[stella117]

No matter what basal insulin (well I've been on TWO!) or what dosage of basal insulin my carb/insulin bolus ratio has remained the same. I just recently upped my basal dosage from 14 units to 16 units. Post-prandial readings were always good--it was the fasting/pre-meal numbers that were the problem.

Are you sure it's your bolus dosage that's the issue? I find that if my basal dosage is off, I can't really correctly estimate my bolus. If say you are 232 before lunch and then 215 after lunch, then your bolus dose correctly covered your carbs but didn't correct the beginning high BG level. Now the high BG level could be due to incorrectly bolusing for the prior meal or a basal dose that is too low.

There are two ways to check and I suggest trying both:

1. Take your waking reading, two hours after breakfast, right before lunch, after lunch, right before dinner, after dinner, before bed. This way you can get an idea of whether it's your basal or bolus that's off. If your post meal numbers are within 20-40 points (I'm talking US conversion here) of where your pre-meal number was, then you have bolused correctly (unless you're also correcting a high, and then you'd want to be between 120-180). If your pre-meal numbers are high while your post-meal numbers are good, then you need to adjust your basal dose.

2. Take fasting readings by delaying breakfast or lunch--whichever works. For example, take your waking reading. Don't eat breakfast. Test again in two hours. If you significantly rise, your bolus could use adjusting. Test again in two hours. If you are rising instead of falling, your basal is too low. If you are falling more than 20-30 points (again, US conversion) then your basal is too high.

Just some guidelines/suggestions.

Another thing--you may want to consider splitting your Levemir into two injections 12 hours apart. This will give you better coverage and thus control. I find that highs/spikes breed more highs and spikes. So if you're spiking when your basal wears off, it makes it harder to stay stable.