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Split basal

PG1759

PG1759

Well-Known Member
Messages
128
Type of diabetes
Type 1
Treatment type
Insulin
Hi, I'm currently on 7 units of basal insulin (lantus) per day. I'm finding my evening readings are always high which in turn leads me to get up high so I'm constantly on the back foot from the word go. This evening I had my evening meal and injected my fast acting (1:10)
My reading before eating was 5.3 however I'm now 10.6 some 3 hours later and I know I will wake up at a similar number - probably no less than 8.0.
Does anyone think splitting my basal would be beneficial ? I'm concerned that as soon as I put 4 units in for the day that I'll be high all day. Would it be worth injecting my usual 7 in the morning and then another small dose on the evening ?
 
My DN wasn't too keen on splitting and in retrospect I see some reasons why. I do my Basal in the evening and as we all know Levemir only lasts a max of 18 hours if that. I don't do a Bolus at breakfast as the Basal will still be working and I don't have much to eat but as the day goes on I take enough Bolus at meals to manage the BS as the Basal wears off. Not splitting saves one injection per day.
 
I don't currently split my basal injection but I am taking a whopping 28 units of levemere at bed time. My consultant has suggested to me that I split my dose- half morning and evening but I haven't trialled this to see if it works as of yet. It makes sense due to the 18 hour duration of action though!
 
Sounds exactly like me, same sort of readings and everything, but I just take 20 long acting on a night, trying to adjust my rapid to suit
 
Bit confused by your post are you taking 7 units lantus at bedtime? Also what total average amount of bolus insulin you take in a day?
 
Can you ask to change to Levemir...? My understanding is its better suited for splitting doses - though I may have misunderstood something about Lantus... Either way, I split my Levemir and all was good, from a numbers perspective.


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If it is your bedtime bg that is high you need to up your bolus insulin ratio for your evening meal. If you are going to bed at 10 bg and waking up at 10 bg your basal at 7 is about right.
 
When I went on to two Lantus injections a day it was actually extra units they asked me to put in.
I was getting high around 6-7pm which is when I take my evening Lantus so it seemed that it was running out. The DSN then asked me to take an extra 6 units in the morning on top of what I was already taking.
I wouldn't rule out your Bolus ratio just being a bit out for your evening meal.
 
Hello. Lantas should last longer than levimer, according to DAFNE. It might be worth giving your diabetic nurse a quick ring?
 
PG1759 said:
Hi, I'm currently on 7 units of basal insulin (lantus) per day. I'm finding my evening readings are always high which in turn leads me to get up high so I'm constantly on the back foot from the word go. This evening I had my evening meal and injected my fast acting (1:10)
My reading before eating was 5.3 however I'm now 10.6 some 3 hours later and I know I will wake up at a similar number - probably no less than 8.0.
Does anyone think splitting my basal would be beneficial ? I'm concerned that as soon as I put 4 units in for the day that I'll be high all day. Would it be worth injecting my usual 7 in the morning and then another small dose on the evening ?
Click to expand...


Try skipping your evening meal for a couple of days and test your bg levels 4 hours after your lunch, if your basal dose is set at the right dose it shouldn't increase/decrease much more than 1.6mmol. It's worth doing a basal test when your not doing anything out of the ordinary, for an explanation on basal testing have a look at the following:

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

If it is your basal running out then do ask about split-dosing your lantus, some find it doesn't last the full 24 hours where others do, if you don't fancy split dosing ask about a new basal insulin that came on the market last year, it's called Tresiba and is said to last up to 42 hours, although you still inject it once a day. It's an expensive insulin by all accounts so your HCP's may be reluctant to prescribe it.
 
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