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Basal test when on a split dose

Discussion in 'Insulin' started by CranberryIce, Apr 21, 2018.

  1. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Hello,

    So basal testing is new to me. Just want to know how people to a basal test when they are on a split dose? Surely the doses overlap at some point?

    I am on Lantus- taking my morning dose at 7.30am and my evening dose at 10.30pm.
     
  2. catapillar

    catapillar Type 1 · Well-Known Member

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    Your small doses of lantus - 5 and 7? - won't be lasting much more than 12 hrs
     
  3. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Thank you.

    I was on 10 in the morning and 9 at night. But gradually reduced both doses due to lots of lows.

    Silly question but what is an average dose of how much basal we need for our bodies - or how is it calculated?

    I know everybody is individual and will have individual needs.I have a medium build and I am tall. Not “active” as such but on my feet all day for work. I eat/try to follow a low carb diet but have never been on such a low dose of Lantus.
     
  4. catapillar

    catapillar Type 1 · Well-Known Member

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    You calculate it by doing basal testing. Here's a guide on how to basal test - https://mysugr.com/basal-rate-testing/

    There's not a lot of point in worrying about what is an average basal dose because you are not average.

    To find the average TDD (so all of your insulin, basal and bolus) get you weight in kg and times by 0.53, bout 50% of that should be your basal, but if you are low carbing you are likely to be taking more basal than bolus.

    I really wouldn't worry about average doses. You know it's the right dose for you if it's keeping your blood sugar in control. That's the important thing.
     
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  5. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Thank you. I was just curious as I was on this dose or similar over 10 years ago and then it almost doubled and now almost halved again. But guessing thats life, and requirements will change depending on my lifestyle etc
     
  6. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Is it a must that you basal test before making changes to your basal dose?

    I have been pretty steadyish over the last few days but have noticed by 4.30pm 5.30pm my BG levels are rising. (Last meal/Novorapid would have been 4 hours ago). Is this an indication that my morning basal dose is low?

    Yesterday even after correcting my BG were bring stubborn and took a while to come down!
     
  7. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Anyone know how I am meant to do a basal test between 6am-12pm
    if I wake about 6.30am and get hit by the dawn phenomenon.

    Today my bloods were nicely in range upon waking 4.3 (6am).

    As I intended to do a basal test I gave my morning dose of Lantus at my usually time of 7.30am (by then I was getting readings around 7mmol.

    By 8am my blood sugars had risen to 8 (no food, no Novorapid). I sooo wanted to correct this but also wanted to see how high my bloods would peak.

    By 10am the rise started slowing down and I am now just below 10 (9.9).


    Arghhhhh :(. This is so frustrating.

    I know on another thread a member posted that they give some units of quick acting on waking to stop/beat the peak. How many units would I give then?

    Any help would be appreciated! x
     
  8. scotteric

    scotteric Type 1 · Well-Known Member

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    Yep, I usually have to take 1 unit when I wake up or I will skyrocket. Start with 1 and adjust if it is too much or too little. If your BG only rose to ~10 without injecting than it sounds like your basal dose is pretty good.
     
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  9. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Awesome! Thank you. So basal testing during 6am-12pm is a no no?

    I am now questioning my morning ratio of 0.5grams of carb to 1 unit. It’s crept up over the last year as I found I was always running high after breakfast. Now I know thats DP.

    If I correct on waking up- maybe my ratio doesn’t need to be as high .
     
    #9 CranberryIce, May 2, 2018 at 12:36 PM
    Last edited: May 2, 2018
  10. scotteric

    scotteric Type 1 · Well-Known Member

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    Not at all, think of the morning correction as part of your basal. So try and find the perfect combination of correction dose and basal dose in the morning and then you can add food!
     
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  11. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Will try again tom with the correction dose this time. I WILL get there!
     
  12. scotteric

    scotteric Type 1 · Well-Known Member

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    You will! Just remember every day is different and there are infinite factors that can affect your BG, so don't be frustrated if you think you have it perfect and then one day it isn't. I find the amount of sleep I get, the quality of my sleep, my stress level and even the weather can change my patterns.
     
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  13. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Thank you for the reminder.
    ahh the joys of being type1
     
  14. donnellysdogs

    donnellysdogs Type 1 · Master

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    The whole point of basal testing is to find out what works for your body... so dont worry about leveks rising or dropping etc as its just an indication that something needs to be adjusted to cope..

    If you do a bolus in morning, I find that I cannot go back to sleep...never as I need it for getting out of bed... so wouldnt take then think, too early, need another 30 mins sleep etc.
    I find that by the time morning bolus kicks in properly at 2-3 hours that I must have before getting out if bed. I also used to have to wait an hour before getting out of bed as well.

    Quite a number of us do take a bolus for getting up. Mine too is 1 unit but I also have to wake at 3.30 am each and every mirning for an insulatard injection that kicks in properly when I need it at 4-8 hours later.

    It deoends upon your correction factor at that time of day. If its 1 unit to 3mmol or 1 unit to 6mml or 1 unit to 2mml. You need to look at how much you are rising and work out from your needs as to how much you need. A starting point of 1 unit would a nurse may suggest for the average person but it depends really on your body and its needs..
     
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  15. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Ah ok so bolus when your actually getting out of bed. I gave one unit this morning...so far so good.

    I am getting up at 3am to test my BG at the moment to make sure I am not dropping low in the night (made easier with Libre). It’s a pain but can only imagine its more of a pain to get up and inject.

    I have always gone with 1unit brings me down by 3mmol which is what I was told by my nurse. I’ve never actually paid attention to if it actually does. So thats another thing I will monitor. :)

    Feel like if I can sort my mornings out the rest of the day will be smoother.
     
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  16. donnellysdogs

    donnellysdogs Type 1 · Master

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    You are absolutely right, if mornings better then it makes whole day better.

    Have you got an accuchek expert blood meter.. as this helps with acting times too.
    Acting time is how long the bolus lasts in your body. Standard set up from nurses is 4 hours but mine is 5 hours 15mins.. and I'm monitoring at the moment as I think its actually longer for bolus...

    There is a lot to think about to make things individual to our bodies....

    Basal testing is the best way for me to eatablish basics.. every clock change twice a year also affects me... heat etc so I basal test often...
     
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  17. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    I have the accucheck expert- but as I use the libre I input insulin and carbs in the libre- not the accucheck.

    The first trend I noticed on my libre was that my bolus lurks around for at least 4 and half hours.

    I took one unit on waking up.... and had a carb free breakfast... no spike today! I woke up higher than I would have liked (9.1). So will try again tomorrow!

    Do you find your ratios are different on weekends too? I have busy but less stressful weekends than on workdays.
     
  18. donnellysdogs

    donnellysdogs Type 1 · Master

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    Yes definitely different on relaxation days to busy days.... or stressed days...
     
  19. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    I tend to run high on the weekends- do I increase basal or bolus?
     
  20. donnellysdogs

    donnellysdogs Type 1 · Master

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    It depends on your results.. generally if high or low 2-3 hours after eating you would alter bolus but if you have lie ins, total relaxation etc then it would indicate leaning towards basal. However... if you are eating foods high in carbs/fat etc like pizzas etc it coukd jyst be the different foods! There are so many factors that the best thing to do (for me) is basal test iver weekend at varying times... and then that will give the basics to look at...
     
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