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Basal rate confusion

B

Beady

Member
Messages
9
Type of diabetes
Type 1
Hi all,

Recently switched to a low carb diet and getting confused by my slow release basal dose. I am not on a pump but inject twice a day, once in the morning and once in the evening and have been told the insulin releases over about 20-22 hours. I inject 12 both times
The confusion is because I frequently go low in the night but my levels creep up in the day without eating any carbs.
I used to inject for the dawn phenomenon but this no longer seems to affect me.
It seems like I need a different night and day rate but as my insulin is 20 hours, not sure how I can do this..
 
Hey @Beady - what insulin do you use and what's your body weight, if you don't mind me asking? If you're using Levemir, and your dose works out at less than 0.2u/kg, then it's very unlikely that it will be lasting 20 hours.
 
tim2000s said:
Hey @Beady - what insulin do you use and what's your body weight, if you don't mind me asking? If you're using Levemir, and your dose works out at less than 0.2u/kg, then it's very unlikely that it will be lasting 20 hours.
Click to expand...

Hi

I am 82.5kg using levemir
 
While I don’t want to go off on a tangent it might be related - I had 1 sausage and egg for breakfast, 0 carbs, and this is what has now happened...

IMG_0945.jpg
 
@Beady for a low carb meal like that, I would definitely have to inject for eggs, because of gluconeogenesis. And as @dancer very astutely points out, sausages often aren't actually carb free, because of all the cheap junk they put in them to hold them together.
 
Do you wake in the night to check your lows?
I have read a number of people complaining that their Libre reports low when they lie on it in the night.
Before adjusting your basal dose to manage this low, it may be worth setting an alarm at around 5am to check your "true BG" with a finger prick.
 
Theres nothing wrong with having differing dosages of basal for morning and evening. But agree with Helen that you should confirm the low is an actual low before making changes. As for creeping up during the day, it sounds like you're not taking any bolus at all, and I doubt your are consuming 0 carbs all the time plus you would probably need to consider bolusing for protein and fats if you're really low carbing.
 
Thanks all - I think I need to read a bit more about low carb diets for diabetics before continuing with this. Not sure I understand what foods to inject for the protein and how to calculate this.

The reason I thought different morning and evening doses wouldn’t work is that they last 20 hours so each dose covers both day and night
 
1) levemir lasts about 12 hours, not 20. That's why levemir is taken am and pm. It's fine to take different doses in the morning and evening.

2) have you done any basal rate testing to see if you are on the right dose of levemir? Here's a guide on how to basal test - https://mysugr.com/basal-rate-testing/ - I woul definitely recommend finger prick testing for a basal test.

3) if you aren't eating carbs your body wants to get glucose from somewhere, it does this by turning protein eaten into glucose. Gluconogenesis is a process that can take a while, so you might see a late rise after a protein meal, you might need to delay your bolus to deal with it. Gluconogenisis is unreliable, you can't guarantee your body's going to turn the protein eaten into glucose. The cautious advice for bolusing for protein is to: work out grams of protein eaten; discount by 30g; divide in half. That's the numbe of grams you apply your I:C ratio to.
 
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