Adjusting basal regularly

[zicksi101]

Anyone have experience with regular adjustment of Basal insulin?

I run 3 times a week and am finding my BG is lower from point of exercise well into the next day. Don't think adjusting only my novorapid only is sufficient to cover the dramatic effects.

Have been testing 6-8 times a day for the last few weeks to establish trends and I now believe I need about 60 to 80g more carbs or equivalent in insulin reduction from point of exercise into the next day (in general, it varies depending on exercise intensity and duration).

Just been put on Levemir recently which I don't have a lot of experience with yet. Was previously warned against adjusting background insulin regularly when on Lantus but believe Levemir is more flexible as a 12 hour insulin, so would be interested on thoughts/experiences on adjusting the background dose safely?

 

[zicksi101]

Also I inject - not on a pump

 

[Daibell]

Hi. I've not heard that you shouldn't adjust Lantus too often but it does last up to 24 hours whereas Levemir is nearer 12-18 hours. I would adjust by a small % and then leave it for 2-3 days to settle. As usual watch out for hypos.

 

[Keith300-01]

I drop my lantus be one unit the day before exercise or going into work and I've now left it down only on 6 units now and inject extra novorapid to keep my blood normal done this for 2 weeks now and in the last 8 days only had 1 hypo due to over correcting been sitting at 8 -14 mark all day though even with the extra units test every 2-3 hours , going on to a pump next month so see what a change will do hope you find a happy setting soon but like everything if we don't try we will never succeed best of luck keith .


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[ElyDave]

If you are exercising regularly you may well find that basal needs go down, because you improve overall insulin sensitivity, which can last >24 hours.

I would recommend that you do some basal testing first to make sure that you've got that right before trying to start adjusting for exercise.

My approach, now that I've done that is that if I'm running more than 4 hours after my last bolus, for less than 1 hour I don't tend to adjust doses, maybe eat more carbs depending on BG measurements before/during/after the run.

Less than 1 hour and within 2 hours of a meal, adjust the bolus.

Sunday long runs, or bike ride, morning basal is cut from 3.5U to 1U, breakfast bolus is 1U, just to keep sugars moving into the muscles. That tends to deal with the increased exercise induced insulin sensitivity, plus extra carbs during the run/ride without any additional insuln.

 

[zicksi101]

Thanks all for the helpful replies.

Good point about insulin sensitivity ElyDave. I've noticed that running has a really dramatic effect - had to cut the basal by 20u when I started running 6 months ago, that was a cut of 50% at the time. Generally speaking I take a lot more insulin than those on single figures basal because I've been T1 for 20 years.

Been doing some no carb meals to check the basal, results are need to increase the basal a llitle when I haven't run for a couple of days, but need to decrease insulin for the hours after exercise.

I'll start reducing the basal for long runs initially and monitor the results.

 

[Kelsie]

Hi
I exercise frequently and change my background (in my case, I am on levimir) regularly depending whether I exercise evening or morning. If I exercise in the morning the I keep my dose at 10 units but if I exercise in the evening I drop this right down to either 6 or even 4 units if it was a long session as exercise can affect your sugar levels up to 10 hours after. I was advised my a sports diabetic consultant to reduce your background insulin by at least a third if you exercise in the evening. I was also advised to split my levimir dose so I inject half in the morning and half in the evening as this reduces likelihood of hypos in the night especially if you exercise pm. Apparently background insulin only really has a 12 hour lifespan so is best to split it I found that since splitting it, it has really helped with keeping my bg's under control hope this helps!


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[SamJB]

Like others, I adjust my basal (Lantus) whenever I do exercise. Different exercise drops it by different amounts. Swimming drops it by 40%, whereas a 4 mile run drops it by 20%.

Recently, I've switched my injection to the morning. This is because I use my pre-bed and pre-breakfast readings to judge how much Lantus I will need. If I got the dose incorrect I can act on it immediately instead of going through the whole day with incorrect basal. This has greatly improved my basal adjustment regime, if you need to adjust yours regularly, I'd recommend taking it in mid morning.