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Am I understanding this right?

W

WWood56

Active Member
Messages
41
Type of diabetes
Treatment type
Insulin
In simplistic terms, as I am on insulin (split Levemir basal, Novorapid bolus), if my basal is right I should be able to go an average day and skip the odd meal? I shouldn't HAVE to eat or else I will go hypo if my basal level is correct and I am not exercising.

Also, if I bolus and my blood sugar is still too high 2 hours after the meal but I go too low before the next meal, I have got my dose of something wrong haven't I?
 
Sounds like your basal is too high. You should be able to skip meals and stay steady. Do some fasting tests and records your levels every hour. Make sure there is no QA insulin in your system. Your levels should remain fairly steady. If they steadily drop, basal too high and vice versa. If you need to adjust dose, do it in 1/2 units if poss.


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Thanks. The nurse kept upping my basal dose but eventually put me on basal/bolus because after meal readings were too high. I think you are right and the basal needs reducing. I will test when the children are back in school and I can concentrate!
 
Yes, if your basal is correct then you should be able to be more flexible with skipping a meal.

My consultant recommended trying to keep meals 5 hours apart so that all quick acting insulin had been used before having another meal qty of bolus.

To basal test then you need to be clear of hypo and hypers and foods in the previous 5 hours before testing.


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I am from the 'old skool' where diabetics eat food at regular times and this has worked very well for me. Until bolus insulin becomes very fast in its onset and short in its duration, I will carry on as I am.

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@iHs that is the approach I was trying to take as I have to eat every 2-3 hours due to having a liver problem, but it just didn't work out for me. I have to maintain a carb intake on dieticians advice or else I lose muscle mass very quickly. Of course the carbs cause spikes and basal alone was just not cutting it.

I fasted this morning. Waking level was 6.8 (bit high really) and it had dropped to 4.8 4 hours later so I think I need to up my night Levemir slightly and reduce my morning dose a bit. Skipping my morning meals made me feel very ill. Yuk!
 
@WWood if you alter yr evening levemir dose, try just 0.5u first as 6.8mmol is not that high. If you aim to be lower on waking then be careful that you dont wake up any lower than 5.5mmol just to be safe. Yr morning levemir without eating br is a tiny bit too much so reduce that by 0.5 or 1.0u and then hopefully yr lunchtime bg will be ok. Basal/bolus adjustment is very trial and error but dont spend too much time fasting. Tomorrow, eat some food and just test bg frequently and then you'll slowly get the adjustment of basal to bolus ok

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Thanks both.

I did not eat breakfast this morning and will take both your comments on board. I can only drop whole units not halves. I am currently on 22 morning Levemir and 12 evening. I will stick with 12 tonight and try 21 tomorrow and eat as usual. I have my diabetic eye appointment in the morning so I need to feel ok, not hungry!
 
If its important that you eat every 2 or 3hrs, then what might be a lot better for you is to use twice daily insulin which has a percentage of basal mixed in a percentage of bolus like 25/75 or 30/70. With these insulins, many eat every 2hrs but they dont inject a bolus as there's no need as it's in the 'mix'. They just inject in the morning before breakfast and then before eve meal and just eat carb to the action of the insulin which is easier to do than achieve perfect bg levels with the basal but need to bolus for meals and snacks



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