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Basal timings

tizzy

tizzy

Well-Known Member
Messages
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Hi can I ask what is the best time of day to take basal insulin I'm currently taking it at lunch time but want to avoid night time lows thanks tizzy
 
If it's just one injection per day then choose either morning or evening. I go for evening when I go to bed. I leave it on my pillow during the day so I don't forget.
 
I have one at 6pm when I have my last food for the day.
When on two levemir I had at 9am and 6pm.
Got alarm set on phone for 6pm reminder just in case.
 
Thank you for your replies I take 1dose of levimir at lunch time and my libre is showing I go low in the early hours I have to make sure I am 10 or 11 to avoid this which is not good would taking it at night or the morning make a difference do you think tizzy
 
tizzy said:
Hi can I ask what is the best time of day to take basal insulin I'm currently taking it at lunch time but want to avoid night time lows thanks tizzy
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If you are having lows in the night, then that's about 14hrs after the basal?
The easiest way is to eat a small carb snack before bed presuming the low is around 2.30am? and test bg before the low tends to happen to see what effect the carb has had.
Another way might be to use basal in the morning and then maybe adjust the bolus at lunchtime and adjust bolus for evening meal. Another way might be move basal to bedtime and adjust it to be less but also try to get carb ratio for eve meal to be correct to allow bg level before bed to always be the same
 
tizzy said:
Thank you for your replies I take 1dose of levimir at lunch time and my libre is showing I go low in the early hours I have to make sure I am 10 or 11 to avoid this which is not good would taking it at night or the morning make a difference do you think tizzy
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It may be an idea to split the dose but I would recommend either @tim2000s or @robert72 advice on this. They helped me enormously when I went back to MDI from my pump.
Splitting levemir morning and evening was good for me prior to going on to Tresiba insulin. Depending on your level of activities it may be worth asking your consultant about Tresiba (Degludec). It is long lasting, you need less and hypos are less... Especially at night.
Your DSN should be able to recommend a split dose.. My DSN was less accurate with doses than the persons here though-lol... Why I've tagged them.
 
Hi thank you all for your input the dsn suggested tressiba but I'm reluctant to change at the moment and would prefer to try and make the levimir work for me better so if I take it in the morning would I need more bolus perhaps later in the day with meals tizzy
 
I worry about weight gain on a different insulin how does tresiba affect weight has anyone experience of this also the dsn said splitting the dose wouldn't help so gave me no insight of how to split it but did say I could try it if I liked
 
@tim2000s ?? Can ypu offer advice on splitting?
No weight gain for me on tresiba. Just a reduction in jabs and qty!!
I know When I went back to MDI nurse recommended something like 20 units levimir for me. But I needed around 6 at night and I think 9 in morning. My units used to vary a lot due to other problems.. Could. Get down to 11 or up to 18... On tresiba its stuck at 9 for the past month.
 
Hi @tizzy, the DAFNE (and NICE) guidance is to take Levemir split twice daily as the empirical evidence shows better results this way. I'm afraid that your nurse doesn't seem to be up to speed.

Normally, the approach is to start by splitting Levemir before bed and when you get up, and normally this is done by splitting 50:50 and testing through the night to see what needs to be adjusted.

It is likely that you will need different amounts am and pm but testing will get you to that.

How large is your Levemir dose at lunchtime? For you to be going low in the early hours, it would suggest it's a significant amount per kg of weight.

Secondly, no insulin makes you put on weight per se. Insulin turns the body off burning fat and makes it burn carbs so being careful about how much you eat is important!
 
Hi and thank you I take8 units of levimir and carb count with novo rapid 1 to 10 carbs I'm gradually bringing my basal down to take in the morning ,tomorrow 10 o'clock .its good to know tressiba won't cause weight gain its something I may ask about next visit to be honest although I suspected I was hypoing during the night sometimes it was the libre that showed me I was tizzy
 
tizzy said:
Hi thank you all for your input the dsn suggested tressiba but I'm reluctant to change at the moment and would prefer to try and make the levimir work for me better so if I take it in the morning would I need more bolus perhaps later in the day with meals tizzy
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Probably yes but bg testing every 2.5hrs is going to be yr guide as to whether you will need to increase or decreasej the bolus in order for yr bg targets to be achieved. The idea of injecting the basal twice daily is to try to create a slightly smoother profile so that the hypo feeling becomes a bit milder.
At the moment yr dsn is probably trying to ease you into doing injections and of course wants you to comply but may well suggest that you try levemir twice per day instead of just once. You can change your carb ratios according to how the basal and bolus work together. On Lantus once per day at night, my carb ratio needed to be 1u to 3g carb, breakfast, lunch was 1u to 7g, eve meal was 1u to 3g again so the bolus was adjusted to the action and doseage of the basal. Using levemir twice per day, the bolus was 1u to 6 breakfast, lunch was 1u to 7g, eve meal was 1u to 8g.
 
So sorry for delay in replying its so so complicated isn't it or is it me anyway taking the basal in the morning seems to going ok a bit high before bed but was eating something anyway to get it up as very worried about the hypos I do feel splitting the dose is the way to go but a bit puzzled if you are only having half the dose does that mean it won't be enough thank you for your help tizzy
 
If you split levimir you need to just adjust it / fine tune to your body....splitting equally morning and night may give you night hypo's and not enough during the day. Levemir although it is a long acting insulin doesn't last that long compared to the lantus and certainly no comparison to tresiba/degludec. Tresiba say there insulin lasts up to 42 hours!! And most of us that are on it I think have needed less units and only one jab a day. That one jab doesn't have to be timed too much either. For the first time today, since I've been on it I realused I hadn't done my jab until 4hoyrs later than usual and it hasn't made an ounce of difference to my levels.
If going higher before bed you really need to assess that your bolus was right.. Perhaps go without tea one night or have it earlier say at 3pm and try to eat nothing till the following morning and check your levels 2 hourly- ideally during the night too.
Bolus insulin is generally out of an average persons body by 5 hours after having the jab... So if you ate at say 3pm your bolus would last until 8pm. Then if you were able to not eat again and check your levels 2 hourly you would see how your basal insulin acts from 8pm throughout the night till the next day...
It seems a lot to do but it doesn't have to be done often-just when you really want to find out correct doses......
 
Hi and thank you having my basal in the morning seems to be a lot better i didn't realise splitting the bolus would be so complicated il certainly be asking about the trissiba sounds good tizzy
 
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