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testing basal

S

static192

Well-Known Member
Messages
346
Location
Birmingham
Type of diabetes
Type 1
Treatment type
Insulin
hi i i checked my sugar at night it was 7.3 so i went to bed then woke up at 6.18am sugar was 8.5 then at 10:11 it was 9.3 i havent had breakfast or food i injecet 25 units of levemir at night does this sound like basal ajustment is needed ?.
 
Hi @static192 Unfortunately no one here can advise you about adjusting your basal dose. You will need to discuss your adjustments with your DSN.

The guidelines from Salford Diabetes Care (http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007) gives the following information:

Evaluating the results and Suggested Changes

For each time period:
  • Compare the BG readings for the three times you have tested a particular time period and look for a pattern
  • BG changes of more than 2.0mmol/l between readings indicate the need to adjust the basal rate
  • Make basal rate changes in small increments, typically 10%
  • The basal rate should be increased 1-2 hours before the BG begins its rise or the basal rate needs to be decreased 1-2 hours before the BG begins its fall
  • Make one change at a time
  • Re-evaluate that time frame after any changes to the basal rate are made
  • Then move on to the next time period
 
I would say the overnight basal is OK as you only went up 1.2mmol....

but a test is always worth it in my opinion...
 
static192 said:
hi i i checked my sugar at night it was 7.3 so i went to bed then woke up at 6.18am sugar was 8.5 then at 10:11 it was 9.3 i havent had breakfast or food i injecet 25 units of levemir at night does this sound like basal ajustment is needed ?.
Click to expand...
Hi there I was having similar issues and after doing appropriate basal tests I found that my basal dose appeared to be correct as my bs remained stable until about 3:30 am where I then started to rise until about 11am - put this rise down to the dawn effect. To manage this my basal tests showed that From waking at 5am until 11 am my bloods steadily rose by 4mmol. As my correction dose is 1unit to drop BS by 3.9 mmol at breakfast I inject my appropriate insulin amount for breakfast including any correction depending in my readings at 5am. This means I still anticipate a rise of 4 mmol - for this I also take an additional half unit to cover part of the DP rise then at 830 am i take another half unit. This approach works for me and only found this as the best way of managing the DP with help of my freestyle libre. I would never say that anyone should try this but this approach has worked for me... Like 'manual pumping' I suppose but may give you something to think about... Good luck and hope you figure out what works best for you
 
Your body releases glucose into the body roughly between 2-8am, and it can continue to do so when you're up and about and didn't eat or take your insulin for the morning. It's possible your basal rate needs to be adjusted, you can do the test @db89 linked to and discuss the results with your healthcare team to see what you can do next. I'm assuming you're not eating shortly before bed, and take the right amount of insulin to cover your food.

If your rates seem fine during the day but never at night, then it's highly likely you're experiencing the dawn phenomenon.

I struggle with the dawn phenomenon myself. My basal values never differ more than 1-2mmol/L, if that at all, but I climb rapidly and high in the mornings. I double my insulin for my breakfast to deal with the expected rise and it helps me not climb more than 2mmol/L most of the time. :) Some people can curb the rise by eating immediately after waking, but this doesn't work for me personally.
 
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