Lantus unit = novorapid unit?

the thing to consider then would be the action of the snack.....

you could say that novorapid has been engineered to match up the rough digestive action of food...

if you could find such a slowly released food then in theory it could......but its unlikely you could survive on that...

The short answer is no it doesn't, think of lantus as the back up system, keeping the pancreas and liver action on track, nova rapid is the pancreas reaction to food. If we could manage with just one the NHS wouldn't be wasting money prescribing the 2

I found when I took just one unit off lantus in the morning I was hypoing all day and needed to keep eating.
Do you have a half unit pen? That is the best thing I ever got. I take 1/2 units with small meals and 1/2 if I need any corrections. I can have small fat snacks in between meals without needing a bolus.
The only time I take lantus during the day is if I'm sick and riding pretty high.

If you are having problems with your insulin ratios, it's worth testing you basal rate: https://mysugr.com/basal-rate-testing/

And then working your way through BERTiE which will make it much easier to understand the changes you need to make.

tinyfilosofer said:

So I was on 6 units of lantus and 15 units of novorapid. Altogether I get to eat 150 grams of carbs.

I feel more comfortable (more in range) actually with 10 units of lantus.
Wondering if I still do 150g of carbs with 15 units of novorapid or 11 units of novorapid with 150g of carbs. Or

10 lantus 11 novorapid and 110g of carb.

Will the latter give me hypo?

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Although it doesn't have to be exactly 50/50 your basal/bolus doses should be somewhere near that percentage, I eat around 180g of carbs a day and my split is currently 46/54

tinyfilosofer said:

Sorry let me rephrase my question again so I can get an answer I need.
Everything being equal, in a controlled environment, over 24 hours, will 1 unit of lantus reduce the same amount of bg as 1 unit of novorapid albeit the rate being slower?

Sorry the question may not seem logical, but the answer is meaningful to me.

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No. The job of lantus is not to reduce your BG. It is to keep it steady over 12-24 hours.

Your basal insulin should, ideally, keep you within approx 2mmol either side of your starting point without food, bolus or unusual exercise. There is a link above on how to test your basal rate.

Once you get your basal rate right, you will be able to work through a bit of trial and error to find your insulin to carb ratio and then be able to bolus for your snacks - the link to the BERTIE course above should help with that. http://www.bertieonline.org.uk

tinyfilosofer said:

So I was on 6 units of lantus and 15 units of novorapid. Altogether I get to eat 150 grams of carbs.

I feel more comfortable (more in range) actually with 10 units of lantus.
Wondering if I still do 150g of carbs with 15 units of novorapid or 11 units of novorapid with 150g of carbs. Or

10 lantus 11 novorapid and 110g of carb.

Will the latter give me hypo?

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I take 10 units of Levemir only before bed, any BS fluctuations during the day would be down to my dosage of Novorapid with carb counting during that day.
If my BS is on the lower side before bed,4/5, then I would take 9 units, but I would have to increase my Novorapid a tiny bit to compensate. This is what I do and not advising you to do the same, we may all be type 1, but we can so different with our management, lifestyle etc.
Best wishes RRB

tinyfilosofer said:

Hmm. I had a high lantus dose before and it caused me to hypo middle of night so I think it does decrease bg.

Also, keep it steady means it must also increase bg as well, I don't think it does that.

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Sorry, I probably didn't put it very well.

Throughout the day and night out livers trickle out their glucose store whether or not we are eating. The job of the background/basal insulin is to balance out the trickle of glucose from the liver. So to get your basal dose right for you you need to figure out how much basal insulin is required to keep you steady - if a higher dose was giving you hypos that is too much, of course too much basal will decrease blood sugar, if blood sugar is decreasing on a fasting basal test (see previously provided links) that is an indication the basal dose is too low. Of course basal insulin won't increase your blood sugar, it keeps you steady by balancing the against the glucose coming out from the liver, if blood sugar is rising on a fasting basal test that suggests basal is too low.

So on a basal bolus regime the basal is designed to keep you relatively flat in the absence of food, bolus, exercise. The bolus is designed to deal with food.

You are asking for an equivalent basal to bring you down my how much a bolus dose brings you down. You are not getting an answer because this is not how most people would use a basal insulin, because this is not what it is designed to do.

It sounds like you are trying to avoid bolusing for snacks by increasing your basal? Maybe because you are quite sensitive to your bolus doses and only need v small doses so you are finding it difficult to bolus for snacks?

Because this would be using a basal insulin in a way that it is not designed for this sounds like quite an advanced diabetic management technique. Before trying the advanced techniques, it is probably worth ensuring you understand the logic of the traditional basal/bolus regime. Then you will be much better placed to make changes to adapt it to suit you. Your questions suggest you migh not be familiar with the basics, the links previously provided and the book "think like a pancreas" give excellent starting points. Who knows, you might even find an answer in applying the basics

tinyfilosofer said:

Hmm. I had a high lantus dose before and it caused me to hypo middle of night so I think it does decrease bg.

Also, keep it steady means it must also increase bg as well, I don't think it does that.

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If your background insulin is too high or too low it will affect your BG.

As stated by others above to find out what your background insulin is doing you will need to conduct Basal testing. During the test your BG shouldn't rise or fall more than 1.7 mmol/L from the start of your test.

Once you have established what is happening you can adjust your basal accordingly.

After that you can then look at your carb/Insulin ratios to see if they need any adjustment.

As mentioned above follow the link on how to conduct a basal test.

Regards

Martin

tinyfilosofer said:

However, I was quite uncomfortable at 6 L and gradually increased it to 10 L.

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This statement seems to lie at the heart of your issues. Why weren't you comfortable on 6u of Lantus?

It sounds as though you are working on what the doctor gave you and have since modified your insulin levels without fully understanding the consequences. I really recommend you basal test as that will tell you exactly what amount of lantus you need.

Alternatively, have a look at the BERTiE online course which will take you through this and things like working out your ratios, and required correction amounts.

tinyfilosofer said:

Here's to clarify: doc gave me 6 lantus and 15 novorapid a day. That was keeping my weight constant.

However, I was quite uncomfortable at 6 L and gradually increased it to 10 L.

I find that if I keep on eating enough to for 15 novorapid in total a day, my weight is increasing steadily.

Therefore, I am considering reducing my novorapid by 4, and eating less.

Just wondering if 4 l = 4 n.

Sorry i keep asking because so far all the answers I got are info in know and the question I am asking is still not getting answered.

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If you follow the links, that will give you the information on how to

1) test and adjust your basal rate so they are correct for you
2) test and adjust your insulin to carb ratio

Using carb counting and a basal bolus regime in the way explained in those links should mean that you dont have to take 15 units of novorapid every day - you adjust your novorapid up and down to accommodate the amount of carbs you are eating. The idea is that you don't have to eat to your insulin, you adjust your insulin to suit you. It sounds like you are already making those adjustments.

tinyfilosofer said:

I do know about the use of the 2 types of insulin etc etc. I just want to ask about the Maths.

Does 1 unit of lantus and 1 unit of novorapid bring down the same amount of bg?

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No.

I don't think there is any formula to make an equivalent lantus to novorapid calculation. Because they are not equivalent.

tinyfilosofer said:

Thanks a lot for the time spent on this thread, everyone. You've been very helpful!

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Do you know how to carb count and adjust your novorapid to suit? you shouldnt be eating to your insulin (ie eating enouht to keep your bg up) and you can reduce your carbs/novorapid without generally altering your basal if its set correctly...