Basal Testing -- What did I learn?

OK, I did a little basal testing this afternoon. I know I am running too high ALL the time. I’m working on it.

Anyway, here are my numbers from an afternoon of testing and not eating:

8:18 a.m. - 247 mg/dl upon rising; injected 55 IU of Lantus

9:40 a.m. - Corrected BG with 10 IU Novolog plus 20 IU Novolog to cover my breakfast, 30 IU total. I eat slow, so my last bite of breakfast was at 10:30 a.m.

2:39 p.m. - 258 mg/dl (+11 from my pre-breakfast level – essentially back where I started four hours after last bite of breakfast)

3:55 p.m. - 293 mg/dl (+35 from an hour and half ago? five and a half hours after eating? why? delayed digestion of protein/fat? delayed gastric emptying?)

4:56 p.m. - 262 mg/dl (-31 from an hour earlier? hours after last bolus? what brought me down? my own insulin?)

5:32 p.m. - 243 mg/dl (stabilized seven hours after last bite of breakfast)

8:26 p.m. - 244 mg/dl (still stabilized ten hours after last bite of breakfast)

I finally started eating again at 8:30 p.m.

So what did I learn? I learned that my bolus of 30 IU of Novolog was enough to get me back to where I started, but not enough to actually correct my high BG. I had a hard-to-calculate breakfast. Next time I test, I should get something pre-packaged, like Greek yogurt, or that I can weigh on my food scale, like berries. Or two boiled eggs. Something I can be more sure of when I calculate my bolus. Leftovers are a nightmare to guesstimate.

I learned that I had a delayed rise (up 35 mg/dl at 5-1/2 hours after my last bite of breakfast) and that apparently my body put out a little insulin and brought it back down, because the Novolog should have been long gone at that point.

I learned that my bolus may be just right, as it held me fairly steady between the 6-1/2 and 10 hour marks post-prandial, changing no more than 18 mg/dl between 5 p.m. and 8:30 p.m., with no Novolog or food on board, just water.

247, 258, 293, 262, 243, 244 – how do I get these down below 140???

I learned that I MUST start walking more – and losing weight – my insulin resistance is acting up. I should have been at least 100 to 150 IU lower the entire day, across the board. Yes I’m doing better than when I was hovering between 280 and 350, but I’m still ridiculously high all the time. I need a HUGE attitude adjustment on the subject of exercise. I need to walk briskly a minimum of one hour per day, plus weight training, crunches and stretching.

Darnitol, JeanV – JUST DO IT. (Now where have I heard that before?)

A few thoughts (which you most likely know already)

Corrections are less effective (per unit) at higher numbers.

Lantus’s profile is not actually very flat in some people. Even the averaged graph has a mini ‘peak’ of activity around or after 5 hours. Worth considering if you often see a dip at around the 8 hour mark when basal testing.

Are these numbers typical at the moment, or have they got drastically different recently. I’ve recently has an experience with insulin storage at the back-end of a box of lantus carts where it became substantially less effective.

Hope the plans for increased activity/weight loss go well :slight_smile:
M

Thanks M,

I don’t think it’s the insulin – I think it’s me. I have been struggling for some time.

One day insulin will send me hypo. The next day it’s like I just injected water.

Case in point: I ate too much this evening (didn’t calculate correctly). I tested almost five hours after dinner and my BG was 358 mg/dl. Eeeek, right? So I injected 20 IU of Novolog. I tested again an hour and a half later (now 6.5 hours post-prandial) and my BG was 363 mg/dl. Since that’s within the range of error for a meter, let’s just say it stayed exactly the same – after injecting TWENTY UNITS of Novolog.

This is not the first time that injecting even a huge dose was like injecting water. I even split the sites: I injected 10 in one site and then 10 in a different site, to maximize absorption. Didn’t matter.

Another time (this really happened) I woke up after hours of not eating and my BG was in the low 140’s. I injected my normal morning Lantus, checked my e-mail, sipped some water, and BAM I went hypo and tested at 36. I dropped over 100 points in an hour just on Lantus (this was before we even added the Novolog.)

Why would Lantus drop me like a rock, and 20 units of Novolog be like water?

It has something to do with all my other hormones, I’m sure: thyroid, adrenals, ovaries – they’re all screwed up.

It also has something to do with exercise – I’m a slave to it now – if I don’t exercise, my insulin resistance gets really awful very, very quickly. If we could measure insulin resistance directly like BG’s with a meter, then my “insulin resistance factor” would double in a week without exercise, and quadruple within two weeks without exercise. It’s very, very striking.

If this is not a regular day, meaning that your bs is not always >200, you should try a new vial.

It happened to me that my NovoRapid didn’t seem to work at all, no matter how much I injected. Then, when I took a new vial, it suddenly worked as it normally does.

If this is, in fact, a “normal day”, talk to a doctor/endo/whoever you use to see.
There are many possible reasons for a day like this. Wrong dose of insulin, wrong calculation of carbs, wrong carbs/insulin ratio, wrong place of injection, even wrong kind of insulin. Not every insulin works in the same way for everyone.

I don’t know how much carbs you ate but those numbers look huge to me! If I ever injected 20 units at a time, I’d had to eat a whole pot of spaghetti or something, no matter if my bs was 200+ or 100.

“Why does lantus drop you while Novalog does not”:
Lantus DOES this. Happened to me, too. Actually, Levemir drops me, too - but I hope I’ll figure out the best dose soon. It’s still a bit of guesswork since I only recently started on levemir.
Well, back to you: those two insulins work differently. If you have a high bs, your body can become a bit resistant to short acting insulin (but it rarely does to lantus) and you need more to bring your bs level down.

As said, I’d suggest that you talk to someone professional, if this is not an exception.

Check for ketones, you may need additional insulin to counteract a buildup of ketyones from the high readings.

Lantus has peaks. Good plan to divide the bolus shots. Sorry that didn’t help. When I start out high, it’s an uphill battle for the rest of the day.

Thanks for the help, y’all. On keytones: I’ve never tested before. Would you believe I bought some test strips and they expired unopened. I never remember when I’m high. I need to buy some more now that I’m back on insulin.