Adjusting Basal without doctor/nurse

[Abo2000]

Hi all and thanks for your time,

I’m on Lantus I usually take 16 units a day, every couple of months for some reason, even though I’m regularly active, my fasting glucose levels increase throughout the day, calling for 18 units of Lantus instead of the original 16.
And then a few weeks later again I can bring it back down to 16 because otherwise I get frequent hypos.

1) I’m assuming it is normal and not that big of a deal, sometimes the body just does it’s own thing?

2) Do I always have to contact my nurse before I change basal insulin amount? I’ve done it once before without letting them know and it worked a treat but I don’t know if it’s something I should or shouldn’t be doing

3) If I shouldn’t be doing it, why not? And what are the risks?

Thank you

 

[Jaylee]

Hi all and thanks for your time,

I’m on Lantus I usually take 16 units a day, every couple of months for some reason, even though I’m regularly active, my fasting glucose levels increase throughout the day, calling for 18 units of Lantus instead of the original 16.
And then a few weeks later again I can bring it back down to 16 because otherwise I get frequent hypos.

1) I’m assuming it is normal and not that big of a deal, sometimes the body just does it’s own thing?

2) Do I always have to contact my nurse before I change basal insulin amount? I’ve done it once before without letting them know and it worked a treat but I don’t know if it’s something I should or shouldn’t be doing

3) If I shouldn’t be doing it, why not? And what are the risks?

Thank you

Hi,

We always advise you contact your diabetes team or doctor when contemplating changing or tweaking of dose.
Especially with the newly diagnosed.

However, I don't personally. I will mention what I do at the clinic for a review or wot not?
I do change my basal dosage to align with an anticipated heavy following working day.
Sometimes, hot climates I might be travelling to or simply a heatwave in the UK increasing my insulin sensitivity will warrant a dosage tweak too..

Testing is key. Do you use a CGM set up?

 

[Antje77]

1) I’m assuming it is normal and not that big of a deal, sometimes the body just does it’s own thing?

Yes, perfectly normal.

2) Do I always have to contact my nurse before I change basal insulin amount?

That's between you and your nurse. Some of us adjust all the time without contacting our nurse, some of us ask if their nurse agrees with their proposed dose change.
Mine asks me how much insulin I take at my yearly appointment, suits me well.

A lot depends on how long you've had diabetes, very different for someone who's only a few weeks in and someone who has been on insulin for 40 years.

If you'd like to adjust your doses yourself, why not contact your nurse to tell her so, and ask how she feels about this?

 

[In Response]

Hi @Abo2000 yes it is perfectly normal for our levels to fluctuate and, hence, our insulin needs vary.
Some find it’s the weather, others it’s stress, sometimes it’s illness or hormones or exercise.
I am frequently changing my basal without telling my nurse. It’s my condition and I manage it.
During my annual review, they take a note of my dose on that day to keep their records up to date but it may change the next day.
As for risks, they are just that you may make a mistake and experience a day of hypos or a day too low. But if you didn’t change your basal dose, you have the same risks.

 

[Abo2000]

Thank you all for your answers, very helpful and definitely brings peace of mind! @Jaylee yes I use a CGM

 

[Porter]

If you complete the DAFNE then you can adjust both basal and Bolus ratios without contact the Nurse or Doctor. I am continually adjusting ratios as my medication is changing every month. Though if unsure at any time I check in with the DSN, which is the annual review. Otherwise seek advice if not yet confident. ATB