Split Basal Testing

Stuboy · #1 (**permalink**) 03-15-2007, 10:10 AM

OK,

So i really need to test my basal. But im confused about where to start.

I split my lantus, I take it at 10am and 10pm.

My waking nubmers are hovering around 7/8 (i'd like to see 5's again)
My evening pre meal numbers are hovering around 9/10/11 (i'd also like to see 4's and 5's again).

I usually eat lunch at about 12pm/1pm, and eat dinner at around 8:30pm, which means i dont usually eat for 7/8 hours between lunch and dinner.

Where do I start? Im not sure which to adjust first and when to stop eating to test each one?

If I take my evening basal at 10pm, then I should be ok just to skip breakfast and test again at 10am when i take my next basal shot?

Confused about adjusting the 10am shot mostly...

REDLAN · #2 (**permalink**) 03-15-2007, 10:35 AM

I'm also on a split basal dose - after all the really good advice I got from the peeps on this forum, thanx (",).

I haven't as yet done any proper basal testing - mostly 'cause I get a big dawn BG rise so I have to eat and inject some insulin.

I've split my dose 5pm and 7am.

If my morning BG is out then I adjust my 5pm, and the other time I tend to go high is b4 evening meal, so I would adjust my 7am basal.

it sounds to me that you need to increase your 10am basal - this should help with the higher early morning numbers as well, as your 10am basal should still be working until just b4 you wake (if you have the typical 20 hour duration)

grace girl · #3 (**permalink**) 03-15-2007, 10:59 AM

I split my lantus as well, and I can tell you how I do it, though someone who knows more than I do may give you some better ideas.

Since you're waking up higher than you like, I'd start with the night test. I eat a normal, non high fat meal at supper time, and eat nothing else that night. I test at bedtime, and generally every two hours during the night. If I'm not having any over night lows, and I find a rise in my bs, then I up the evening dose of lantus 1 unit, wait three days and do the test again.

Am test: no breakfast, no coffee, only water. Check bs upon rising and then every hour until my normal lunchtime.

Afternoon test: skip lunch. Only water. check bs every hour until dinner. (this test caused me to finally realize just how much of a drop I get when the lantus hits full force, about 4 hours after I take the injection)

Evening test: skip supper. Only water. Check bs every hour until bedtime, upon which I usually eat something to keep from starving to death over night.

These daytime tests should each be done on a different day, and if for some reason something happens during the test that isn't your normal routine, abort the test and do it again the next day.
If you find yourself going high, ajdust the dose, wait three days and test again.
Also be aware that you might have to ajdust the bolus for certain meals if you end up adjusting the basal.

I was told by my endo that as a general rule, if I'm high at fasting, increase pm dose, and if I'm going high during the day, adjust the am dose. It does take some tweaking and every one's body is different. I'm taking 17 units in the am and 7 at night, and I still have some lows that are associated with the lantus, but any lower dose brings on too many highs.

It's all rather time consuming, for it takes a few days to do them all, but it will really help you pinpoint where you're problem is.

One thing I noticed, you say you go 7-8 hours between lunch and supper....that makes me wonder if your liver is kicking in and making you go high. Have you ever tried having a snack midway during that time to see what happens? Just a thought.
I hope all of this helps.

Stuboy · #4 (**permalink**) 03-16-2007, 05:23 AM

I nearly always feel my lows, and with a 7-8hour break without food, I dont feel low at any point, i've tested half way through that at 4 hours and was still quite high.

I find it very difficult to wake up to test in the middle of the night even once. So every 2 hours would be really hard for me, I just dont wake up!

I think the evening needs adjusting first, which is easier to start with, just a pain with the mid-night testing.

I seem to require more lantus over night than I do during the day. This morning I woke up at 13

and that was with 11units at 10pm.

grace girl · #5 (**permalink**) 03-16-2007, 08:56 PM

Overnight testing is a pain, I agree. I have to set and reset the alarm clock to be able to do it. If nothing else you should do a 2am check to see if you're possibly going low over-night and rebounding. If that be the case more lantus at night will just make it worse.