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long acting dose

C

Claire

Well-Known Member
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110
Location
United Kingdom
Happy New Year all!

I was just wondering...how do you gauge whether your long acting dose is correct? I was taking 7 units levemir at night but have brought it down to 5 units for the past week as I was starting to wake up under 4 despite being around 8 when I went to bed. I'd like to have the dose as low as possible, but not sure how to tell when it's too low? Any tips?

Claire
 
Hi Claire,
I have never really worked this one out for sure either to be honest..but I think that you are on the right lines if you are drifting down over night. the other thing to watch out for I guess, whether you think you may need to reduce it further, or whether you have reduced it too much is a general watch on what you blood sugar does through out the day.

I my complety ubexpert opinion, I think you have done the right thing, but may need to tweak your short acting dose a bit to compensate...on the other hand, you may not! Trial and error alas.
 
It sounds like you have done the right thing, are you now waking up with better blood sugars?

there isn't really too low a dose, if your blood sugars the rest of the day are in range then it's enough.

if you still have problems there are options to switch your injection to the morning, or to split it.
 
Hi All

Setting basal levels accurately allows you to sleep without worry and, when awake, delay or miss a meal without worry (quote from book!)

The guidance on this that I've found says to divide the day up into three 8hr periods starting from 4hrs (minimum) from your last food and/or your bolus. Finger stick to get a starting BS which should be between 5.6 and 8.3. Then eat or drink nothing that could affect BS - I drink water and eat nothing, safest way.

Get a BS every two hours or more. It should rise no more than 0.8mmol/l and drop no more than 1.7 at any time. If it does, end the test and carry on as normal but adjust basal insulin up or down as indicated by the BS going high or low, wait 48hrs min. for the body to stabilise and test again. Etcetera.

The night basal is easy, assuming you don't bolus or eat so late that your 4hr wait time takes you into the small hours! But you do have to set the alarm for the night-time finger sticks....

The morning 8hrs commences before breakfast - so NO breakfast and NO lunch either! -and ends 8 hrs later ie something like teatime. If you're lucky, that is, meaning your basal test went off ok.

Finally, for the last period, have a normal breakfast and bolus insulin then start 4 hrs afterwards, miss lunch and supper which you can make up for after 8pm or thereabouts.

I'm on Levemir at 3u at 8pm and 7u at 8am and, BTW No 1, you DO take your basal insulin throughout and, BTW No 2, have a pretest meal that is not too rich in fat or protein that could cause the liver to convert it to glucose many hours afterwards. As I'm so new to all this, I have to check quite often because of honeymoon etc but it's settling down now at last.

I was a bit surprised not to see something along the above lines from the more experienced/better qualified members of the forum. Is there anything they wouldn't agree with?

Regards to all QRP
 
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