1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2021 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
  4. Guest, stay home, stay safe, save the NHS. Stay up to date with information about keeping yourself and people around you safe here and GOV.UK: Coronavirus (COVID-19). Think you have symptoms? NHS 111 service is available here.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Anyone here who uses only Bolus & no Basal or very less basal?

Discussion in 'Type 2 with Insulin' started by db270, Sep 24, 2019.

  1. db270

    db270 · Member

    Messages:
    11
    Likes Received:
    2
    Trophy Points:
    3
    My basal (long acting - NPH, Lantus etc) insulin needs seem to be very less as compared my bolus (fast acting) needs.

    I was wondering if there was anyone else (T2s obviously) here who takes no basal or less basal as compared to bolus? And has their blood sugar under control. How much basal & how much bolus units do you take per day?
     
    • Useful Useful x 1
  2. xfieldok

    xfieldok Type 2 · Well-Known Member

    Messages:
    3,987
    Likes Received:
    2,565
    Trophy Points:
    178
    Everyone is different and other peoples doses won't help you.

    As a T2 why are you on insulin rather than diet controlled?
     
  3. Juicyj

    Juicyj Type 1 · Moderator
    Staff Member

    Messages:
    8,168
    Likes Received:
    6,565
    Trophy Points:
    198
    @xfieldok This member is simply looking for suggestions from other members - questioning why they are on insulin is irrelevant. If you don’t have anything supportive to offer then please don’t respond.
     
    • Like Like x 2
    • Agree Agree x 1
    • Winner Winner x 1
  4. Diakat

    Diakat Type 1 · Moderator
    Staff Member

    Messages:
    5,600
    Likes Received:
    4,169
    Trophy Points:
    198
    Another T1 but I was wondering if you take metformin too? That acts to block liver dumps so may reduce basal need?
     
    • Winner Winner x 1
    • Informative Informative x 1
  5. Seacrow

    Seacrow LADA · Well-Known Member

    Messages:
    372
    Likes Received:
    164
    Trophy Points:
    63
    At one point (pre pump) I was allergic to all available basal insulins. I was taking high doses of bolus, and spreading meals over 24hrs to try to mitigate having no basal, but I still felt lousy. Every single day felt like I was just recovering from flu. So, I survived no basal, but really don't want to try that again.
     
    • Hug Hug x 1
  6. db270

    db270 · Member

    Messages:
    11
    Likes Received:
    2
    Trophy Points:
    3
    Yes. I do take Metformin & I know that it blocks liver dumps. But most T2 on insulin also take metformin, so I was just curious to know if there are others who have very reduced or no external basal needs
     
  7. NaijaChick

    NaijaChick Type 2 · Well-Known Member

    Messages:
    178
    Likes Received:
    69
    Trophy Points:
    68
    I take only Bolus (Fast acting) twice a day with meals (11&12 units).
    I have not been prescribed basal.

    I think this is because I’ve dropped my HBA1C from 10 something to 7.4 in 3 months.

    So just so people don’t freak out, you can be prescribed bolus without basal.
     
    • Informative Informative x 3
    • Like Like x 2
  8. xfieldok

    xfieldok Type 2 · Well-Known Member

    Messages:
    3,987
    Likes Received:
    2,565
    Trophy Points:
    178
    I am sorry. I was genuinely interested. When I was dx, I was offered insulin with no mention of lifestyle/diet changes. Fortunately I found this place first.

    My current use of insulin is soley to beat the steroids into submission and makes little sense to anyone that isn't me, least of all to the nurses at the surgery who are baffled....
     
    • Friendly Friendly x 1
  9. db270

    db270 · Member

    Messages:
    11
    Likes Received:
    2
    Trophy Points:
    3
    Thank you. I have a few more questions if you don't mind.

    - Have you done a "basal test" to figure out if you need basal additional to whatever your pancreas provides?
    - How long since you have been diagnosed with T2?
     
  10. ringi

    ringi Type 2 · Well-Known Member

    Messages:
    3,366
    Likes Received:
    1,218
    Trophy Points:
    158
    I expect your body is still making a lot of inslin, but due to high inslin resistance it is not enough to control your BG after your meals. It is possible the inslin level your body is making is higher then someone without diabetes, but as your pancreas is working "full out" all the time the inslin level may change little over the day. A cpeptrade test would comfirm this, but hard to get for T2 on NHS.

    In a person without diabetes the background level of inslin is very low, then when they eat a meal their pancreas very quickly releases a short burst of high level of inslin - this is called "first inslin responce" and is often stated in research papers as an increase in rate, not obsolete level. This short lived high level of inslin is responsible for removing the glocose that gets added to the blood from the digestion of carbs in the meal. Mostly this high inslin level gets used by the liver, and never get to the rest of the body - very different from injecting inslin.

    In type2 diabetes the "first inslin responce" mostly stops working, hence resulting in high BG increase if a meal contrains more carbs then there is enough inslin to convert into fat. (The glycogen stores are normally nearly 100% filled in a person with type2 diabetes unless they are eating a lowcarb diet)

    The level of carbs in the meal mostly determines how much the meal will increase BG however protein also increased BG a little, so even if a meal has no carbs an increased level of inslin is needed by the body to control BG. It is not possible to predict if your body can provide the level of inslin needed for a carb free meal, without you doing careful experiments, monitor your BG and being very aware of the risk of hypos.

    It is even possible that your meal time inslin reduced how much inslin your pancreas makes over the few our after the meal to below the level the pancreas makes while you are not eating.
     
  11. db270

    db270 · Member

    Messages:
    11
    Likes Received:
    2
    Trophy Points:
    3
    I have also moved to something similar now. I started with 70% basal & 30% bolus, then to 50-50 & then 30-70. But now I take only bolus (old style Insulin R). Not taking basal affects me a bit only before breakfast & before dinner. My sugar levels are 15-20 points higher before breakfast & before dinner than they were when I was taking basal (NPH). And the amount of basal I needed for just those twenty points was something 7 units twice a day. So my doctor advised me to stop basal & increase my bolus just a little bit. I now have 10 & 12 units of bolus before breakfast & dinner respectively.
     
    • Useful Useful x 1
    #11 db270, Oct 16, 2019 at 3:49 AM
    Last edited: Oct 16, 2019
  12. NaijaChick

    NaijaChick Type 2 · Well-Known Member

    Messages:
    178
    Likes Received:
    69
    Trophy Points:
    68
    How weird that we are both on such similar doses. *****Sugar Free Hugs*****
     
    • Like Like x 1
    • Friendly Friendly x 1
  13. ickihun

    ickihun Type 2 · Master

    Messages:
    13,443
    Likes Received:
    18,374
    Trophy Points:
    298
    I'm reducing my insulin units and found Metformin greatly helps with how much basal I need. I hv tried without basal but I range just a bit higher than my consultant advises. I hv nerve problems in my legs and one foot/toes worse than the other so don't want to risk more damage or loss of sight.
    My main aim in reducing units is to improve my weight loss after bariatric surgery.
    Only a few days ago I had to stop reducing my basal but in doing so I needed less bolus. I'm currently on holiday so haven't weighed myself to see if my stalled weight loss has been rebooted. I've lost 5st on insulin but know type2s have high/severe insulin resistance so part and parcel is needing extra insulin to keep excellent control.
    I'd say if you hv good control on no or less basal monitor heavily just incase that changes unexpectedly. Inform your team at your next opportunity. Monitor monitor monitor and if your bgs creep up don't feel bad about reintroducing or increasing safely under medical advice.
    I'm very confident changing my units but not everyone is so always take medical guidance when making important changes to your insulin routine.
    What are your fbgs looking like for pass 2wks? Also in comparison to days with less/no basal?
     
    • Informative Informative x 1
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook