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Basal Insulin Help Plz!

Discussion in 'Type 1 Diabetes' started by evej, May 13, 2018.

  1. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    After doing DAFNE I found that the best education you can get is from your own testing and analysis....our doctors aren't there with us dealing with all the variables we need to deal with so we are the professionals day to day...provided we make the effort and keep good records....they are good when we get so boggged down with it all and need a fresh pair of eyes though...
     
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  2. evej

    evej Type 1 · Well-Known Member

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    I'm in Canada and can't get the DAFNE that I can tell. Will continue testing :)
     
  3. evej

    evej Type 1 · Well-Known Member

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    This morning, there is a clear gradual rise in BG of approximately 4mmol/L from 10pm to 10am. I have eaten no carbs, but have given a correction bolus of 4u Humalog at 7am. Since I am now splitting my Lantus, and lantus takes 1 - 2 hours to start working, peaks in about 6 hours and lasts 18 - 24 hours, would this not suggest I'm not taking enough Lantus at night?

    My reasoning would be that the daytime Lantus (15u) has barely started to work (3 hours post injection), and the night time Lantus (6u) would be approximately level, but past its peak and maybe starting to tail off a bit (15 hours post injection).
     
    #43 evej, May 16, 2018 at 5:29 PM
    Last edited: May 16, 2018
  4. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    The peaks you speak of aren't that defined....it's action stays pretty level for most of its duration.....

    You can essentially keep increasing the lantus overnight until you hypo at 3am....the increase you seen till 10am may still have been the effects of DP.....

    What was the before bed reading and the ones after....?

    Did you eat with the morning correction...?
     
  5. evej

    evej Type 1 · Well-Known Member

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    These are from my Libre which is about 2 mmol/L higher than blood levels, but still numbers are too high overall.

    I went to bed at 10.4 around midnight.
    Woke at 12.4 at 5:30.
    At 7am was at 14.6. Took 4u Humalog and 15u Lantus
    Ate 2 eggs at 8am
    By 10 I was at 14.1. Took another 2u Humalog
    At 11 was at 14.9
     
  6. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    What's the libre graph like overnight...?..

    It seems like you are holding steady enough overnight...but still creeping up on the morning...

    Would be interesting to see what a basal test reveals I'm the morning actually.....

    So many things to try and rule out...lol....

    You may need to adjust the correction factor due to the increased resistance to insulin in the morning.....so maybe 1 unit to drop you 2 mmol.....

    One thing at a time though...
     
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  7. Alison54321

    Alison54321 Type 1 · Well-Known Member

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    I think I might be taking on mother role here. I know it's counter-intuitive, but having a small amount of carbs for breakfast might improve your blood sugar.

    Those morning ones don't look good at all. Especially as you've taken the Lantus, and the humalog, and they still aren't going down.

    Maybe some raspberries, a grapefruit, or something you like. Always best to eat food you like. Sometimes fasting for too long can raise cortisol levels. Also fruits contains lots of anti-oxidants, especially vitamin c, and for people with diabetes, vitamin c is quite important.

    Ok, that's my mother like intervention over.
     
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  8. evej

    evej Type 1 · Well-Known Member

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    Here's a pic of the libre, and a pic of the paper graph. Right now it seems as if dosing twice daily with Lantus isn't making much of a difference. The line IS flatter than it was, but I'm pre-empting a morning rise with 4u Humalog. If I don't, I will just continue to increase.

    One unit of humalog in the morning seems to do absolutely nothing, even when Libre says I'm flat - ie. not trending up or down.
     

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    #48 evej, May 16, 2018 at 10:50 PM
    Last edited: May 16, 2018
  9. evej

    evej Type 1 · Well-Known Member

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    Alison, NONE of my numbers are good (even though blood is 2 mmol/L lower than the Libre with this sensor for some reason) lol. The only exception was suppertime but that was before I switched to twice daily Lantus. For whatever reason, around 3 or 3:30, it's like my body says "Oh that's what I'm supposed to do... and it settles down within target". Probably not fair to judge just yet as it's only been a couple of days of split dose. Any advice is greatly appreciated. I did eat, but no carb - just two eggs around 8am.
     
  10. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    I find eggs make my BG spike in the morning... but any other time of the day I can eat them without any bolus...
     
  11. evej

    evej Type 1 · Well-Known Member

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    Seriously? Wonder why... I start spiking before I eat anything - around 5:30 or 6am. If I don't bolus, it just keeps rising. Guess I wonder why about that too lol. I'm gonna try eggs in the afternoon...
     
    #51 evej, May 16, 2018 at 11:51 PM
    Last edited: May 17, 2018 at 12:12 AM
  12. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    The paper graph looks ok....if it was in range....a small hike in the morning...and then what looks like a normal spike at lunch.....

    Why are the graphs different...?
     
  13. evej

    evej Type 1 · Well-Known Member

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    They're the same day/time. The one is a shot directly from the metre. The other is a photo of the paper graph. The metre one just looks more bunched up and so the spikes are more pronounced. I find I get valuable info from looking at both.
     
  14. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    Yeah, I agree......the stretched out one is my preference....lol.....

    so how's your dose adjustment journey going today...?
     
  15. evej

    evej Type 1 · Well-Known Member

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    So, yesterday and overnight, was the first time EVER I was in (mostly) target from 3:30pm to 6:30am!!!!! In the late afternoon and evening i had to prop up my blood sugar several times with 5 to 10g of carbs, and at night I dropped from 11.9 at bedtime to 8.4 - a drop of 4mmo/L. I took 15u Lantus in the morning and 7u at evening. Sooooo... my reasoning is that I need to drop back to 6u Lantus in the evening, and MAY need less during the day. I took 14u Lantus this morning, and will take 6u tonight. Thoughts?

    Does the 14u I took this morning affect what i should take in the evening?

    Also, should I try eating a carb for breakfast? Clearly I start rising BEFORE breakfast, so don't think a carb would make a difference, but I have had suggestions to try adding a small carb.

    Thanks!
     
  16. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    Both your Lantus doses are independent, so what you need overnight wont have any bearing on the day....you should also try and only change one thing at a time.....

    from the last few days I would say the 6 units of Lantus at night is pretty much there, so it can be ticked off as correct for now.....you can now focus on the day time....

    Because you went low in to the afternoon that could suggest too much basal [provided it wasn't any previous bolus/bad carb calculation etc] but its too early to tell, more testing required unfortunately....;)

    So 14 units the next morning [is it morning for you now....?] and test away...

    Should you eat a carb, yeah, you can........having a small carb as early as you can alongside some insulin will actually help the DP process come to an end....and probably more effectively than a carb free breakfast, due to the quicker digestion response...

    [READING BACK: I sometimes get carried away with dosing advice. I am not a doctor, just an experienced diabetic, so take this advice with the normal caution you would take when making insulin adjustments....;)]
     
  17. evej

    evej Type 1 · Well-Known Member

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    I'm gonna assume 6u Lantus at night is the right amount for now, and will try to test basal at noon today. I went low at 10:30pm, and my previous Humalog was 4u at 6pm. From 6pm, I had a very small supper carb bump, and then dropped steadily to 10:30 when I ate 10g of carbs. Since the last Humalog I took was 6pm, that would suggest the basal is a little high, wouldn't it? I was not able to run a good test during the day yesterday. Too many small corrections needed. I am having a small carb for breakfast.

    It's morning yup! And understood about you not being a doctor.
     
  18. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    There is a chance the Humalog could be contributing but trial and error will confirm it....

    Out of curiosity, what was the 4u at 6pm for?

    Enjoy your breakfast....
     
  19. evej

    evej Type 1 · Well-Known Member

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    Fair enough re: Humalog. The 4u at 6pm was for supper.
     
  20. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    What was the supper I mean....;)
     
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