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Changing Basal Insulin - Observing what happens and hopefully providing some "lessons learned"
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<blockquote data-quote="tim2000s" data-source="post: 747571" data-attributes="member: 30007"><p>[USER=150825]@bhk[/USER] Thanks for your feedback. I wonder whether your issues with Lantus were similar to those I had elsewhere where it wasn't forming a reservoir correctly and then shoots through and causes dramatic lows - there are a few of us on the forum who have experienced this. </p><p></p><p>If you look at one of my earlier posts in this topic, there is an operational surface that demonstrates the effective length of operation of Levemir in different doses. I have found that I do better thinking of Levemir as two basals. One for the day and one overnight. </p><p></p><p>My overnight dose is 8u when not exercising and 6u when exercising previous to the injection. I find this keeps a flat blood glucose level overnight when fasted. It doesn't seem to provide twelve hour coverage though, so I've come to the conclusion that I need to cover the last 1-2 hours with a correctional dose of fast acting.</p><p></p><p>My daytime basal is 14u, as during the day, I do consume carbs, although in small amounts. At 14u, with low carb consumption, I have determined that my glucose levels remain reasonably flat. Again, I don't think the levemir lasts a full 12 hours though, and unless I am at the gym of an evening, I find that I need to provide a correction dose to keep myself on an even keel. </p><p></p><p>I've arrived at these levels over a couple of weeks of basal testing and a bit of trial and error. It seems to work. My biggest issue is that to push the duration of the insulin up, I have to increase the dose to a level where managing my levels becomes that much harder. This can at times be frustrating!</p><p></p><p>I do wonder whether I should run my daytime basal slightly higher anyway and allow it to account for the gluconeogenesis that I see due to the protein content of my diet instead of managing it with boluses. Neither really seems optimum.</p></blockquote><p></p>
[QUOTE="tim2000s, post: 747571, member: 30007"] [USER=150825]@bhk[/USER] Thanks for your feedback. I wonder whether your issues with Lantus were similar to those I had elsewhere where it wasn't forming a reservoir correctly and then shoots through and causes dramatic lows - there are a few of us on the forum who have experienced this. If you look at one of my earlier posts in this topic, there is an operational surface that demonstrates the effective length of operation of Levemir in different doses. I have found that I do better thinking of Levemir as two basals. One for the day and one overnight. My overnight dose is 8u when not exercising and 6u when exercising previous to the injection. I find this keeps a flat blood glucose level overnight when fasted. It doesn't seem to provide twelve hour coverage though, so I've come to the conclusion that I need to cover the last 1-2 hours with a correctional dose of fast acting. My daytime basal is 14u, as during the day, I do consume carbs, although in small amounts. At 14u, with low carb consumption, I have determined that my glucose levels remain reasonably flat. Again, I don't think the levemir lasts a full 12 hours though, and unless I am at the gym of an evening, I find that I need to provide a correction dose to keep myself on an even keel. I've arrived at these levels over a couple of weeks of basal testing and a bit of trial and error. It seems to work. My biggest issue is that to push the duration of the insulin up, I have to increase the dose to a level where managing my levels becomes that much harder. This can at times be frustrating! I do wonder whether I should run my daytime basal slightly higher anyway and allow it to account for the gluconeogenesis that I see due to the protein content of my diet instead of managing it with boluses. Neither really seems optimum. [/QUOTE]
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