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Confused

lma89

Active Member
Messages
33
Location
Beverley
Type of diabetes
Type 1
Treatment type
Insulin
Feeling self conscious about my basal dosage as a few friends who are type one have such low doses I wonder how they are living. I shall start at the beginning
I have been a type one for 14 years and 3 years ago changed from a two a day injection to basal bolus regime, I couldn't get control of my blood sugar so a diabetic friend advised splitting and tweaking, worked wonders I was taking around 20 units pm and about 17 am. A few months later I developed some odd virus that attacked my joints and tendons and I ended up on steroids for about 2 months because of the pain, obviously this caused my sugars to rocket, I started the steroids at just under 11.5 stones, I ended up putting on 1 and a quater stones and my basal was 45am and 45 pm which was ridiculous I was going through insulin like water, I got off the steroids, I now weigh just under 12 stone but my basal is 30 units pm and 27 am, I cannot get below this or my ratios for bolus just go out the window and I end up high all day. Is It just because I'm still carrying some extra weight that my basal is so high? My diabetes nurse told me not to worry because my long term readings are spot on. I don't know my mind is frazzled
 
Have you done a basal test just to check your basal is correct?
 
A test to check that your basal insulin keeps your blood sugar in range.

There are various links to instructions online. Here's one site. It's aimed at pump users but is valid for those on multiple injections too:

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

The idea is to ensure your basal is right as it's the foundation you build on with your meal insulin. Sometimes a basal can be wrong but it's not immediately obvious as meal time insulin is compensating.
 
I personally like this basal test site - it gives you some idea of what to do afterwards as well:

https://mysugr.com/basal-rate-testing/

lma89 said:
What are your typical basal doses
Click to expand...

It doesn't really matter what they are - enough to keep you alive is the right answer! One way of reducing your basal requirement is to undertake resistance training. It increases muscle mass and insulin sensitivity and a number of us have seen our amounts reduce by half by doing this kind of training.
 
have you tried a different basal insulin?
lantus was like water for me, don't think it worked for me.
i am now on levemir and i have 5/8u am depending on work day or weekend and 3.5u/5u pm again depending if a work day or weekend.
 
I have moved in the last month from insuman to humulin with insuman I was 35 am and pm so I seem to be getting some where with this one but it seems I can't get any lower I think I will just change to how I was pre steroid and see about changing bolus ratios to suit I wake up high in a morning after going to bed around 8.0 which as I have read would suggest I'm having hypos in my sleep
 
I was on Levemir but became resistant to it so have switched to tresiba. Your basal may not be right for you so it's worth looking at others as it sounds to me like you are taking alot so a basal test is also advisable - it's essential to get the basal right as then you are on a level playing field for getting your bolus ratios right.

Remember your basal can change throughout the year too, I find I take more in the colder months, also as a female I need more around my period as I become insulin resistant then, it's useful to track your doses too to detect patterns, I use Diaconnect, it's a smart app on my phone but great for emailing my DSN when I need extra support
 

Possibly. That's one explanation, but there are others, eg the Dawn Phenomenon, where your body 'dumps' glucose into your blood sugar ready to start the day.

As others have said, there's no right dose of basal - only what works for YOU.
 
Hi. It's possible you are currently in a vicious circle with the excess weight causing insulin resistance which the insulin will be struggling with. Do keep the carbs way down at least for while to try to reduce the weight and break the possible circle. As others have said, don't worry too much about your start of the day blood sugar but rather the 2 hour post meal ones. My DN advised me to keep my start of the day level between 5 and 7 which I try to do. I'm not sure why you think you may be going hypo during the night if you wake up high? Surely it would be the opposite; it is for me?
 
It's either hypo or liver dump, but if I go back to what I was a year ago and go back to one a day basal, and focus on ratio instead of being lazy and making my basal level high enough so I just do a 1:1 bolus, I remember when I first started this regime I was put on one 25 injection a day at bed time and we was working at what ratio would suit me best I got so far gave up and confused with what others was saying about just putting my basal up and I'd be fine. Clearly that wasn't for me. I have two days off work, I'm gona go back to basics, one basal injection and work on my ratios, and increase them I probably should have just stuck with the advised dosing, but when you hear stories from friends who are diabetic Its so confusing
 
Yes, it can be confusing. Could your DSN help at all?

Basically, your basal should keep your blood sugar within range all day even if you don't eat. You need to get that step right first. Not eating all day is hard for most people so the basal test links show you how to break the day down into segments so you only have to not eat for a few hours in a day.

Once you get your basal right (or confirm it's already right) then you can move on to your meal time ratios.

Basal testing sounds a nuisance but it provides a solid foundation to build on Once you're sure that's right, it'll be a lot easier to get your ratios right.
 
Well i thought she would but all she said was aslong as your long term reading is ok I wouldn't worry. But more insulin means more chunk and more chunk needs more insulin grr
 
Yes, which is why it's good to 'fine tune' your insulin, as suggested.

It can be a pain getting back on track if something throws you off, but there are lots of people who can support you here

Edited to add - you could try pushing for support with your DSN. Maybe say what your problems are and what you're trying to do?
 
Also as you get older , you may need more insulin. Or build up a resistence to a basal insulin. I was on lantus for years but last year it just wasnt working accurately , was changed to Levemir twice a day and altho the morning dose worked , the evening one to longer to fine tune because of the dawn phenomenon.
Good luck with it. When i was doing basal testing on new pump I started on the weekend and took monday and Tuesday off and focused on recordings. It really helped fine tune what badal i needed
 
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