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RE: [IPk] Constant basal requirement?

When I first went on a pump I started on a constant basal and stayed on in 
for about 1.5weeks and it sort of worked but a quite widely varying basal 
works so much better for me. I can't help thinking that lantus is just more 
predictable. Alternatively the people it works for have varying levels of 
insulin provided by lantus (assuming it doesn't provide an absolutely rock 
steady level in some people) and this just happens to fit well with their 
insulin requirements over 24h.
I also split my insulatard in to 2 doses, morning and night, which does 
improve flexibility, but certainally didn't solve the problem of 2am 
hypoglycaemia and 7am hyperglycaemia. The pump works though :) just wish I 
could persuade my PCT to fund me...
DM 7years (yesterday!), pump 7months

--On 22 July 2003 10:41 +0100 Jackie Jacombs <email @ redacted> 

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> 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!
> Jackie
> 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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