Do you adjust basals depending on evening meal?

[Saka]

Since the dawn of the new year I've started eating salad one night a week (trying to be healthy). But, I've found that the nights I have salad, which is virtually carb free, maybe 8g max, I will always have a night time hypo.

Levels are fine when I go to bed, usually between 7.5-8 mmol/L. Other nights when I have evening meals with more carbs in, my levels remain pretty steady during the night.

So I'm thinking if my basal was lower on the night I have salad for tea, I wouldn't have the night time hypo. But, I don't if this is abnormal or whether other people adjust basals depending on what they eat.

Thanks
Ian

 

[Ipodlistener]

I'm pretty new to this. Only just over a year. But I think it takes perhaps 48hrs to see a change with your basal effect. I could be wrong. How about being more healthy other days. Then you could not try to do it all on one day. Please don't look at this as a put down

 

[Rokaab]

But I think it takes perhaps 48hrs to see a change with your basal effect

That depends entirely on the basal, Levemir will show results fairly quickly, tresiba however does take about 3 days as its much longer lasting so would not be one you would just change for a specific day as it just wouldn't work for doing that, and Lantus would be somewhere in the middle of those two.

@IanPozz which basal are you actually using?

 

[Antje77]

I'm pretty new to this. Only just over a year. But I think it takes perhaps 48hrs to see a change with your basal effect.

Depends on the basal you use.

Since the dawn of the new year I've started eating salad one night a week (trying to be healthy). But, I've found that the nights I have salad, which is virtually carb free, maybe 8g max, I will always have a night time hypo.

How many hours after your last mealtime insulin do the nighttime hypos happen?
For me, it can have a tail of 5 to 6 hours.

So I'm thinking if my basal was lower on the night I have salad for tea, I wouldn't have the night time hypo. But, I don't if this is abnormal or whether other people adjust basals depending on what they eat.

I don't adjust basal depending on what I eat, but your nighttime hypos could have a relation with your food.
If your usual meals are slow acting carbs made even slower by fats, they might keep your levels higher largely through the night (the dreaded pizza effect where you can still be fighting increased BG some 6 to 8 hours after eating the pizza), and therefore make you drop if you don't have this food still going in your system like on salad days.

I have a feeling adjusting your basal would only help if you're on Levemir, but the proof of the pudding is in the eating of course, only one way to find out.

You could of course add some salad throughout the week and eat a little less of the other food. That way you'd eat the same amount of salad/other food over the course of a week but more equally spread.

 

[Saka]

Thanks for the comments! I use Levemir which, as you've all said, is the only insulin that would allow for basal adjusting.

My diet's pretty good on the none salad days but my meals always include more carb than the salad which as @Antje77 helpfully points out, may still be causing my levels to go up into the early hours.

Last night, I had a hypo at 1am, having eaten salad at 5pm and I'd had my dose of Levemir at 6pm.

I think I'm going to try the basal adjusting next time I have salad for my tea.

Once again, thanks for the responses.

 

[In Response]

Basal should not be affected by what you eat. If you are hypoing following a lower carb meal, it suggests to me that your basal rate is too high all the time but you overcome this through the carbs you eat on a "normal" dinner.

As for basals taking 48 hours to see a change in dose, this depends upon the basal. For example, Levemir typically lasts 12 to 24 hours (it is common to take it twice a day) so a change can be seen within 12 hours. In contrast, Tresiba lass much longer so a change can take 3 or 4 days to take effect.
Before I changed to a pump (it does not use long lasting insulin), I used Lantus and would always adjust my basal after exercise to avoid hypos.

 

[Antje77]

If it was me I'd give it a try, being on Levemir, if only out of curiousity, I'm wired that way.
(Assuming you're comfortable playing with your insulin doses in general of course,but I guess you are if you can swich between carby meals and salad. )
Do you split your Levemir dose between morning and night?

 

[Saka]

If it was me I'd give it a try, being on Levemir, if only out of curiousity, I'm wired that way.
(Assuming you're comfortable playing with your insulin doses in general of course,but I guess you are if you can swich between carby meals and salad. )
Do you split your Levemir dose between morning and night?

Yes, I've been diabetic for 25 years and am confident with dosing adjustments so this doesn't worry me or fill me with dread.

I do have a split dose, 5 in the morning and 14 in the evening.

 

[Antje77]

Well if you do try, let us know how it worked out!

 

[EJTC]

Yes, I've been diabetic for 25 years and am confident with dosing adjustments so this doesn't worry me or fill me with dread.

I do have a split dose, 5 in the morning and 14 in the evening.

Can I just ask why you take more Levemir in the evening and less in the morning? And not the other way around, ie more in the morning and less in the evening?