need advice on basal

e||ement · #1 (**permalink**) 06-19-2009, 07:24 AM

two weeks ago i decided to up my NPH (which i take once, at bedtime) from 8u to 9u. the two weeks prior i was having higher morning readings and higher readings before supper. i tried increasing my lunch bolus but that didn't really help.

after increasing the basal, i've been experiencing more frequent lows (sometimes twice a day), but better all around numbers. however basal testing (fasting) indicates it's too much, and i can't really go without eating for too long or i start to tank.

so, i scaled back my basal last night to the 8u again. this morning my fasting was 7.8 mmol/l.

in my shoes, what would you do?
thanks.

lorilei · #2 (**permalink**) 06-19-2009, 07:35 AM

can u try a half unit change instead if morning numbers rise again? did u test through the night?...make sure it is not a dump to recover from a low versus a continuous rise...i'm not at all familiar with using nph, so disregard any info if it doesn't apply!!

e||ement · #3 (**permalink**) 06-19-2009, 07:43 AM

good idea on the half unit change, i will try that

i have tested through the night previously...and i'm definitely not going low.

also, the fact the the 9u dosage gave me beautiful morning numbers leads me to believe that it's not a liver dump with 8u.

maybe that half unit will be the right balance...

here's a supplementary question: if you increase your basal that slightly, do you typically have to adjust your I:C or should it be the same?

jenb · #4 (**permalink**) 06-19-2009, 10:42 AM

I use Levemir and was having a problem similar to yours. I did a lot of testing and decided that the duration of action was only about 8 to 10 hours with the amount of basal I use. I now take 3 doses at 8 hour intervals: 8.5 u @ 10:15 p.m., 6.25 u @ 6:15 a.m., 3.25 u @ 2:15 p.m.. This seems to have flattened my blood sugar levels pretty effectively.

No change in I:C ratio.

Jen

lorilei · #5 (**permalink**) 06-19-2009, 12:25 PM

you may find that you use a little less rapid in you tdd if your starting number is more on target...but you do this through your normal ratio..just less likely to need a correction too...once you get your basal down you are much less likely to have to chase highs and subsequent lows with your rapod