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RE: [IPk] basal cover on glargine/ humalog

My hospital has now changed the DAFNE guidelines so you can be on glargine
instead of twice daily insulatard

-----Original Message-----
From: email @ redacted [mailto:email @ redacted]On
Behalf Of Abigail King
Sent: 25 April 2003 16:30
To: email @ redacted
Subject: [IPk] basal cover on glargine/ humalog

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how easy is it to prevent a rise in bg due to higher basal needs at certain
times of the day by giving a bolus of short acting before this rise occurs?
imagine it would be safer to do this with the predictable action of glargine
then the unpredictable effects of insulatard. I remember being on mdi with
insulatard once daily and humalog befroe meals and I was giving huge doses
humalog with my evening meal : bg was high pre evening meal and usually
high before bed. It seesm very difficult to correct an already high bg with
short acting analogues unless you already have accurate basal coverage: the
short acting otherwise sems to hold bg constant due to increase in bg
increasing insulin resistance I expect, But surely injecting it before the
rise would be reasonably effective

I wonder whether DAFNE courses still favout twice daily insulatard or
they use glargine more. Or does it depend on the patient and what they are
already using? Does the course take into account varying basal needs at
differet times of the day
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