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Basal adjustments

asyarlk

Well-Known Member
Messages
155
Type of diabetes
Type 1
Treatment type
Insulin
Hi

Just wondering, I take 6 units of lantus at 10pm each night. In the past my morning readings would be around 6mmol. Over the past week they have ranged between 4.6-5mmol. I've also tested 1hour after my basal and I sometimes have dropped a mmol. I have cut carbs down but I wasn't a big carb eating so have found that relatively simple (phew). I take about 3u of novorapid each day. This obviously varies from day to day but that's an average. When I have a no carb meal I find I rise a little (2mmol) and then stay steady for the next 4/5 hours ( such a relief as I was going up and down like a yoyo).

Are my morning readings a concern? Should I adjust my basal?

Thanks in advance. I'm sure my nurse has mentioned this before but I've had so much info since being diagnosed I've forgotten some bits!!
 
Hi! It sounds to me like your readings are looking great! I also wake up at around 5mmol and I'm very happy with that. I think 4.6-5 is ideal. What is your reading right before bed? Is it staying steady through the night?
 
They say if your basal dose is set right your bg shouldn't fluctuate no more than 1.7mmol, so your near enough there.
 
Thanks. This is all really helpful. So is it ok to go to bed at 6mmol and wake il at 4.8mmol?

My nurse said go to bed at 8mmol and wake up around 7mmol.

What are your recommendations?
 
asyarlk said:
Thanks. This is all really helpful. So is it ok to go to bed at 6mmol and wake il at 4.8mmol?

My nurse said go to bed at 8mmol and wake up around 7mmol.

What are your recommendations?
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Can't make recommendations and override your nurses advice, but personally if my bg was only dropping 1.2mmol overnight then I'd be happy with that if this was the norm, if you wanted and to act as a safety barrier you could aim for your bg to be a little higher before bed so that you wake in the 5's say or low 6's, but the choice is yours, the nurse is just thinking about your safety and doesn't want you to hypo's in your sleep which is understandable.
 
Sounds good to me as well. I wish mine was so well controlled.
 
Your numbers are fine as they are just to put your nurses mind at rest perhaps do a couple of night time tests. This way you can prove your are not going hypo if that is her concern
 
I agree with the others that your readings sound good...........

If my readings fluctuate by 1-2 mmol I am happy with my basal dose..........

differences of 1-2 mmol in your BG readings are minimal and our blood glucose meters are not that accurate anyway....

your on such small dose of insulin both the basal and bolus, so its likely any change, even a single unit, would have a significant effect, so I think your fine and don't need to adjust at the moment.......
 
Your numbers are fine. Sounds like the nurse is just trying to increase the safety barrier to avoid hypos. I was told to aim for between 5 to 7 mmol fasting but in practice aim for 4.5 to 6
 
Ok great advice everyone! Thanks! What do you normally go to bed at? If I'm below 6 I normal have a snack even if I don't want one. Is this normal?
 
asyarlk said:
Ok great advice everyone! Thanks! What do you normally go to bed at? If I'm below 6 I normal have a snack even if I don't want one. Is this normal?
Click to expand...

If it works it works, better to have that snack and not go low during the night and disturb your sleep, but in theory if your basal dose is set right there shouldn't be a need to snack before bed if bg levels are within range.
 
asyarlk said:
Ok great advice everyone! Thanks! What do you normally go to bed at? If I'm below 6 I normal have a snack even if I don't want one. Is this normal?
Click to expand...
I used to be too nervous to go to bed below 7mmol without having a snack. But after doing some basal testing to work out the best Lantus dose (I take 7 units) I now feel confident going to bed without eating a snack beforehand, as long as I am above 5.5. This seems to be working well for me, as even if I go to bed at 5.5 I don't seem to drop more than 1mmol by the morning. Obviously there are lots of external factors that could affect this and I'm sure one day it might be different but I'm conscious of putting on weight following t1 and insulin injections so cutting out the bedtime snack was important for me. If you don't mind one or a few sleepless nights of waking up to do regular testing you should be able to feel confident about how your levels fluctuate through the night and hopefully you'll be able to not bother with the bedtime snacks if you're not hungry.
 
I normally have my evening Bolus around 7-8 pm hence when I have my Basal at 11pm I know that only the Basal will have an effect during the night (unless I'm already verging on a hypo) and that will be background and if balanced will keep bs stable. I only have a snack before bed if my bs is too low.
 
My lantus sometimes just doesnt do anything at all, sometimes I've injected as much as 20 units or none at all a few days at a time. Could be insulin resistance or lantus not up to its standards anymore.
 
@nmr1991, there are a few options. Lantus can have an odd release timing dependent on how it creates the reservoir. It also loses efficiency if out of the fridge for a long time (I used to see 22 days then have to change the phial).
 
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