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Type 1 Diabetes
Tresiba, Dawn Phenomenon, Split Dosing
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<blockquote data-quote="kitedoc" data-source="post: 1802149" data-attributes="member: 468714"><p>OK, Apologies for my confusion ! Your GP should have some info on how many steroid inhaler puffs reaches the equivalent of a low dose steroid tablet ( i.e. the amount that is likely to affect BSLS) (I did know once, but the inhaler strengths and steroid types have changed over time). There may be drug info by the company that does give the answer.</p><p>My understanding of the Dawn phenomenon is that it begins about 4 am and might last an hour or 2. How does taking Novorapid at between 4 am and 7 am deal with the 4 am beginning of the event? Yes, Novorapid has a variable peak timing, say 1 to 3 hours, which may things tricky ++! For me, it was nearer 3 hours so I needed to actually take it 1 hour before meals to be sure of best controlling BSLS. So a 4am shot might cover you from say 5am to 7 am or so. But may not if your peak Novorapid effect is 3 hours from injection. Your readings would help you sort this out, no doubt.</p><p>The idea of the 12 mn Novorapid dose depends on the peak timing being nearer the 3 hour mark. Another tweak I have tried with some success is to utilise the difference in absorption time between insulin injected in the abdomen vs in the leg, say outer thigh.</p><p>With no exercise of the leg to be injected say for an hour up to and following injection (exercise increases rate of absorption I believe,) an injection of a small amount of Novorapid say 12am to 12.30 am into outer thigh subcut tissue ( not muscle!! I have made that mistake to my cost !!) might, MIGHT, just peak say 3.30 pm in anticipation of the Dawn event. The Novorapid would be through by ? 6 am. If it works for your BSLS it saves you precious sleep ! Just a suggestion to think about with your doc. Fingers and toes crossed !!! To put it politely and carefully, the exercise restriction does however influence the timing of any 'nocturnal activity occasioning exercise'.</p></blockquote><p></p>
[QUOTE="kitedoc, post: 1802149, member: 468714"] OK, Apologies for my confusion ! Your GP should have some info on how many steroid inhaler puffs reaches the equivalent of a low dose steroid tablet ( i.e. the amount that is likely to affect BSLS) (I did know once, but the inhaler strengths and steroid types have changed over time). There may be drug info by the company that does give the answer. My understanding of the Dawn phenomenon is that it begins about 4 am and might last an hour or 2. How does taking Novorapid at between 4 am and 7 am deal with the 4 am beginning of the event? Yes, Novorapid has a variable peak timing, say 1 to 3 hours, which may things tricky ++! For me, it was nearer 3 hours so I needed to actually take it 1 hour before meals to be sure of best controlling BSLS. So a 4am shot might cover you from say 5am to 7 am or so. But may not if your peak Novorapid effect is 3 hours from injection. Your readings would help you sort this out, no doubt. The idea of the 12 mn Novorapid dose depends on the peak timing being nearer the 3 hour mark. Another tweak I have tried with some success is to utilise the difference in absorption time between insulin injected in the abdomen vs in the leg, say outer thigh. With no exercise of the leg to be injected say for an hour up to and following injection (exercise increases rate of absorption I believe,) an injection of a small amount of Novorapid say 12am to 12.30 am into outer thigh subcut tissue ( not muscle!! I have made that mistake to my cost !!) might, MIGHT, just peak say 3.30 pm in anticipation of the Dawn event. The Novorapid would be through by ? 6 am. If it works for your BSLS it saves you precious sleep ! Just a suggestion to think about with your doc. Fingers and toes crossed !!! To put it politely and carefully, the exercise restriction does however influence the timing of any 'nocturnal activity occasioning exercise'. [/QUOTE]
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