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RE: [IPk] Constant basal requirement?

Jos wrote:
> Does anyone here have constant basal insulin requirements
> or know of anyone that does? The impression gained from
> reading this and other lists is that everyone has variable
> insulin requirements so insulins like Glargine are only
> useful in so far as we can more reliably predict when an
> extra snack or extra insulin is needed each day.

 I expect there might be a few somewhere who find a constant basal rate works"
most" of the time but I
 don't suppose there are many. We are still having loads of problems with the
Lantus dose and getting
 worse levels than on NPH. Plus, because Sasha's Insulatard was a split dose,
morning and evening if she
 was very active during the day and early evening we could lower the evening
dose of NPH now we are using
 once a day Lantus we are stuck with the same dose. Sasha is also waking up with
higher levels than she
 was on NPH. She is nearly always nearly 9.0 mmols by 7.30 where as on NPH she
was more frequently around
4 to 7mmols.

I did two hourly test the other night and these are the numbers

8.8 mmols at 10.15pm

6.2 mmols at  12.00

4.00 mmols at 2.30am (gave 5 carbs milk in case she was dropping too low.

5.7 mmols at  4.00am

8.9 mmols at 7.45

 We give the Lantus in the morning. I am worried that if we increase the Lantus
that Sasha would go too
 low in the early hours. I think these are similar figures to those you got with
Emily. Though this was a
 good day getting only 8.8 mmols at 10.30 as we have had more days when she is
more like 12 mmols at
11.00 pm!

 The other thing is I think that we might be under dosing with the Lantus
because we are seeing rises in
 the evening towards our bedtime even when the meals appear to be covered
correctly by the Novorapid but
 the trouble is we are sometimes getting lows after meals and sometimes highs.
Also yesterday we went to
 the park for a hour or so and Sasha bg was only 4 mmols before setting off. So
I gave a 8 carb ice cream
 before we left and despite beginning moderately active (not as active because
we had to shelter from the
 rain for a while) when we got home her BG was over 15 mmols. But as we are
sometimes seeing a drop to 4
 mmols in the middle of the night I am concerned that increasing the Lantus will
cause hypos which is one
 of the reasons why we switched to lantus in the beginning. My life seems
consumed at the moment with
testing and trying to puzzle things out.

 I think I might have to switch the Lantus to the early evening then if it has a
six hour peak it will be
 gone before the middle of the night. Also it is very hard to work out what is
happening during the day
 as we are obviously dosing with the Novorapid and if the Lantus dose is not
spot on all these other
boluses are not going to work out right.

 Sasha was 8.8 at 7.45 this morning and we gave 4.5 units of NR at 8.00 am now I
have just checked her BG
and it is 12.00 mmols!

Mum of Sasha aged 9 weight 28 kl 62 lbs

11 units lantus at 8.30 AM

average 11.5 of Novorapid during day
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