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Split dosing - is this "normal"?

KarenG

KarenG

Well-Known Member
Messages
52
Type of diabetes
Type 1
Treatment type
Insulin
Hi all

After 20 years on the same regime (Novorapid X 3 bolus) and 1 X Insulatard overnight, I switched about a year ago to split doses 2X Insulatard 12 hours apart. The advice at the time was to split my old 20 units Inulatard dose by 2 ie 10 units twice a day.

After fiddling around with it for a while I had landed on 13 overnight (10pm) and 8 day time (10am) with Novorapid X 3 for food.

I've just got a Freestyle Libre and its highlighting that I think the 8 may still be too much.

This seems odd. Is such a split (much more required overnight than in the daytime) normal?

Many thanks
Karen

Ps Novorapid is pretty low at 4 units breakfast, 2 lunch, 7 teatime. I am a pretty avid exerciser and observe my own version of moderate carb consumption. Three years ago I was on 80 units/ day and weighed a lot more, so this feels low to me but it may not to others! T1 for 38 years.
 
The profile of insulatard is such that on a single dose a day it doesn't last 24 hours. I'm quite surprised they only moved you to twice daily with it recently as throughout the time I was on it (about ten years) it was a twice daily insulin.

It's more unusual to run a single daily dose of insulatard than two!
 
I think it's the proportion of the split, rather than the split itself, that @KarenG is asking about? I.e is it normal to take 38% am and 62% pm

I think you don't need to worry so much about what is "normal"* if your libre shows your basal is working for you, that's the main thing. Dont get too hung up on what is normal/average - they are good starting points - the important thing is what works for you :)

Edit: *normal for the proportions of the split. I think they usually split the basal 50/50 am/pm when people start off splitting it, and then fiddle about with it as you have done to figure out what works for the individual.
 
catapillar said:
I think it's the proportion of the split, rather than the split itself, that @KarenG is asking about? I.e is it normal to take 38% am and 62% pm

I think you don't need to worry so much about what is "normal"* if your libre shows your basal is working for you, that's the main thing. Dont get too hung up on what is normal/average - they are good starting points - the important thing is what works for you :)

Edit: *normal for the proportions of the split. I think they usually split the basal 50/50 am/pm when people start off splitting it, and then fiddle about with it as you have done to figure out what works for the individual.
Click to expand...

Tim, thanks for your help but catapillar understood what I meant - the (obviously not clear enough!) question was about the proportions and not the split itself. I feel like I should defend the diabetes team by saying that I never proactively asked for dosage/insulin help until a year ago and they then suggested splitting the dose. Ironically I only really sought their help after getting advice here. the Insulatard was never meant to be 24 hour cover, it was simply for overnight, and I realise was a very old regime.

Catapillar - thank you very much - I will stop fretting and keep fiddling :-)
 
The larger dose you have found you need is compensating for the natural rise in glucose produced by the Liver in the early hours of the morning.

Using your Libre as you know you can monitor when your BG rises and if needed adjust your dosage and or the time you take your night time background insulin.

Regards

Martin
 
Thanks Martin. I am surprised, I guess, that the Dawn Phenomen would have such a material effect!!
 
Hi. The 20 units split 2 ways often works better so not unusual to need slightly less in total. Also if you have loss weight and are more active your basal needs are lower. If the proportion works for you then its the right dose
 
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