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Basal monitoring/adjusting

T

Tracie1212

Well-Known Member
Messages
138
Type of diabetes
Type 1
Hi can anyone send me a link for basal monitoring and adjusting dose.

Started on Tresiba last Thursday night at 22 units for three days

Changed to 21 units for three days but had 4 lows since mid night through morning. Thinking of 19 units tonight. Want to bring back dose from 10pm to earlier in night. Shattered from scanning through night lucky enough to have Libre freestyle.

Thanks
 
Just a question.......are you sleeping longer than 8 hours.....? as you essentially don't need to scan more frequently than that.....

I don't know any sites off the top of my head but with injections you are prettyty limited to the scope of any adjustment.....provided there is no significant dawn phenomenon, you are just looking to see a steady line, plus or minus 2 mmol overnight.....if its not, then you adjust it up or down a unit or two, depending on your sensitivity to insulin.......

I was a 2 unit per adjustment guy.....;)
 
Hi having to wake at 2am as low and eating oatmeal biscuits then low at 6am then eating Cereal bar. This has been for last 6 night's. I will be reducing dose tonight thinking of 19.

Thanks
 
Meant to say have to go to bed at levels of 12 but still going low.

Im eating around 6/7pm doing carb counting around 20 carb if I don't put right amount of insulin in I feel unwell. Then get to Tresiba dose 10pm and have to push levels up.

Thank
 
@Tracie1212 In your situation, I would be contacting my diabetes team and tell them what is happening.
They should be able to advise on your dose, especially as they have just changed you to Tresiba; they should be keeping an eye on you.

It is possible you have some of your previous basal on board.
I know Lantus is supposed to last 22 - 24 hours and many people report increase of BG before this time but there may still be some still in your body. When I transitioned to a pump, I experienced some lows for the first few days due to the remaining low levels of Lantus.
 
Hi@Helensarmy

Thanks for your reply . Its been over 5 days now since finishing Toujeo I have been ringing Nurses they have not phoned me to see how I'm getting on. When I voiced my concern about using a like for like dose I was told that this was correct for me. Other patients I know started on slightly lower doses which I now feel would have been more suitable for me. I've reduced to 21 but feel 19 is best tonight I'm exhausted just hope don't go too high.

Appreciate your support.

Thanks

Tracie
 
Tracie1212 said:
Hi@Helensarmy

Thanks for your reply . Its been over 5 days now since finishing Toujeo I have been ringing Nurses they have not phoned me to see how I'm getting on. When I voiced my concern about using a like for like dose I was told that this was correct for me. Other patients I know started on slightly lower doses which I now feel would have been more suitable for me. I've reduced to 21 but feel 19 is best tonight I'm exhausted just hope don't go too high.

Appreciate your support.

Thanks

Tracie
Click to expand...
hi tracie
i started on like for like dose when i changed from lantus to tresiba i only had to change my dose by 1 unit since .but nurse told me any changes take 3/4 days to take effect also are you checking your lows by doing a finger prick test as sometimes libre reads lower than bgs actually are hope you get sorted and get a decent nights sleep sending hugs :)
 
Hi@Karen8967

Thanks for your reply.

I agree Libre is out by around 2 levels I've been consistently under 3 in early hours of morning on finger prick tests over 6 nights.

Such hard work hope I turn a corner soon.

Thanks

Tracie
 
Personally, I'd drop to like 16 or something then work my way back up till I'm stable.
 
Thanks I've injected 19 units of Tresiba.

My Ketones are 0.1. Will monitor through night and hopefully blood sugars will hold at good level and Ketones will stay put too.

Fingers crossed.

Thanks all

Tracie
 
Hi Tracie... You are on the right track. The main thing with basal is to make your alteration and then give it a few days to settle before making another move. Eventually you'll find that you are waking with a steady line and then you can work towards getting your pre-bed levels lower.
 
Tracie1212 said:
Hi can anyone send me a link for basal monitoring and adjusting dose.

Started on Tresiba last Thursday night at 22 units for three days

Changed to 21 units for three days but had 4 lows since mid night through morning. Thinking of 19 units tonight. Want to bring back dose from 10pm to earlier in night. Shattered from scanning through night lucky enough to have Libre freestyle.

Thanks
Click to expand...
The technique described in Gary Scheiner's Think Like a Pancreas book is, for every 1.6mmol/l change in overnight levels adjust your basal by 10%. I followed this when I was doing a lot of HIIT training, which affected my basal a lot; I used to have to adjust it by 20% every day and this technique works perfectly.
 
Thanks @jackois and samjb

I injected 19 Tresiba at 9.45pm last night awake at 2am ate biscuit to prevent hypo. 6am this morning blood sugar 5.1. Ate breakfast early and reduced novorapid slightly. Going to stay home today, rest and monitor.

My plan is to inject Tresiba at 8.45pm tonight and gradually bring back to an earlier injection time to make it more manageable for me.

Will see how I go today I am really sensitive to any adjustments as in changes in insulin behaviour pattern is much the same on day 1 as it is on day 3.

Thanks
 
Tracie1212 said:
Thanks @jackois and samjb

I injected 19 Tresiba at 9.45pm last night awake at 2am ate biscuit to prevent hypo. 6am this morning blood sugar 5.1. Ate breakfast early and reduced novorapid slightly. Going to stay home today, rest and monitor.

My plan is to inject Tresiba at 8.45pm tonight and gradually bring back to an earlier injection time to make it more manageable for me.

Will see how I go today I am really sensitive to any adjustments as in changes in insulin behaviour pattern is much the same on day 1 as it is on day 3.

Thanks
Click to expand...
You're welcome!

I know Tresiba lasts a lot longer than the Lantus I use, but I found changing injection time to the morning to be better. It means you can make an immediate change to the dose, after the basal test I described, so you don't go all day with the incorrect dose of Lantus and you can be more certain that the next night will not be riddled with hypos.
 
Hi another question about Tresiba.

If I adjusted Tresiba daily by say one unit as in 19 one day then 20 the next day and rotated would there be any harmful effects? I know we are advised to leave for 3 days to establish pattern but my life is very different every day.

I adjust my novorapid ratios so wondered if I had flexibility to do this with Tresiba.

Thanks all
 
Tracie1212 said:
Hi another question about Tresiba.

If I adjusted Tresiba daily by say one unit as in 19 one day then 20 the next day and rotated would there be any harmful effects? I know we are advised to leave for 3 days to establish pattern but my life is very different every day.

I adjust my novorapid ratios so wondered if I had flexibility to do this with Tresiba.

Thanks all
Click to expand...

Harmful effects would be if your blood sugars went too high or too low with that variation. So if your blood sugars are better as a result with adjusting doses, there's nothing else to worry about.

(caveat : libre or similar will be helpful for seeing detail - fingerpricks can miss peaks or troughs. Like a stopped clock, it is probably possible to have an insulin regime which shows you in target twice a day on fingerpricks, but that wouldn't show the problem areas :-) )
 
Thanks@evilclive

I always feel better on the day transitioning between dose changes. My lows are between midnight and 10am.

Adjusting novorapid ratio daily was 5 for breakfast now at 2.

Im taking Tresiba slightly earlier everyday hope I can eventually get a good night's sleep.

Thanks
 
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