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Basal testing advice

P

pinewood

Well-Known Member
Messages
792
Location
London
Type of diabetes
Type 1
Treatment type
Insulin
Over the last few days I've needed a lot more NovoRapid than normal to keep my levels steady. I'm not unwell and don't think I'm coming down with anything. Perhaps it's my honeymoon coming to an end but I was only diagnosed in December so hope that's not the case.

Anyway, my question is that I am currently taking 7 units of Lantus before bed. My Libre shows my levels remain steady over night - it's virtually a flat line every night. That suggests my basal level is right, yet during the day my levels seem to have a tendency to naturally rise regardless of food intake. For example, if I wake at 5.5 I seem to be at 7 within an hour or two even if I haven't eaten...

Does this suggest I should try split-dosing my Lantus? Or increase it, even though my levels are steady overnight? Or move the entire dose to the morning?

Any thoughts would be gratefully received!
 
I get a BG rise when I wake and have to bolus 3u just to keep my BG level without food. Annoying as I can't do proper basal tests, but that's how it works for me. Rest of the day and night I'm fine.
 
robert72 said:
I get a BG rise when I wake and have to bolus 3u just to keep my BG level without food. Annoying as I can't do proper basal tests, but that's how it works for me. Rest of the day and night I'm fine.
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Maybe that's the same for me, then, just a natural BG rise on waking... although lately I also seem to gravitate upwards during the day too (but guess it's impossible to accurately basal test during the day unless I fast...)
 
If you're constantly being pulled upwards in the day then is would suggest you need a different daytime basal
 
This is a very common pattern and it doesn't indicate your basal is wrong. It sounds like your basal is spot on actually. Many people get a dawn rise and a wake up rise. The wake up rise is easier to deal with. If it's predictable, you can take some short acting insulin as soon as you wake up. If it's less predictable, test and correct a little later. I doubt you would be able to fix this by juggling your basal.
 
pinewood said:
Does this suggest I should try split-dosing my Lantus? Or increase it, even though my levels are steady overnight? Or move the entire dose to the morning?
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Certainly worth a try, but before you do have a word with your DSN and ask how you should go about split-dosing.

The 1.5mmol morning rise is normal, much like Robert I also see a bg rise soon after waking.
 
I get this too. Quite often I have to eat straight away when I wake up in order to stop the morning rise. I can wake up 5.5 and then within half an hour I can go up to 6.9. I make sure now that I eat and inject so that I can counteract this morning rise. It is such a pain as sometimes I don't want breakfast and I worry about having my insulin without eating anything. I also find on a normal working day this isn't a problem as I am in a rush in the morning so I have to eat but at the weekends I struggle as sometimes the morning rise will happen when I'm lying in bed and then when I get up for breakfast I'm low so it all depends on timings. I have had to put my Lantus up as I have noticed that I have gone back to my normal weight now so it is worth keeping an eye on it.
 
asyarlk said:
I get this too. Quite often I have to eat straight away when I wake up in order to stop the morning rise. I can wake up 5.5 and then within half an hour I can go up to 6.9. I make sure now that I eat and inject so that I can counteract this morning rise. It is such a pain as sometimes I don't want breakfast and I worry about having my insulin without eating anything. I also find on a normal working day this isn't a problem as I am in a rush in the morning so I have to eat but at the weekends I struggle as sometimes the morning rise will happen when I'm lying in bed and then when I get up for breakfast I'm low so it all depends on timings. I have had to put my Lantus up as I have noticed that I have gone back to my normal weight now so it is worth keeping an eye on it.
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Now that I think about it it's the same for me actually - when I'm working it tends to be fine as I have my rushed morning routine, walk to the tube station etc. - it's at weekends and when on holiday from work that I notice it's a problem. I have much better control when I'm at work, as soon as I am out of that "routine" it's more difficult to manage!
 
Wekends with 3 hr lie ins from 5am to 8am have a huge impact on me too.
Fortunately I have a pump to set up two different profiles.. It just a case if remembering to change them over.

However, do speak to your DSN before splitting doses. It maybe that you need to amend your timings rather than splitting....
 
I get that too can wake with quite a normal reading but can rise without nothing to eat etc. my nurse said your body will produce sugar naturally no matter what
 
Tylers73 said:
I get that too can wake with quite a normal reading but can rise without nothing to eat etc. my nurse said your body will produce sugar naturally no matter what
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Yes it may but then you need to have the right amount of insulin at the right time to manage the rises.... It is possible to cope with the surges of glucose being released..
 
Injecting Lantus once per day at bedtime, i always got a large rise up in bg by mid morning even without eating anything for breakfast. If eating breakfast, i would need a 1u to 3g carb to cover the high bg and probably lack of basal.
 
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