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Looking for some guidance - insulin coverage

DDonnachie

DDonnachie

Newbie
Messages
3
Location
Saltcoats
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
that sugar seems to be in everything ....
Hi Folks

looking for a little advice, currently my control is pretty abysmal and I'd like to try to get it back in line so to speak.
I've been diabetic for over 10 years primarily treated with Insulatard and Novorapid, fairly recently I've noticed that my routine is pretty messed up. I take Novorapid after breakfast, lunch and dinner and take insulatard before bed, my issue is that normally my dinner time does will be around 6 PM but I don't take the bed time dose of insulatard until just before I go to bed which is often after midnight. So I think that leaves about a two hour (at least) window where none of the insulins are working.
Am I right in thinking that there is no harm in taking the insulatard at around 10 PM ish ?

I'd rather not say what my current night time readings are, but they high..

I appreciate any adivce you can give on this.
 
DDonnachie said:
and take insulatard before bed, my issue is that normally my dinner time does will be around 6 PM
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Those two doses are quite close together, if I remember right the max duration for Insulatard is 12-14 hours, maybe you should discuss this with your HCP's, also ask if changing to Lantus, Levemir or Tresiba would be a better option for you.
 
sorry Noblehead, I take novorapid 3 times a day ( I think it lasts about 4-5 hours), the insulatard (which lasts about 12 hours) I only take once a day.
 
Hi. I would see no problem in taking the Basal at 10pm? I assume you are carb-counting the Bolus. Levemir is now the NICE recommended Basal. I'm not sure if overall it is better than Insulatard but it only lasts 15-18 hrs but a bit better than 12 hours.
 
thanks Daibell. Not so much carb counting more taking a reading and adding about 45 to it. Although I can drop that a bit if I'm now giving it longer to work.

Just trying to change from bad habits to better ones.... one at a time :)
 
DDonnachie said:
thanks Daibell. Not so much carb counting more taking a reading and adding about 45 to it. Although I can drop that a bit if I'm now giving it longer to work.

Just trying to change from bad habits to better ones.... one at a time :)
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Echoing previous comments, you probably should talk with the hospital/GP about whether you are on the right basal. Levemir split as morning and evening doses will give closer to 24 hour cover. If you search the forum for Salford you will find advice on how to check your basal levels.

With respect to Novorapid its total duration is 4-5 hours but most of its action tends to be in hours 2-3. For this reason many us bolus before we eat (anywhere between 10-45 minutes depending on individual responses) to give it time to get into the system before the BGs rise.
 
Very interesting forum. I was looking for more info re Levemir and found some comments quite eye opening if not scary. I have been on Levemir for about 2 years increasing the dosage up to 58 units to get BG in order. In January I went on the XPert course which I thoroughly recommend. After the course finished and sticking quite strictly to what I was taught I managed to bring my Hba1c levels down from 75 to 62 and that was taking in Christmas and new year! I was rather pleased at that and it gave me confidence to do much better. At the same time I managed to reduce my Levemir from 58 to 48 units due to the number of hypos I was experiencing ( lowest 2.4) All well though. But I was finding my morning BG were mostly 7-9 and couldn't budge that. A diabetic children's nurse friend told me that all her kids took Levemir in the evening compared to me taking in the morning. So I tried that over the last week. While my BG in morning is good the rest of the day is abysmal. I found that after about 20 hours it wasn't working and I have had readings in the high teens!! WHAT?? I haven't experienced that for ages then looking at results carefully concluded that Levemir is not a 24 hour bonus as I was told. I'm going to go back to morning injections as when it runs out it will be during the night and not day time when I am eating. Has anyone else anything they can add to this observation. Also I was quite intrigued to read one comment about splitting the Levemir injection morning and evening. Although this would give 24 hour coverage would it not be double the dose one was receiving at the mid point? Or do you reduce the dosage. Again would that not defeat the purpose. I am a bit confused and also annoyed that health workers didn't explain the limitation of Levemir. Any comments welcome.
 
I know there's a lot of hate for Lantus but it works very well for me! I take one dose in the evening and it gives me good coverage over 24hours. I certainly noticed how well it usually works the other day when I was about 3 hours late giving it.
I did have an issue with morning hypos as I used to have over 12 hours without any food but a light snack has fixed those for me.
 
I am starting to dislike Lantus. Last two days I have been high in the morning. This morning it was 12 rising to 15 when I got up. This was after increasing my Lantus dose 2 units from yesterday. 10 Units of humalog and 3 hours later with nothing to eat and it is falling very slowly.
 
Nuck said:
I am starting to dislike Lantus. Last two days I have been high in the morning. This morning it was 12 rising to 15 when I got up. This was after increasing my Lantus dose 2 units from yesterday. 10 Units of humalog and 3 hours later with nothing to eat and it is falling very slowly.
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Hi @Nuck ,

I don't use Lantus, but I do recall seeing posts from others to the effect that the efficacy of Lantus starts to wane after about 20days. How long has yours been out of the fridge?
 
I was on Levimer for years and haveing 2 a day. My morning dose was about 16 but my evening was only 6. I found it not to last 24hrs but nearer to 21 hrs. the morning seemed to adjust daytime levels and the evening adjusted the night levels.
everyone though is different with different needs. The specialist teams are best to put you in the right regime
 
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