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QUESTION ON BASAL LANTUS

S

stoney

Well-Known Member
Forgot to ask the DSN on Monday this question.

Is it possible to adjust the amount of basal on a daily basis, also how accurate does the time have to be as James' can vary from 10pm to say 11pm sometimes depending on evening activities etc. and making sure that he does not eat after his basal.

For instance. At the moment it is 15 units. So when his readings are slightly up at night wondered if I could change it to 16 units. Then the following night if it normal readings, take it back down to 15 units, or would it mess with his regime. I am trying to figure out if by increasing the Lantus and sticking to a strict time every evening his morning levels would be roughly the same each morning, or am I being a bit naive here.

Any advice would be appreciated :|
 
I think keeping within of the basal injection time is fine -at least I've not had problems.

If I miss my basal injection time by 2 hours on Mon say, what'll happen is my blood sugar may start to go up up to 2 hours earlier than they usually would on the Tues.

Perhaps more to the point though, if you then inject at the correct time on Tues, there's the risk of running a little bit lower on the Weds. It depends though what type of basal is being taken.

15 unites equates to just over 1 unit every 2 hours. So missing the injection spot by an hour will mean being half a unit's difference for an hour of the following day.

I change my basal occasionally, but it's usually in reaction to a consistent period of highs or a period of lows -sometimes the need to change the basal is seasonal. I'll only change my basal by about 2 units maximum at a time.

Hope this helps a bit and maybe someone will explain things better than me.
 
funnily enough saw my Endo yesterday and she was talking about Lantus. She said it was not like the other short term acting insulins that can be changed around when you need. Evidentally the Lantus needs a week to get used to it's new dose.

Anyway that's one bit of info to take on board. I don't use it so have no experience of it - just repeating what she told me. I do hope you find a solution soon though , guess you'll have to talk to the Dr et al again.
 
Hi,

When i used lantus i was told then when changing basal insulins that any change should be left for at least 3 days to see the effects of any change.

You shouldn't change his basal insulin because he's slightly high one night.

The whole idea that the basal insulin is meant to control the changes in BG's that your body naturally causes and to have a background as a normal pancreas does.

The bolus insulin is solely to cover what you eat and bring any highs down to a normal level.

If it seems he's having highs or lows that seem to be around the same time of day then it could be likely the basal needs altering.

Depending on what bolus insulin you use and how long it takes to wear off can indicate the basal insulin needs tweaking, by this i mean if he went low 5/6 hours after a meal, and your bolus insulin only has a life of 3-4 hours this would indicate that it's the basal insulin thats causing the hypo.

Hopefully you use a diary so this is a very important tool in spotting any trends over the past few days that would indicate changes being needed.

If he is slightly high after a meal, make sure you know the carbs were counted accurately and that his ratio for insulin is accurate.

Hope this helps and makes sense :)
 
Any background insulin you need a couple of days for to see how it pans out..

Missig the time slot on the odd occasion isn't going to upset things too much in most cases we hardly notice it, but missing to often will cause all sorts of problems with control..

It's not until you go onto pumps that you truely appreciate how long background insulin lasts in the system... Before going on my pump I was splitting my background insulin 11pm and 11.30am... It actually took 4 days before my last injection of background (levimer) finally filtered out of my system and not to have an effect on my blood glucose, easily indentified by my changes in blood glucose levels..

Even with the pump you need to give a day or two when changing your basal (background) profiles to see how it pans out if you don't you end up in a right royal pickle..
 
I am on lantus and adjust it when I need to.
People's responses to lantus can be quite variable. Personally I would look for a pattern over 2 or 3 days, but I wouldn't wait a whole week before re-tweaking if it was just a question of a unit at a time; it may be different for you. I've heard that the wait-a-week thing is particularly useful if you are changing basal from Lantus to, say, Levemir - you might expect slightly different results as the Lantus exits your system. (and as jopar says, if you are waiting for basal to totally leave your system)
The only other thing to say is that if you are adjusting basal DOWN, i.e. if you had a hypo in the night, don't wait several days. Adjust down a unit right away. (it's a common sense rule of thumb but I was pleased to find that they taught me this formally on DAFNE too).
 
Stoney,

Lantus isn't meant to be adjusted from day to day and as others have said it takes 2-3 days for changes to be seen. The higher evening levels I suspect are probably from miscalculating the carb content of his evening meal, I am saying this as you say that some evenings his bg is normal so therefore his basal insulin is fine and its the insulin/carb ratio you need to address.

I normally stick to the same time each evening to inject lantus, that said I have injected one hour earlier/later and not seen any difference in my bg.

Nigel
 
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