Just curious to know what other peoples 24 hour daily basal needs are. I am LADA, been on insulin for 2 years. Started off on only 2 units basal a day! I am now up to 12 units of basal (pumping) per day. Is this a small amount? I'm 26 years old, eat pretty low carb, and weigh 100 lbs. I'm noticing my basal needs have obviously increased over the past two years is this normal and do they continue to increase over time? How many units of basal do you take?
HAPPY TUESDAY!!!
-Jenn

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Hi Jenn ... I started pumping about a year and a half ago. At the time, I was .35/hr so 8.4 units per 24 hour period.

About 2 weeks ago, I upped it to .40/hr which means 9.6 units per 24 hour period.

I'm afraid that I don't recall what I was shooting up prior to the pump. Maybe 12 units of Levemir??

My uneducated hypothesis is that as time goes on, our basal needs increase because our own pancreas is producing less and less insulin with each passing year, but others will likely have more accurate information on that.

I also take about 12 units basal a day. I think this is a typical Type 1 amount, though of course it varies for us all. Mine varies up and down over time, but I don't think it has gone up. But I was on oral meds for 15 months misdiagnosed as Type 2, so I obviously missed the period of time when I'd have very low insulin needs. I seem to recall my basal on MDI being around 16.

I was diagnosed 3 1/2 years ago, shots was 6u, pump is around 5.1u per day with all the different rates.

9.05 per day

A pump is much more realistic the lower your daily dose is. I went on the pump right away and was approved through my insurance through a very low c-peptide result on lab blood test. I LOVE my pump! Especially since I take such small amounts I can even take .1 units per hour, turn my pump completely off when I'm low, take tiny amounts every few hours for a high protein/fat meal, etc. I HIGHLY recommend it! ESPECIALLY if you are on tiny doses!

Excellent question ... I hadn't even considered that aspect of it so it makes much more sense now. The minimum is 85 units. I waste some every time and that is certainly a consideration.

It never occurred to me that one would need to have X as a basal rate to make pumping possible/warranted.

I have a basal rate the fluctuates between 0.025u/hr and 0.3 u/hr. I use a pump because that's the only way I wouldn't go low in the early afternoons. Also, I can put as little as 30u in my pump and use it. It just depends on the brand I suppose and how quickly you go through insulin.

Varies between 20-30u pr. day, seemingly independent of excercise. I'm a T1.

On average, in published studies, Type 1's with little/no native production have an average total daily dose of about 0.7-0.8 units/kg of body weight. Basal would be between 40 and 60% of the TDD according to the books "Using Insulin" or "Pumping Insulin" books.

Naturally, as with everything in diabetes, there is a great deal of individual variation. The numbers above are averages.

To give an example of the calculation above, a 100 lb T1 is 45 kg or so. 45 kg * 0.8 units/kg is about 36 units TDD. So basal might be in the range of 40-60 % of this....
or 14.4 to 21.6 units per day.

As for myself, I weigh 170 lbs or 77 kg, which would predict about 61 units a day of TDD. I use about 67 units a day, of which I use a total of 36-39 units a day of basal at various rates.

And yes, that amount has increased from 10 units a day basal 2 years ago at diagnosis as the autoimmune process of destruction of beta cells progresses and native insulin production falls off.

Those figures seem quite high to me, HPN. I don't think most type 1's take that much unless they've developed insulin resistance. I never found those "per body weight" formulas as too accurate. I think degree of insulin resistance is a lot more a factor than a relatively small difference in body weight. Other factors include diet and exercise.

As I said, there is a great deal of variance between individuals.

The averages I got come from the data sheets of, for instance, Novolog, which showed in their trials that their T1 users were using , on average, 0.7 u/kg +/- 0.2 u/kg.

TDD

Weight will have some influence - a 170lb person will likely uses more than a 100lb person. Since insulin is the "key" that lets glucose into cells, someone with more mass with have more cells and need more insulin.

I do agree with you that the degree of insulin resistance makes a big difference.

UCSF's diabetes center, for instance, uses a formula of 0.55 u/kg as a starting dose estimate to be conservative.

Of course all these need to be tuned to tthe individual, that is why the doctors and CDEs start off small and ramp up.

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