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Insulin adjustment and time zones
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<blockquote data-quote="RussG" data-source="post: 234365" data-attributes="member: 30691"><p>Hi all,</p><p></p><p>I too am flying out to Australia for Christmas (yes, I know I am very lucky!). I'm on MDI, levemir basal but I take a 17:83 ratio am to pm, i.e. I take 4u in the morning and 20u in the evening. I fly out at 2010, when I'd usually take 20u. However I land early morning GMT in Dubai, have a three hour or so wait and then fly on to Oz, taking off at nearly the normal GMT when I'd take my 4u in the morning. This seems okay up to now.</p><p> </p><p>However, after a 14hr flight, I then land early morning in Australia, but because of the time difference that's about the same time that I would be taking my evening 20u dose if I had kept to GMT. </p><p></p><p>I'm slightly concerned about taking too much in the 'morning', as I have found that if I take 5u in the morning, I hypo at lunchtime and in the early evening. My initial thought was to reduce to about 2/3 total dose and top up with bolus as needed, but I’m in a bit of a quandary about how to migrate my doses to the right balance at the right time. My HbA1c is 5.9%, brought up from 5.2% in May but my consultant wants me to raise it a bit higher as I'm having too many hypos.</p><p></p><p>Where I will be is ten hours ahead of GMT. Plus I'll have a nearly three year old and two in-laws in their early 80s taking their longest ever trip to deal with!</p><p></p><p>The only other option I reasonably think of is to take the first 20u dose and the second 4u dose as normal then leave the 2nd 20u dose for an additional 10 hours and take it in the evening, local time of the first day and accept I'll run high for the longer leg.</p><p></p><p>Any thoughts?</p></blockquote><p></p>
[QUOTE="RussG, post: 234365, member: 30691"] Hi all, I too am flying out to Australia for Christmas (yes, I know I am very lucky!). I'm on MDI, levemir basal but I take a 17:83 ratio am to pm, i.e. I take 4u in the morning and 20u in the evening. I fly out at 2010, when I'd usually take 20u. However I land early morning GMT in Dubai, have a three hour or so wait and then fly on to Oz, taking off at nearly the normal GMT when I'd take my 4u in the morning. This seems okay up to now. However, after a 14hr flight, I then land early morning in Australia, but because of the time difference that's about the same time that I would be taking my evening 20u dose if I had kept to GMT. I'm slightly concerned about taking too much in the 'morning', as I have found that if I take 5u in the morning, I hypo at lunchtime and in the early evening. My initial thought was to reduce to about 2/3 total dose and top up with bolus as needed, but I’m in a bit of a quandary about how to migrate my doses to the right balance at the right time. My HbA1c is 5.9%, brought up from 5.2% in May but my consultant wants me to raise it a bit higher as I'm having too many hypos. Where I will be is ten hours ahead of GMT. Plus I'll have a nearly three year old and two in-laws in their early 80s taking their longest ever trip to deal with! The only other option I reasonably think of is to take the first 20u dose and the second 4u dose as normal then leave the 2nd 20u dose for an additional 10 hours and take it in the evening, local time of the first day and accept I'll run high for the longer leg. Any thoughts? [/QUOTE]
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