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RE: [IPk] Constant basal requirement?


 I don't know if its common or not. I try not to alter the Insulatard on a daily
basis but if I knew that
 Sasha had been a lot more active than I had expected I would reduce the dose
and it would certainly
 effect that night. If we didnt reduce the dose we would be feeding the insulin
all night. Usually I do
 alter it when the spring comes and I know that the twins are going to be out
most evening. Then when the
 nights draw in I increase the dose. The year before last when we when on
holiday the weather was wet
 and damp and so in the evenings the twins were inside much earlier than they
would have been back at
 home, we spent most of the holiday getting up in the night to give extra short
acting and then checking
 later because her levels were going so high during the night. We didn't realise
until months later that
 it was because the evening Insulatard was set too low for staying indoors. It
only amounted to about two
units more or less but made a huge difference.

 I am not sure what effect is would have if you increased the dose for a few
days to cover your periods I
 can only suggest if its predictable that it might work. But maybe only if you
give the insulin in a
 split dose. It is right that you shouldn't alter your long acting insulin on a
daily basis and I don't
 change the daytime one just the evening and that seems to work that night and
the next days levels are
just as predictable as normally which of course isn't always very predictable.

 I have found that the Lantus does take a long time to change. If you increase
it you need at least 3
 days to get a good effect and when you decrease it take a lot longer to make
any difference. You
 certainly wouldn't detect a difference in the same way as altering the NPH.
Well in my limited

 Perhaps you can see if anyone else does this and make a temporary alteration to
the evening NPH. Maybe
it only works if you take the majority of NPH in the morning.


> > How did split dose insulatard work? My diabetes centre originally had
> > this
> > and not lantus as a requirement for doing the DAFNE course on the
> > basis that
> > it offered more flexibility becuase you can alter the doses of the
> > morning
> > and night insulatard.
> Is this common?  My DSN has told me not to alter my Insulatard dose
> more often than every three days, with the result that I don't alter it
> at all unless I think it needs changing permanently.  This is a pain
> because I quite often need extra insulin for a couple of days - before
> my period and at other times, sometimes for no reason that I can see.
> So I just increase my other insulins and that covers my extra need for
> most of the day - for the night, I omit my bedtime snack.  However, I'm
> finding that with the Novorapid it doesn't work so well - if I take
> more than I need for the food, I go hypo later in the evening and am
> still high at bedtime.  If I don't take extra, I'm just high.  And even
> though I skipped the snack, I'm still high in the mornings - if I do
> eat the snack, I'm even higher.  So it would be really helpful to be
> able to change my basal insulin temporarily.
> Eleanor
> (b. 1977, dx. 2002, Actrapid x 2, Novorapid, Insulatard)
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