[kel4han]

What is the duration of your bolus? At hour 2 I am high , then it peaks here and at hour 3 I am more in range. Hour 4 I am perfect sometimes low but hour 5 I may go to low (under 80 for me) If you ask the endo they will say Novolog duration is about 3 hours, but the drug insert shows up to 5 hours, which is where I am at. So, then how would you know if your ratio is correct, if you are not in range until hour 3.5 or 4 ???

[JediSkipdogg]

All insulins have a leading spike, a peak, a downward fall, and a tail (that's what I call them.)

The two major keys when figuring out insulin duration are the fall and the tail. Keep in mind, insulin effects everyone differently, but there are the general numbers. Novolog is about 90% used in 3 hours. Then that final 10% or so is the rail that can last an additional 2 hours. Therefore, one may still notice their BG dropping up to 5 hours after the bolus is given. It just won't be a significant drop in most cases.

[Cyborg]

Sounds like you have your ratio set perfectly...

[xMenace]

Keep in mind basal rates too. A high basal and low bolus can produce these results too. Try profiling your basals before messing with the boluses,

[kel4han]

What will a correct Basal allow you to drop at night? I have been experimenting with this too, becuase I used to drop about 150pts at night on 8u levemir at dinner. I am now at 4units and drop about 50-65pts at night. I thought you should stay within about 30pts overnight??? I am still honeymooning, and am considering no basal............

[Cyborg]

When your basals are set correctly, you should be able to skip a meal (or go overnight) and not have your bg vary by more than 30 pts. This link provides some good info on basal testing.

[kel4han]

hmmm. Thanks for that, but I couldn't quite get it from that info since I am on MDI not a pump yet. Still researching. Thanks!

[Scratch]

Originally Posted by kel4han

hmmm. Thanks for that, but I couldn't quite get it from that info since I am on MDI not a pump yet. Still researching. Thanks!

Well, there's a reason why MDI is sometimes called the poor man's pump. Both use the principles of basal and bolus insulin, where basal insulin is meant to be the amount of insuln needed to match the amount of glucose released by the liver and body, and bolus insulin is used to handle the consumption of carbohydrates.

The big difference between basal insulin rates for pumps versus MDI is that pumps are programmable to put out differing basal rates over 24 hour periods, which is useful since our bodies basal metabolisms go through 24 hour cycles. With Lantus and Levemir basal on MDI, you're going to have a very flat basal rate of insulin.

I think as an MDI'er the biggest thing is trying to find the basal dose that will let you almost certainly sleep safely and comfortably for 8 hours overnight. I think that's the one you're going to be testing for. It took me some time to get my basal dose titrated comfortably, the difficulty I had was my basal dose of insulin drops my blood sugar, but then after 3 or 4 in the morning, my liver begins pumping out more glucose, and my blood sugars tend to start rising. It took time and testing to find a dose which lets me feel comfortable that if I go to sleep with a BGL betwen 130 and 160, I won't hypo before 3 AM, but also won't find myself elevated above 180 if I should sleep in to 8 or 9 AM.

[Cyborg]

Most of the tests from the link are applicable to both MDI patients and pumpers.