Is there any rule to spacing your basal and bolus injections apart? Or it is safe to inject both together

[Riley124]

Hi! So Im about to start splitting my basal dose starting tomorrow at 8 units, 12 hours apart (without the supervision of a doctor because he hasnt heard about splitting. But decided to do it since Levemir works upto 16 hours instead of 24 for me).

The idea is to take my basal at 6am right upon waking up, breakfast, then go to college until about 4pm by which id be home and can bolus and have lunch. So my next basal injection would be at 6pm.

NOW, my concern is about the probability of my bolus at 4pm overlapping with my 2nd basal inj at 6pm (since my bolus stays active for 3 hours in my body) I imagine this should cause insulin stacking and should set me up for pretty bad hypoglycemia when id also have the morning basal running in me too

So, what is the probability of this overlap? Especially for Levemir users? Should i be worried about anything?i still have to find my right basal doses too by the way!

Sorry, i just want to be proactive and avoid errors since i dont have a CGM at the moment!

 

[Finnlee]

I don't think you need to worry about stacking with basal and bolus. Basal has a totally different profile (16-24 hours) to bolus insulins (3-5 hours).

If you notice you're going low due to both basal and bolus peaking at the same time, you could try shifting your basal injection time around to find what works for you.

For what it's worth, I also split my basal (Abasaglar). I have my morning basal dose at the same time as my breakfast bolus around 7a, and my evening basal dose around 9.15p, a few hours after my dinner bolus. Also, when I started splitting my basal, I found I had to reduce all my bolus doses by 25%.

 

[Fenn]

Hi, welcome

I am no expert AND we are all different but I overlap Basal/Bolus (also split) all the time without a thought, in fact it’s often the bolus that reminds me to do my basal so I literally do them seconds apart.

 

[Riley124]

I don't think you need to worry about stacking with basal and bolus. Basal has a totally different profile (16-24 hours) to bolus insulins (3-5 hours).

If you notice you're going low due to both basal and bolus peaking at the same time, you could try shifting your basal injection time around to find what works for you.

For what it's worth, I also split my basal (Abasaglar). I have my morning basal dose at the same time as my breakfast bolus around 7a, and my evening basal dose around 9.15p, a few hours after my dinner bolus. Also, when I started splitting my basal, I found I had to reduce all my bolus doses by 25%.

Hi so this is exactly the kind of answer i was looking for. Please help me out with a couple more questions.
What is your daily basal dose for the am and pm? Do you find your basal to peak eventhough you split it and are taking a lower dosage?

 

[Riley124]

Hi, welcome

I am no expert AND we are all different but I overlap Basal/Bolus (also split) all the time without a thought, in fact it’s often the bolus that reminds me to do my basal so I literally do them seconds apart.

Hi! Thankyou for replying! Do you find your basal to peak even with a split dosage? Im worried about the morning dose overlapping with the evening dose. Or worse my bolus for my late late lunch overlapping with my evening basal. What is your routine and dosage for your basal too? And what is the insulin you use

 

[Finnlee]

Hi so this is exactly the kind of answer i was looking for. Please help me out with a couple more questions.
What is your daily basal dose for the am and pm? Do you find your basal to peak eventhough you split it and are taking a lower dosage?

Everyone's dose will be different so what works for me won't necessarily work for you.

I don't notice any significant peaks with either my morning or evening dose. If I did and it coincided with a meal, I'd either adjust the basal dose or adjust the basal timing.

Before my split, I tended to run high in the hours leading up to my once daily dose, but if I increase the once daily dose, I'd run low at other times of the day/night.

Splitting works really well for me and when I showed my doctor what I'd done and how it was working for me, she approved. I was careful when I switched so I didn't double up on doses in the changeover. I erred on the side of less basal insulin (correcting with bolus as needed) until I found my sweet spot.

 

[Fenn]

Hi! Thankyou for replying! Do you find your basal to peak even with a split dosage? Im worried about the morning dose overlapping with the evening dose. Or worse my bolus for my late late lunch overlapping with my evening basal. What is your routine and dosage for your basal too? And what is the insulin you use

Hi, I use Levemir Basal and Novorapid Bolus, I may not be a good example, I was afraid of injecting correction novorapid without food for a long while, since discovering how incredibly useful this is, I guess I inject a tad too little levemir because if im creeping upward I will bang in a unit or two of novo, I currently (I say currently because I play with it alot) Inject 2 units of novo as soon as I wake, before my pee tmi? lol then 8 units of levemir at 6:30am the novo flattens my horrible dawn phenomenom, the levemir keeps me between 7 and 8 with an either slightly rising chart through the day or a flat line, I have suggested to my nurse that I could do better and try to keep it around 6 but she seems happy with these numbers, I see the endo on Tuesday so will suggest it to him too but just had a great (for me) hba1c so I assume he will say stay with what im doing, I then inject 6 units of levemir around 8pm after dog walk, this is currently perfect for keeping me between 8.5 & 6 during the night. I see no drop off or overlap as my injections are technically around 10 and 14 hours. The effects of levemir seem numb, if that makes sense?

This whole lot of babbling is solely dependant on me eating a very low carb diet, when I eat the carbs my numbers are all over the place, my basal goes up alot along with my novo (obviously) I am yet to master carbs after all this time, but would love to do that one day, for now though I am happy to have reasonable (excellent for me) control.

I am sorry if I didnt answer your question but wrote an essay.