How do you know when

[Brian23]

How do you know when you need to start a basal bolus? The Dr. thinks i may be LADA (GAD came back negative, insulin level were at the low end of normal, but normal). I got the flu two weeks ago and was having trouble getting my sugar levels down. I have now been on lantus for a week (6-8 units a day) and my BG came down to about normal. I take my lantus about 12p.m. I average 110-130 on a 8hr fast. Today I ate BBQ chicken, rice dressing & baked beans for lunch - 104 mg/dl 2hrs later. Tonight for dinner i ate Chips & Salsa (probably too many) and 3 beef fajitas - 319 2hrs later, 180 3hrs later, 120 4hrs later. Should i try to take more lantus or think about getting some sort of rapid insulin. It seems since I had lunch 1 hr after the lantus injection, i was lower after lunch? Any help would be appreciated.

[notme]

I think the first thing you might want to look at Brian, is how many carbs were in your meal. Chips (especially corn tortilla chips) will drive your blood sugar through the roof. Flour tortillas (three) have about 20-30 carbs each. Your meal was very rich in carbs. Your lunch numbers seems much more in line and I would guess it has more to do with what you ate vs. the time you took your lantus.

Why have you decided to take your lantus dose at noon?

[Funnygrl]

I agree, it looks like that high carb meal was the problem.

[soso]

I have been on Novorapid with meals for a year and recently added a very small dose of Lantus (3 u but may up this a bit soon ) I started taking it in the morning, but the main reason I wanted it was to get my fbg back into target range, so now I have moved it to 12 noon and it seems to be helping. My main reason not to take it at night is just my nervousness about night time hypos, which I realize may be unfounded, but figured I can move it to later if I need to and by then I will be more confident about it (hopefully!)

[Brian23]

Why did you start Novorapid with meals and not use a basal insulin? Why did you begin the Novorapid, how do i know if i should begin a rapid insulin?

[BlueSky]

How do you know when you need to start a basal bolus? .... Should i try to take more lantus or think about getting some sort of rapid insulin. ....
Increasing your Lantus may make you go low beween meals. Generally speaking, the way to stop bloodf glucose spiking after meals is to bolus beforehand.

[soso]

Why did you start Novorapid with meals and not use a basal insulin? Why did you begin the Novorapid, how do i know if i should begin a rapid insulin?

When I was first diagnosed I went on a very low carb diet (ala Bernstein) and managed pretty well for the first year..the second year things just slowly deteriorated to the point that I was eating only about 25g carb per day and my fbg had crept up to the high 5's (my Dr and I like it 5.6 or under) I tried Metformin on the off chance it would help, but it did nothing ( I exercise a reasonable amount)
At that point, my fasting BG was still reasonble, my after meal bg were in the 7's on less than 10g carb, so I decided the pp numbers were the biggest problem (not to mention my diet was not satisfactoy either)
I knew that if I used a basel, my pp numbers would improve, but to keep within target after meals and eat a more reasonable diet I would have to take a large enough dose I would be risking hypos in my fasting periods ( inc late morning and late aft as I do not eat between meals) This made me realize I would probably still have unwelcome spikes after meals and would basically end up 'feeding the lantus' a couple of times a day which would risk a weight gain problem too...
So I added Novorapid and logged extensively for a few weeks and it worked like a charm. The break that gave my own insulin gave it enough storage power to run my basel nicely.. That was a year ago and at that time my fastings were 4.1 to 4.9...over the course of the last year, those fbg's have risen to the 5.7 to 6.2 (and even a few 7's) so I decided to add a basel as clearly my own insulin is not quite managing anymore... everything else in my regime is the same.
I started a few weeks ago with a morning shot of 2 u Lantus, I have since upped it to 3 u at midday and am going to slowly move that to a later time as my fbg is still not perfect. I may have to up it a little more as well, but I am going very slowly as it is such an upsy downsy time of year... I started in the morning as I was worried about night time hypos....

It has def helped.. got through the season with only 2 high spikes and one horrid low, both not dire though...

To my mind, if the problem is mealtimes—treat that and do it effectively.
If a person is diabetic, at some point they are going to need to count carbs and react accordingly, better start as one means to go on.

My own thought has been, if it is too hard or doesn't work for me I will just have to think again.. for now at least, my choices have worked out OK..
Good luck..