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Advice on changing to a Basal-Bolus plan

Rob2006Scott

Rob2006Scott

Well-Known Member
Messages
88
Location
Lancashire UK
Type of diabetes
Type 1
Treatment type
Insulin
Hi,
I knew it wouldn't be long before I had a question!

After seeing my DSN today we have decided that I would be better on a basal-bolus rather than a fixed dose of insulin. This is to get better control of my BS. It's not bad just a bit erratic at times. I'm changing from Novomix 30 to Levemir and NovoRapid.

It means more injections and I will need to inject at work (shouldn't be an issue there) and when out and about. What's the protocol with this?

I'm not carb counting yet until I've met with the dietician but I will need to in the future

I've not been too worried about things so far, lucky to have good support, but this just feels a bit daunting. Any advice you guys could give will be greatly appreciated.



Thanks.
 
It will mean more injections, if you eat 3 meals a day then you will need to bolus three times and with levemir as a basal you will almost certainly need to split-dose to give you a full 24 hour coverage.

Don't worry about injecting at work, once you've done it a few times you will be less conscious and your work colleagues won't bat an eyelid (hopefully).
 
To get whats called insulin to carbohydrate ratios okish, you will need to bg test about 6 times during the day and for a while, you will probably need to bg test once or twice during the night to try to get your basal level ok so that its not too much or too little. This is easier to do I think by asking for a target bg to achieve before a main meal and then allow the bolus with the basal to achieve a certain bg target 2-3hrs after doing the bolus injection.

With the help of your dsn, they should be able to take a rough guess at starting you off on an amount of insulin applicable to your bodyweight and from that calculation will probably advise 50% for basal and the 50% divided up over 3 injections for the bolus. This can be adjusted to give the right balance through bg testing and changing either the amount of basal or the amount of bolus. Some people love this regime as it gives them more scope to eat different food values and others think the regime is hard work doing mental calculations and extra injections and extra bg tests
 
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