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What does basal insulin actually do

Discussion in 'Insulin' started by borderter, Jul 1, 2012.

  1. borderter

    borderter Type 2 · Well-Known Member

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    Have noticed that the basal insulin does not seem to do much so can anyone tell me exactly what its supposed to do? :?:
     
  2. anna29

    anna29 Type 2 · Well-Known Member
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    Hi .
    How many units of basal are you currently using?
    What insulin therapy and regime are you using?
    Do you split dose your basal insulin?
    Basal insulin is a steady "background cover of insulin" , though some
    insulins perform better if split dosed.
    Giving full background cover, rather than tailing off after certain number of hours.
    Hope this helps/
    Anna.
     
  3. borderter

    borderter Type 2 · Well-Known Member

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    I stopped using basal about 10 months ago because it did not appear to make a difference
    I am type2 on novorapid bolus and have a good hba1c but lately find bgs rise quite a bit 2 hours post meal but is ok again before next meal and so this is the basis for my question,will levemir flatten out that post meal spike ? if not why should I be using it
     
  4. anna29

    anna29 Type 2 · Well-Known Member
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    If you only single dose with levemir it can tail off after 18hours.
    How many units of levemir are you using?
    Levemir does perform better if split dosed, then giving a full 24hours background cover.
    If you're just single dose the levemir, and post prandial 2-4hrs after food you are still high
    maybe not enough background cover present?
    The nova rapid bolus should reduce the peaks after foods eaten.
    Hope this helps ?
    Anna.
     
  5. borderter

    borderter Type 2 · Well-Known Member

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    Anna I am not using levemir as I said I stopped using it 10 months ago and only use novorapid
     
  6. Anonymous

    Anonymous · Guest

    Hi borderter,

    It sounds like I'm doing the opposite of you, as I've dropped my bolus and kept the basal (which is lantus). It reduces the baseline of my levels so that, with the low carbing, I manage not to spike above 7 after meals.
     
  7. tresadern

    tresadern · Member

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    I have just seen this post and found the discussion very interesting. I'm type 2 on a Novorapide/Levermir combination but am having quite heated arguments with my advisers as to how I use this combination. Please see my post 'NovoRapide and Levermir combination' 7 July 2012 in 'Type 2 diabetes' and a mixed selection of responses. I need to read more about bolus and basals but the argument I'm having with my team is because I refuse to take the same amount levermir at every bed time if my sugars at that time are low, and because I increase the dose if my 'closing' sugars are high. This is totally against professional advice that I should take the same levermir dose irrespective. I tried this for a short time and suffered several night hypos. You'll see from the post that experience has led me to a rough rule of thumb that I take 5 units of levermir for every point that my bedtime reading exceeds 5. e.g if bedtime sugars are 10 I take 25 levermir, if bedtime reading is 15, I take 50 levermir. This works fairly well for me and my sugars first thing in the morning are 5 to 10 probably 80% of the time. Since the last argument I have kept very detailed records of my bedtime and morning readings, and the pre-bed dose of Levermir which prove (and I will stress this) that FOR ME, Levermir before bed reduces my sugars overnight. Hence my refusal to take any if my sugars pre bed are low. I'm having a bit of fun with this serious stuff by plotting all my data on a pretty colour Excel chart and will present it to the team when I see them again next month in the hope of impressing them with my ORIGINAL MEDICAL RESEARCH. Interestingly however the chart so far shows that while the waking readings are fine, my pre-bed readings are far too high and that I'm therefore not taking enough Novorapide before dinner. I therefore intend to increase this dose from now on to get this reading down. But this of course will reduce my bedtime readings and in turn, if successful, lessen the need for Levermir! Perhaps at this stage however I'll be told by the team that I really should start the 30 Levermir units per night, every night and inject less Novorapide before dinner!!! They will also of course, quite rightly, tell me to cut down on the carbs and to totally eliminate my beloved Mars bars and my beloved sugar packed Shloer grape juice. And you think you're confused!!
    Tresadern
     
  8. glucosegirl

    glucosegirl · Well-Known Member

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    I copied and pasted this from another website. It explains what basal insulin is and what it does.

    In people without diabetes, a steady amount of insulin is released into the bloodstream, day and night. This insulin is also called basal insulin and helps control blood sugar between meals and during sleep.

    Basal insulin therapy also works day and night to control blood sugar between meals and when you sleep. A basal insulin therapy may be prescribed to someone who needs an insulin to work slowly with the purpose of delivering long-acting diabetes control. It’s taken either once or twice a day at the same time every day, often with your evening meal or at bedtime, to help give up to 24-hour insulin coverage.

    Hope this helps.
     
  9. borderter

    borderter Type 2 · Well-Known Member

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    Well I have started on a moderate dose of levemir now and so far its not helped a great deal and I wont take a bedtime dose as from checking bgs at 2 and 3 am am down to 5.2 so dont want to risk a night hypo but after evening meal bgs rise quite a bit but then as said fall to good levels through the 2-3 am slot so am going to need to do a higher carb to bolus ratio for that meal and just hope for uneventful night X my fingers
    It still feels like levemir is only water LOL
     
  10. judy.suirane

    judy.suirane · Member

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    Just a question as I'm new to all this. I am on levemir 20 units at 10pm . My mornings are great with by under 6. My pre bed levels fluctuate between 6 and 15! It seems the levemir has run out after supper. Should I be takng a split dose of 10 units one at 10 pm and one at 10 am? Confused!!

    Thanks
    Judy



    Sent from my iPhone using Tapatalk
     
  11. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    your liver secretes glucose for all your critical systems........lungs, heart, brain, etc........this is a constant flow for obvious reasons as you wont always have digesting quick acting carbs on board..........

    your basal is what delivers this energy source to these systems........

    the most important side of insulin delivery really........
     
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  12. ElyDave

    ElyDave Type 1 · Well-Known Member

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    The role of basal insulin in an insulin dependent diabetic is to deal with the glucose released by the liver steadily in the background. It's a very slow action to match the slow release from the liver. The novorapid or similar quick acting insulin takes care of mealtime carbs, and if you are dosing correctly should see a 2hr post meal spike of around +2mmol/l vs pre meal.

    Getting the basal right is crucial. You should not be seeing big overnight drops or increases. If you regularly need a bedtime snack to avoid a hypo you have too much background, if you are regularly high in the morning, too little background. Try avoiding carbs in the evening to fine tune and adjust by 5-10% either way until you have it right.

    For type 2 I'm guessing there will be differences, but don't ignore the role of basal.
     
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  13. Daibell

    Daibell LADA · Master

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    Hi Judy. Levemir only lasts 18 hours max (Google the web for graphs). Some people split Levemir. My DN wanted to add a Bolus instead and I rely on my evening Bolus injection being enough to make up for the Levemir running out of steam
     
  14. judy.suirane

    judy.suirane · Member

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    Thanks.. Thinking that was happening out off steam. Started taking krill and vitamin d and seem to be settling to a good pre bed reading 6.2 mmol. 20 units of levemir.


    Sent from my iPhone using Tapatalk
     
  15. gemma.88

    gemma.88 · Active Member

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    My son ad to take his in the morning as his bed time readings were always high so they switched it from bedtime to morning the readings have come down abit but not much, I think he needs the dose putting up tbh x

    Sent from my HTC Wildfire S A510e
     
  16. BunnyBabe

    BunnyBabe Type 1 · Member

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    I often think of basal insulin as a tap, constantly dripping- the drip is insulin so it helps to keep blood sugars under control and mimics the liver
    Hope this helps :)


    Sent from the Diabetes Forum App
     
  17. borderter

    borderter Type 2 · Well-Known Member

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    Im now on lantus and it works well for me but i need to take it at breakfast and it keeps me steady for 24 hours
     
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