How do I lower my basal and make sure I'm still on the safe side?
Inspired by the "how much is to much" discussion, here's my "how few is too few", or sort of.
After switching from Lantus to Levemir and losing about 10kg, I had to lower my insulin doses. Generally, that's very normal since weighing less usually means that you'll need less insulin.
But there are days, like today, I just don't know what is going on.
I used to inject 20-22 units of Lantus. When I switched to Levemir I was advised to plit it 10/10 which worked for a while. At some point during the early phase I even took 14/12. Then, more or less suddenly, it became less and less. At the moment I'm down to 7/2.
On a regular day it's hard to tell if it's too much basal. I can't differ between "too much bolus/wrong carb guessing" and "the right amount of bolus but too much basal". It usually works out but I don't know how much of it is a coincidence.
Today I woke up at 61. So I ate something, and injected my regular 7 units of Levemir. As the day went on, I dropped to 66 and 69 again. Again, I ate something in both cases. 94 was the only number in range I had later. Half an hour ago, I was at 66 AGAIN!
Does that mean 7 is still too much? How is that even possible?
Also, so far I've been eating something every night since I have to be 120+ because even 2-3 units Levemir bring me down to <80 over night.
What is so weird about it is the fact that lowering my doses doesn't seem to change anything. I was at 60 in the morning when I took 9 units, and I'm still at 60 with 2 (variation possible depending on how much/what I ate at night and/or during the night, so it can be 100 but that food-caused).
I know that many diabetics are afraid of lows - I'm someone who is more afraid of high numbers, ketones and purposely leaving out injections. For me it takes a lot to convince myself that it is okay to lower a dose, I always fear I'm taking less than I need.
On the other hand, I'm forced to lower my doses, I don't want to be on the low side too often either!
Any suggestions on a (safe) strategy?
I know that I need SOME insulin but there is not much room for changes left with just 2 units.
Should I take that 1 unit? Leave it off and see where I'll end up? How do I know how few is too few? I know that it is possible to have normal numbers and still lack insulin, and I can't stop "living", meaning that I'm going to have normal meals during the week. I can't have days like today on a regular basis... not eating carbs unless my bg is low.
I was dx 13+ years ago and until now, I've always had higher doses.
I think it's save to say it's not a honeymoon phase.
But what is it?
After switching from Lantus to Levemir and losing about 10kg, I had to lower my insulin doses. Generally, that's very normal since weighing less usually means that you'll need less insulin.
But there are days, like today, I just don't know what is going on.
I used to inject 20-22 units of Lantus. When I switched to Levemir I was advised to plit it 10/10 which worked for a while. At some point during the early phase I even took 14/12. Then, more or less suddenly, it became less and less. At the moment I'm down to 7/2.
On a regular day it's hard to tell if it's too much basal. I can't differ between "too much bolus/wrong carb guessing" and "the right amount of bolus but too much basal". It usually works out but I don't know how much of it is a coincidence.
Today I woke up at 61. So I ate something, and injected my regular 7 units of Levemir. As the day went on, I dropped to 66 and 69 again. Again, I ate something in both cases. 94 was the only number in range I had later. Half an hour ago, I was at 66 AGAIN!
Does that mean 7 is still too much? How is that even possible?
Also, so far I've been eating something every night since I have to be 120+ because even 2-3 units Levemir bring me down to <80 over night.
What is so weird about it is the fact that lowering my doses doesn't seem to change anything. I was at 60 in the morning when I took 9 units, and I'm still at 60 with 2 (variation possible depending on how much/what I ate at night and/or during the night, so it can be 100 but that food-caused).
I know that many diabetics are afraid of lows - I'm someone who is more afraid of high numbers, ketones and purposely leaving out injections. For me it takes a lot to convince myself that it is okay to lower a dose, I always fear I'm taking less than I need.
On the other hand, I'm forced to lower my doses, I don't want to be on the low side too often either!
Any suggestions on a (safe) strategy?
I know that I need SOME insulin but there is not much room for changes left with just 2 units.
Should I take that 1 unit? Leave it off and see where I'll end up? How do I know how few is too few? I know that it is possible to have normal numbers and still lack insulin, and I can't stop "living", meaning that I'm going to have normal meals during the week. I can't have days like today on a regular basis... not eating carbs unless my bg is low.
I was dx 13+ years ago and until now, I've always had higher doses.
I think it's save to say it's not a honeymoon phase.
But what is it?
Replies to This Discussion
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Permalink Reply by Anne on -
Alright... I'll give it a try:
Since m bg went down again instead of up although I didn't inject any new basal and I'm scared of going low(er) during the night, I'll leave it as it is.
Set my alarm to 3:30 and 5:00 for bg checks.
Perhaps Levemir lasts longer than I always thought?
I'll see. If it's not significantly higher at 3:30, there might be some basal from my morning dose left. Same goes for 5:00.
If I'm not significantly up higher at 10:00, I'll try to leave it with just one injection/day for 3 days.
Never have I been so confused... not since I was a kid and new to everything involving insulin.
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Permalink Reply by Kelly WPA on -
The best way to know for sure is to do basal testing - you don't eat or take fast acting insulin and test your BS every hour for about 8 hours. Your BS should not go up or down by more than 30 points. If you start at 100, you don't want to drop below 70 or go above 130. If you are dropping low, then you are taking too much Levemir.
It is possible that Levemir lasts longer than 12 hours for you - the range is anywhere from 5 3/4 hours to 23 hours. We are all different so you need to figure out what works for you. I actually take mine 3 times a day but I know that is what I need because of doing the basal testing.
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