Basal question...(I think)

grace girl · #1 (**permalink**) 06-21-2007, 07:21 PM

Just for background, I take lantus 2x daily.

I'm noticing a trend. Breakfast is okay. Lunch, I'm on target at the two hour mark, but my b/s barely budges 15 points from that time until dinner, anywhere from 2 to 4 hours later.
Dinner, I usually walk after dinner and I'm normally around 130 two hours after, but then it rises. It does this if I don't walk, too.
Now I know that I'm consuming more fat at dinner than lunch simply due to the difference in what I eat, but it's not THAT much.

Would these things indicate not enough basal?

JediSkipdogg · #2 (**permalink**) 06-21-2007, 08:08 PM

It could be not enough basal or too much fat. I have that same exact problem at dinner and luckily I'm on a pump. Since I have the pump I can do a combo bolus to extend it out so I don't dip low. You may need to try that with shots, give one shot and then 2 hours later give a second shot. Yup, it's annoying, but really the only way to do it if it's not the basal. And to find that out, you just need to skip dinner and see if it rises.

JediSurfer · #3 (**permalink**) 06-21-2007, 11:58 PM

Hi,

Now Lantus should not have any influence on food. Its used just to keep the body ticking over and control the glucose which is stored and released naturally to keep the metabolism in order. Your bolus insulin is the the one which accomadates the food for meals and the like. Lantus is a background insulin.

Your fasting rate should give a good indication of wether or not the basal rate is correct. If you were to just sit all day and do nothing and each nothing your blood glucose should stay around the same sort of numbers. But exercising will increase the absorbtion of Lantus which would require correction with food or glucose.

If I have higher numbers after a meal it usually due to an incorrect bolus. I my case Apidra. Apart from yesterday when I completely forgot to take my 6am Lantus shot.

Thats my personal experiance with Lantus. maybe some else has something different to say.
Hope this helps

someone · #4 (**permalink**) 06-22-2007, 12:16 AM

Like JediSkipdogg said, you should skip dinner and see what happens. There is really no way of accurately knowing whether it is your basal or your carbs that are raising your BG. If your BG rises when you don't eat dinner, then it is most likely your basal. You can just hope your insulin carb ratio is wrong, because that will save you a shot.

xMenace · #5 (**permalink**) 06-22-2007, 04:07 AM

IMO there's no way your basals can be accurate 24-7 with long term insulins. This could be one of those periods. The trouble with adjusting your Lantus though is that it affects the rest of your day. I'd do some detailed testing first, but, whether it's a basal or bolus issue, I suspect a raise in bolus is called for.

grace girl · #6 (**permalink**) 06-22-2007, 06:20 AM

More testing! GOOODDIEEE!!!

Seriously, though, thanks guys!

LancetChick · #7 (**permalink**) 06-22-2007, 08:18 AM

Yeah, skip dinner once just to see what happens. Some people just have different basal rates at different times of the day. I bolus with Humalog, and I find that I have to double bolus a LOT because it outruns most foods that I eat. It sounds like something simple to me.

RLK · #8 (**permalink**) 06-22-2007, 08:27 AM

Grace girl, when are you taking your Lantus? If memory serves me, you're splitting it into two doses?

grace girl · #9 (**permalink**) 06-22-2007, 10:26 AM

Quote:

Originally Posted by RLK

Grace girl, when are you taking your Lantus? If memory serves me, you're splitting it into two doses?

Yes...9 am and 9 pm. I've wondered more than once if changing the times would help. Because the stuff only lasts about 20 hours for me, and the weird doses I take to keep from going hypo over night, I have a basal gap right around dinner time...

cheryl · #10 (**permalink**) 06-22-2007, 11:00 AM

I just want to say I hate dinner personally, I notice though, that I just stick with complex carbs I do fine, high fats, I better start a working out...or high protien other wise i get a rise later on like last night I so had potato's and chicken wings with some carrots, yea as soon as i felt that wizzy feeling going aways I was a moving around doing tons of house work, i was 110 four hours later whew.....anyway, but you said the walking is still not working, it sounds like bolus issue's more then basal.....to me....cause for me it depends on my meal in he evening what is going to happen, if this happens with everymeal it is a basal issue if it doesn't then it is a bolus issue....

Cheryl

grace girl · #11 (**permalink**) 06-22-2007, 11:19 AM

The thing is, with the walking I'm coming in around 130 at two hours after dinner...I keep thinking that if I take more bolus I'm going to go low....

cheryl · #12 (**permalink**) 06-22-2007, 11:59 AM

Ok then are you higher then four hours if I remember correctly.......wow ok I see your point, so what happens if you don't walk you'll be high 2 hrs then even higher post meal....hmmmm I was having that problem when i ate too much protien at a meal.....that is just me I hate dinner, I feel normal I can eat anything for breakfast and lunch and know what I am gonna be by four hours dinner floors me too.....see I had done all my basal tests so I know it is accurate, and then that is the best thing I guess suggest make sure basal is accurate if it is, might be bolus or the flippin food LOL

Cheryl