Advice please about my doses...

[Cookie]

Hoping someone can help/advise me :albertein

At the moment, I take Novorapid before meals. I also take Insulatard at night - 30 units (although not convince this is enough quite frankly as am often high in the morning).

I am wondering if I should be taking a dose of Insulatard during the day as well? Quite often my blood sugar has risen for really NO reason during the day. It can be a good level and even though I've not eaten anything, it's high again later on.

I think I should perhaps be taking Insulatard through the day as well.

Any thoughts?

[duck]

Possibly. Can you get on Lantus? If I recall Insulatard is N or NPH and I think that stuff is utter **** (if I said what I wanted to say about NPH, Tony would kick me off this site for being vulgar).

Can you post a couple days of blood sugar readings (the two-hour post meal variety) in conjunction with what time you took your insulins and what kind of insulins were taken?

[Cinnabon]

Cookie..
If you read through and search you will fins a lot of forum members worship N (NPH)... NOT!!!!!!.
It provided no stability for blood sugar levels giving me nothing but frustration as hard as I tried, I never got anywhere. I ended up splitting up my doses to about 4-5 shots. Sounds like you are also experiencing Dawn Phenomenon.

[amccrazgrl]

i took R and N before the pump and it was just fine for me

[Erin]

If Insulutard is N, then I always took two doses. A large(er) morning dose, and a small(er) evening dose. If Insulutard is a slow / no peak insulin similar to lantus, it sounds like you're just not taking enough. If you're going high in the morning and going high when fasting then you're not taking enough. Test this by checking your blood sugar during the night. If you start out at a good number, and have not eaten / bolused for at least 2 hours before bed (the longer the better) you will be watching ONLY the effect of the insulutard on your numbers. (well not ONLY, but as close to ONLY as we are ever going to get). If your numbers rise during the night, you're not taking enough, if they drop you're taking too much. Talk to your doctor before taking my advice, as I'm not a doctor.

[MarkMunday]

Cookie,

Insulatard acts over 24 hours. But it peaks at 4-12 hours. And, if you are taking it at night, you will be running out of basal insulin in the late afternoon the next day. If you are waking with high blood sugars, it could be because the increasing action of the Insulatard is rising from a very low base and is not adequate to cope with combined effect of the evening meal and the Dawn Phenomenon.

The diagram below shows how the action of Insulatard fades after 12 hours.

I had a similar problem when I was using only NPH as a basal inulin. I also have a strong DP. And I used to have high morning blood sugars in spite of injecting all the NPH before bed. But when I started taking Lantus in the morning and a much smaller dose of NPH before bed, it came right.

I now inject 8 units of Lantus first thing in the morning, and 5 units of NPH before bed. And my blood sugars are reasonably stable over the whole day. I also use Novorapid before meals.

If you cant get Lantus, try splitting your NPH into morning and evening shots, 12 hours apart. You will probably have to reduce your before-lunch Novorapid shot because the morning NPH shot will be peaking.

Cheers,

Mark

[buzzborne]

I was on Insulatard (as was my dad before switching to lantus) and we both only ever took it before bed, have not heard of taking it in the morning and evening.

I think it may be a good idea to talk to your Dr about going onto Lantus... if not to see if you can split the Insulatard.

[DeusXM]

See if you can get transferred to Lantus, or if for some reason you can't, then I'd suggest splitting your Insulatard dose. I take half my Insulatard dose in the morning and the other half in the early evening - my last A1c was 6.5 and I wasn't even particularly trying that hard either, so you can get a flexible, well controlled regime with Insulatard.