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splitting background insulin......

Discussion in 'Type 1 Diabetes' started by jonesy, Aug 27, 2010.

  1. jonesy

    jonesy · Well-Known Member

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    this may seem like a silly question but.......

    if you are splitting, is it best to have both doses equal?

    my son is currently on 7 at night and 3 in the morning.
    i just assumed it was best to take equal doses and was going to gradually work to 5 and 5.

    makes sense to me....but am i missing something?

    jonesy
     
  2. shedges

    shedges Type 1 · Well-Known Member

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    Best way to work it is surely to split proportionally to the time between injections.

    If I were to inject 12 hours apart, I'd split in half.

    If I were to inject at, say 10pm and 6am, I'd do it 1/3 and 2/3 ... but that's just my theory... has anyone out there got some practical results or advice?
     
  3. ebony321

    ebony321 · Well-Known Member

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    I split my doses and take 12 in the morning and 16 at night, It doesn't have to be even, everyones different and it's common to need mor insulin at different times of the day..

    if uneven doses work how the should then why change it. :)

    Editing for other post: i take mine at 9pm and 9am (12hoursapart)
     
  4. timo2

    timo2 · Well-Known Member

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    Hi jonesy,

    The 50/50 dose at 12 hours apart rule is really only a rough guide when switching to a split dose.
    Both the morning/night ratio and the timing can be adjusted to suit whatever works best.

    I'm taking 12 units AM and 9 units PM, roughly 10 hours apart.

    Regards,
    Timo.
     
  5. SophiaW

    SophiaW Type 1 · Well-Known Member

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    I agree that it's a guide. Everyone is different and you may find you need more insulin during the day than at night while others need more at night and less during the day. Jess currently has 6 units at 7.30am and 4 units at 8.30pm (that's levemir she's on). It took some experimenting and random fasting tests to discover what works best for her.
     
  6. noblehead

    noblehead Type 1 · Guru
    Retired Moderator

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    Jonesy,

    Definitely start with a 50/50 split, so start him on 5 and 5 and test thereafter, although you may have to adjust his doses eventually. Not sure what your lad is using, but if its lantus remember that changes do take around 2-3 days to work, and only adjust by 1 unit at a time.

    Good luck!

    Nigel
     
  7. jonesy

    jonesy · Well-Known Member

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    sorry, should have said....levemir.
     
  8. noblehead

    noblehead Type 1 · Guru
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    To my knowledge you should see changes within a day when using levemir Jonesy, if unsure you could always ask your son's diabetes nurse for some advice on this matter.

    Nigel
     
  9. iHs

    iHs · Well-Known Member

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    My thought on this is if you are changing from doing one basal injection at night, then you should do the split gradually as you are already doing Jonesy. That way you should be able to spot the changes in bg levels when you test, as you increase the morning basal.

    Everyone's split ends up being different so Timo is right. Think of basal insulin as just a very slow acting insulin and you can adjust it to suit what you want it to do. I had a gap of about 13-14hrs between basal doses so my split was 14u in the morning (same time as my bolus for convenience)and then 5-8u before going to bed. I always tried to make sure that there was a gap of about 4hrs between eve meal bolus and basal at bedtime. That way, if I went hypo in the night, I knew it was because my bedtime basal was not right as the bolus wasn't active enough to do anything.

    I eventually got my basal dose stable on 5u as I made sure that my eve meal insulin to carb ratio was sorted to give me a bg level of about 6 before going to bed and I could get in the morning with a bg of about 7 (which is what my consultant advised prior to me getting a pump).
     
  10. Jen&Khaleb

    Jen&Khaleb · Well-Known Member

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    Khaleb was on 2/3 morn and 1/3 night but he's nearly on 50:50 now. He seems to be doing some growing and is chewing through a bit of insulin at the moment. After being sick all through winter I can say it has been a bit hard to keep up with his changes as his food/activity levels are about the same.

    The best split is the one that works to keep bsl's stable.
     
  11. Angeldust

    Angeldust Type 1 · Well-Known Member

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    The last 2 posts are good advice.

    I decided to split mine 2 weeks ago as I felt it was only lasting 20hours and was always waking up hypo. I kept the dose the same and split it 50/50 12 hours apart. 10am and 10pm. The morning hypos have stopped :)
     
  12. copepod

    copepod Type 1 · Well-Known Member

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    I aim to have injections when it's easiest to remember - for me, that means Humalin I at bedtime (around 2300) and getting up (around 0700), basically equal each time, but if I'm up all night, particularly if cold, wet and concentrating, as I was marshalling on TERREX adventure race in Lake District on Sat night, then it's helpful to reduce each dose - I finally got a couple of hours sleep after last team left at 0330 on Sun until getting up at first light to remove abseil ropes from rock buttress and carry out packs weighing around 40kg per person. So, didn't actually have a bedtime, but still had evening injection at 2300 and had morning injection around 0700 just before striking tent. All worked out fine - blood sugar wise, although needed to replace a guyline and reproof groundsheet.
     
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