Does everyone sugar level rise when they miss basal insulin

hi guys i want to ask everyone who is diabetic type 1 if you guys miss your basal insulin does ur sugar level rise iv been trying trying to figuire out but it seems my liver isnt dumping glucose when my basal insulin runs out iv been fighting with my doctors they say they think my body is still producing insulin which i highly doubt i know when i eat my sugar rises but i need insulin to make it come down but because i carnt get my basal right its make it impossible iv done basal testing it doesnt really work as my sugar wont move even if i put basal higher or lower

Can only go from personal experience. T1D for 50 years and just had a kidney transplant so had to start from scratch figuring out new basals, boluses, etc.

You are right that we have no control over how much sugar the liver produces or when. We only hope it produces it systematically, the same amounts at about the same times each day. Hence we come up with a series of basal rates.

If I give myself a bolus and it never appears to lower my BG that is probably because my basal is too low and as a result your BG is rising because your basal is too low but at the same time your BG is dropping from the bolus even if you can’t see it on your CGM.

Try to get your basals right one period at a time. It is best to do this after fasting. If your BG is rising your basal is too low. If your BG is falling your basal is too high. You want you BG to be about the same if you have no bolus and no food but only basal insulin in your system.

Took me a while but I finally got my basals close to being right and now I can see boluses working as expected. I’ve stopped trying to figure out an unexpected high or low because that is probably as result of the liver producing too much or too little sugar for which we have little or no control moment to moment.

Good luck.

As a Type 1, I’ll die at some point without basal insulin (and of course, assuming no boluses!). So, “yes” my bg will rise w/o basal. It rises at night, so my pump provides a larger basal rate during the night than during the day. It also rises when I get up.

Type 1 for 27 years, and yes, if I forget a basal dose or have my pump disconnected for more than about an hour, my BG rises quite sharply. It sometimes eventually levels out at 300-500 mg/dl, but won’t come down on its own without a big correction (often is very slgugish in coming down if caused by lack of insulin).

I use a pump which uses short-acting insulin for both bolus and basal and therefore do not have a long-acting insulin in my system. If I have an insulin delivery problem or just go without my pump for a couple of hours, my BG would soar and go up a couple of hundred points in 3 or 4 hours.

If you take a long-acting insulin (Lantus, Levemir, Tresiba, etc.), you still have some insulin action even if you miss your injection by a couple of hours. Tresiba might even cover you for another day.

If you want to get an idea of whether you are producing insulin, you should ask your doctor to run a c-peptide test.

1 Like

Yes, my glucose does rise when my basal insulin is under-dosed or absorption is impaired. As @Laddie said, whether you use a pump or take a separate long acting basal insulin will make a difference in how this insulin deficit presents.

When my short-acting pump-delivered basal insulin is interrupted, I see a long march upward in my glucose. It’ll take a lot more insulin to correct that high compared to preventing it in the first place. Since long-acting basal insulin has a long tail of action, the effects on blood sugar levels may be delayed.

It’s my understanding that basal insulin (whether short acting pump delivered or long-acting delivered via pen or syringe) is intended to metabolize the glucose output of the liver, nothing more or less. Mealtime bolus insulin is meant to counteract the glucose effects of eating. In the real world, the line between basal and bolus insulin is blurred but it helps us to think about their separate roles when we dose insulin.

When I was on once-daily Lantus, I still found that my blood sugar would rise quite a bit (hundreds of points in mg/dl) within a few hours of forgetting it. This wasn’t the case on twice-daily Lantus. And on Tresiba, I took a dose 7 hours late once and stayed flat during that time.

1 Like

I would also agree type 1,no basal insulin, blood sugar will go up. I have been pumping for a long time so it’s been awhile since I used a basal insulin. But I will say the few times over the years when I had infusion set issues (kinks or not snapped in correctly) it only takes a few hours before those horrible high blood sugar symptoms start.
Couldn’t say if you are still producing insulin, but there are tests that would tell you that.

Yes,

T2 here, but if I miss the basal insulin or take a reduced dose (like I need to go pick up the refill that day) my blood sugar shoots up.

Yes I take mine at night Tresiba and if I miss my sugars are really off the next day. It last the 24 hours lantus never lasted the night