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Missed Insulin Dose

M

Mark Rawlinson

Well-Known Member
Messages
383
Type of diabetes
Type 2
Treatment type
Insulin
I think I missed a Toujeo (long lasting) insulin dose this morning) this just occurred to me 7 hours after. I know not to inject now to compensate but has any one else done this and noticed any difference ?
My dose is 40 units I still did the rapid acting insulins and blood tests and only noticed a slight rise in BS
 
Mark Rawlinson said:
I think I missed a Toujeo (long lasting) insulin dose this morning) this just occurred to me 7 hours after. I know not to inject now to compensate but has any one else done this and noticed any difference ?
My dose is 40 units I still did the rapid acting insulins and blood tests and only noticed a slight rise in BS
Click to expand...
Toujeo is a very long acting insulin.
This means that a change in dose (or in your case a missed dose) won't be immediately noticable.
Without this dose it's likely that you'll run higher than usual for 3 or 4 days.

With this particular basal insulin, I'd definitely dose 7 hours late if it were me. What does the leaflet say about missed doses?

I'm on Tresiba, which has a similar action time to Toujeo and I aways take it before bed, which is anywhere between 10 pm and 7 am, and it still keeps my numbers very stable.
 
Antje77 said:
Toujeo is a very long acting insulin.
This means that a change in dose (or in your case a missed dose) won't be immediately noticable.
Without this dose it's likely that you'll run higher than usual for 3 or 4 days.

With this particular basal insulin, I'd definitely dose 7 hours late if it were me. What does the leaflet say about missed doses?

I'm on Tresiba, which has a similar action time to Toujeo and I aways take it before bed, which is anywhere between 10 pm and 7 am, and it still keeps my numbers very stable.
Click to expand...
If within 2 hours ok to inject other wise nothing is said i suppose am safest not to inject
 
Took the insulin around 5 yesterday afternoon, no side effects and a fasting BS of 8.7 this morning (my hasting BS has never been constant)
Will do the full units at 8am today (40 u)
watch this space
 
"I think I missed". to help with knowing if you did or not you could be useful to write/mark down soon as you have injected.

your on multiple injections a day now so should qualify cgm. libre app has a really useful function to record doses. some insulin pens, smart, eg novapen 6/echo have a last dose check functionality which can tell you the last injection alongside how many units you injected. if using that imo i'd avoid scanning the pen to insert the doses into libre logs as i personally got annoyed with it due to having to keep on editing the prime... found that the more logs added the slower libre app would be..

you speak to your dsn about advice for 'correctional doses' if running higher than normal.
 
Mark Rawlinson said:
Not a clue I don't do that routine yet
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might be worth getting a wee head start on noting down carbs in meals :) dsn here got me to note down carbs for a couple of weeks before adjusted dosages. it should give them a better idea of whats going on too for any upcoming reviews. hopefully as relatively new on insulin they are keeping a closish eye on bg
 
Mark Rawlinson said:
Taken a risk injected 20 units (half dose) roughly 8 hours later
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Hi,

Been following this.
To be fair I’ve had the odd did I, didn’t I last night with my basal & the following day’s numbers tell a tale..
When I’m certain I have actually forgot. (Pending on how late I realised.) A half measure is normally a decent plan?

Can I ask if you are prescribed a sensor?
The trends from using one of those (in my case a Libre.) can be a dead giveaway with me regarding average trends?
 
Jaylee said:
Hi,

Been following this.
To be fair I’ve had the odd did I, didn’t I last night with my basal & the following day’s numbers tell a tale..
When I’m certain I have actually forgot. (Pending on how late I realised.) A half measure is normally a decent plan?

Can I ask if you are prescribed a sensor?
The trends from using one of those (in my case a Libre.) can be a dead giveaway with me regarding average trends?
Click to expand...
no sensor just finger pricks
type 2
 
grantg said:
might be worth getting a wee head start on noting down carbs in meals :) dsn here got me to note down carbs for a couple of weeks before adjusted dosages. it should give them a better idea of whats going on too for any upcoming reviews. hopefully as relatively new on insulin they are keeping a closish eye on bg
Click to expand...
would have to learn how to do that
 
Jaylee said:
A half measure is normally a decent plan?
Click to expand...

i was advised against that not long ago (bear in mind type1/lada) was given correctional dosage info instead to bring sugars back in range using fast acting alongside told to just do at next meal (so not too early) or at least 3-4 hours before next injection due to 'insulin stacking' effect possibility of lowering sugars a lot faster. having to keep a eye on levels for a few hours afterwards as well.

(edit added hours after 3-4)
 
grantg said:
i was advised against that not long ago (bear in mind type1/lada) was given correctional dosage info instead to bring sugars back in range using fast acting alongside told to just do at next meal (so not too early) or at least 3-4 hours before next injection due to 'insulin stacking' effect possibility of lowering sugars a lot faster. having to keep a eye on levels for a few hours afterwards as well.

(edit added hours after 3-4)
Click to expand...
I use Lantus & have to be 99.9/100% certain that I forgot…
Fully understanding how my basal works (or the absence of..) using a meter then meter & sensor..
With the absense of Lantus. 18to 24H profile for me. I’m like a yo yo the following day correcting & skipping meals till the next Lantus shot just to get by off an actual forget.

I woke up one morning in a hotel room after a night out & asked if my room mate had seen me handling a pen like device?
It gets too routine.
He responded to having a memory of me fiddling with a blue pen.. when I tested, I was around 5.5Mmol. So deducted I had taken my basal…
It is possible for me as a T1 of nearly 50 years to delay my basal by upto 3 hours on a lively night out. (In this case playing in a band & given accommodation. The incident in this case was 15 years ago?
But not wake up 8 hours later wondering what happened after we got back to the room..
In this case a decent BG test concluded I automatically gave the dose along with testament from a bass player who knows nothing about how I manage my diabetes.. ;)
 
Mark Rawlinson said:
no sensor just finger pricks
type 2
Click to expand...
You’re on insulin?

In short. Push for a sensor.
It would help your diabetic team & more importantly, you..?
Still helps to use a meter. Helps you know the sensor is reasonably calibrated.

I will draw a driving analogy..
The HbA1c is like an “average speed check” on a motorway?
The meter is like a “speed camera.” Just a snapshot of how fast you were if triggered at “that” time…
Using a sensor is like having a “dash cam..” records a more detailed account of your current journey.
Including any crashes? ;)
 
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