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Help with Basal Dose if anyone's got a moment to spare

Paulaah

Well-Known Member
Messages
92
Good Evening,

I'm still new to all this - diagnosed in Feb and still in Honeymoon Period. This is my third posting so I really apologise if I'm asking too much, but I can't say enough how much this forum helps me.....

I upped my Lantus last Thursday from 7 to 8. I waited a few days for it to bed in and then did the overnight test as recommended on this forum and also in "Think Like a Pancreas". Results as follows:

6.6 before dinner. Had low fat dinner with some rice (50g carb) as carb. Had 5 clicks of Apidra.
9.8 2 hours after
7.4 at bedtime - 3 and a half hours after dinner
7.0 at 2 a.m.
6.2 at 7a.m.

So on this basis, all looked well with less than 1.7 variance between going to bed and getting up with no dip in night.

However, I then decided "in for a penny and in for a pound", so did another test at 8.30 a.m. before eating my breakfast and it had gone down to 5.3. It shocked me a bit, because I'm not used to seeing such low results, and it was nearly a whole mmol. Does it sound as though the Lantus is too strong, or is that normal from your experiences?

Overall, my results have been more stable and easier to predict, but the low numbers are scaring me a bit because I'm so frightened of hypos as I had so many when I started taking insulin.

Any advice would be much appreciated.

Paula
 
Paula,

I think you need to base a decision on more than one nights worth of readings.. I know its a pain in the butt but I would do maybe three or four nights worth of readings testing every two hours, it may seem like a real pain but once you have sorted your basal dose your life will be so much easier.

For a one off set of results I would suggest that they look good although its difficult to be 100% certain if you are still in the honeymoon period and producing some of your own insulin that will muddy the waters a little.

Hypo's are scary and certainly as a newly diagnosed you need to be extra careful but those readings are respectable and you should proud of them!

I would suggest you do a couple more sets of readings and then make a decision... but as long as your blood sugars remain stable then I would say at the moment your basal dose is fine.
 
The other thing to remember is that most meters are not that accurate!
Do a quick test on one finger, and then again using another finger - you'll find you get different results (even witht he same meter). If you use two different meters then the results are likely to be even further apart.

For someone who has just been diagnosed those figures are excellent (and even for someone who has been doing this ages!).

A variance of 1.7 could just be meter inaccuracies...
 
Paula,

I often "dip" before a meal, when I was on lantis and in my case novorapid.

According to the books, it means that you are using the Lantius for your carb intake, as well as for your background. I tried lowering the lantus a bit, and upping the novorapid slightly.

I am sorry to say I never got it to work. As has been said, you need to monitor this over a couple of days/weeks even..just to make sure it is a pattern, and nothing to do with time of the month, the meal that you had that evening, the fact that you were particualry stressed, chilled out that morning.

For me, I went back to how it was, and had to be especially careful when it ws coming up to meal times. 5.3 is not low, and is something I love to see on my meter...but you do have to be careful if you were going to have a lie in etc.

I sorted it out by getting a pump in the end.
It is early days for you, adn you really sound to be doing well. In the honeymoon period, I guess it could be that when you woke up, your pancrease woke up abit, and produced a little insulin (Why am I thinking about Bagpuss after typing that!) It does take a while for thiing to settle down. You are doing the right things though..good luck!
 
Paula,

I agree with what others have said and best to test over a few nights before adjusting your dose.

Nigel
 
Thanks to you all for your replies.

Some really great advice as well as a bit of encouragement. It's such a lonely situation this insulin lark!! .....so it's a boost to hear some words of wisdom.

Am going to do some more test cases as you suggest, but take comfort in the fact that my readings have been quite steady since upping my Lantus dose.

Thanks again.

Paula
 
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