there then increase or decrease the dose in small increments (2 units).

If you find you run smoothly on 2 split doses then turn your attention to the bolus doses then any other factors that could affect control (injection sites, illness, s tress, pmt if applicable).

This isn't easy but it is a good way to gain some insight into your basal requirements given that these do change as you lose/gain muscle or fat, get pregnant etc.

Diabetes UK still run a careline so you could try there though they can't give you numbers and nor can we or the internet.