i’ve become very curious about basal insulins for those of you that do not use a pump (for whatever reasons). i am asking b/c i want to figure out a saftey/back-up plan should my pump go on the fritz. i only use Novolog in my pump, so i do not use any long lasting insulin, only fast acting.
so, what is your prefered basal insulin and why, and, how do you use it (twice a day? once a day, etc)
also very curious about how many shots, on average, do you give yourself each day and why and when.
looking forward to hearing back from all of you MDIs out there.
@daisymae, I have used both Lantus and Basaglar. They work the same way for me, pretty well.
I was on MDI for 1.5 years, until August 2017. I found that it works better for me to split my dose morning and evening. If there is an odd number of units for 24 hours, I use the larger injection for the night.
I think I get a small peak about 2 hours after I inject.
I haven’t tried any other basal insulin. I am waiting to try Tresiba when swimming season is off.
I forgot to write my number of shots. I do a lot of small corrections, so I bolus a lot. On bad days I might bolus 20 times. On good days I might bolus 4-5 times.
Tresiba, I consider it lightyears ahead of anything else. 1x daily. It’s long action makes it an extremely smooth profile and extremely forgiving about how/ when you take it, and for me i don’t have much trouble with physical activity with it that I did with Lantus.
The number of bolus shots can very hugely… maybe from as few as 2 to on the worst days more than 10… but that’s rare i’d say on a typical day 4-5
I use Lantus 2x per day (currently 730 am & 4 pm). I’m switching to Tresiba soon. I was hoping I’d get it in the mail today! Looks like it’ll be tomorrow.
I use Humalog as my fast acting insulin, and I do quite a few bolus shots throughout the day. Probably 5-8, depending on the day.
Until I started pumping I used NPH, Lantus, and Tresiba each in turn. Of the three I disliked Lantus, was doing 2x daily to even out the spikes. NPH is a roller coaster, and Tresiba is a dream come true! Tresiba lasts ~38 hours in my body, has not discernible spike and doesn’t stack. Giving up Tresiba is my only regret when I started pumping.
I could create a thread. I think Jen’s basal needs may vary a lot more than mine do. My strategy is to start with 25 units of Tresiba per day for 3 days, and then increase or decrease my dose depending on how my blood sugar levels look (with an emphasis on overnight levels). I’m hoping it will be relatively straightforward
I do pretty well on Lantus overall, but I have some trouble with lows at night when I’m swimming regularly. Eric gave me some pretty great suggestions on how to address that, so I’m hoping that won’t be a problem on Tresiba. We’ll see.
Tresiba, presntly 19 units daily in AM. So far I am happy with Tresiba. My basal is tuned in for moderately strenuous daily activities. Hard to define that, but it means if I find myself sitting a lot for a day or more (long drives, vegging out at computer or TV, etc) it becomes obvious that my basal is not keeping up on those inactive days. Number of daily Bolus varies from 3-5 on active days to a max of about 8 on inactive days (lots of stacking to correct rising BG on those days.)
Based on your basal amounts (from when you were swimming two months ago), your swimming schedule, and your weight, these amounts and this schedule would be a good starting point. A little bit of fine-tuning would be needed, of course.
This allows you to have zero basal for swimming (with just a bit of remaining IOB to cover your basal metabolism). And it allows you to switch from swimming days to non-swimming days very easily.
I also have a write-up for your use of Lantus, but that is a bit trickier because Lantus duration is not as predictable as Levemir duration. (Based on your weight and dose, Levemir would last about 12 hours, which makes it easy to use for zero basal exercise).
If you are not going to swim, Tresiba might be worth looking into. But I am assuming you want a plan that includes swimming.
With Levemir
On swimming days:
8am
breakfast (with normal bolus for food)
11am
swim
1pm
finished swimming, take 4.5 units of Levemir, and also the normal NovoLog dose for post-workout carbs
10pm
7.0 units of Levemir
On non-swimming days:
10am
5.0 - 5.5 units of Levemir (depending on how long it’s been since your last exercise day)
10pm
7.5 units of Levemir
With Lantus
On swimming days:
8am
breakfast (with normal bolus for food)
11am
swim
1pm
finished swimming, take 8.0 units of Lantus, and also the normal NovoLog dose for post-workout carbs
On non-swimming days:
8am - 10am
4.5 units Lantus (just whenever you wake-up)
8pm - 10pm
5.0 units Lantus (about 10-12 hours apart from your morning Lantus shot)
Both of these options would give you close to zero basal for swimming, with Levemir being closer to zero than Lantus, and also giving you better coverage the rest of the day with minimal down-time.
Of these two option, Levemir would be my first choice for you.
Happy to clarify any info you want.
Betcha some Junior’s these amounts are within 0.5 unit of what you would need.
Once you get your basal tuned correctly, the number of shots you need on MDI will be about the same as the number of boluses you need on a pump.
this sounds awesome. i will also discuss this plan with my endo. thanks for going through all the work! i will download it and have it handy at my desk (which is where i keep everything of any importance )
