A question that nobody solves me !!

I am Type 1 and every time I ask an endo or diabetic partner the following, he looks at me with a rare face:
The rapid amount of insulin you click has something to do with the amount of slow insulin you take?
That is, suppose that a person is punctured 18 of slow a day, and quickly 10 at breakfast, 5 in loan and 8 at dinner (hypothetical case).If one day he eats more at breakfast and click 12 fast, is it expected that slow insulin does not work so well for the rest of the day, having to increase it too?Or on the contrary, slow insulin only depends on the body weight and the patient's abdominal fat?
I have read some articles that say that basal insulin should not have any hypoglycemic effect ever, always keeping glucose stable even if you jump a meal.In fact, they say that the way to prove if your basal insulin is correct is skipping a meal and checking if the glucose remains stable.Is that true?

It's true.Do not confuse basal insulin (Lantus or Levemir) with the rapid.Basal insulin serves to maintain glucose between meals.If it is well regulated, we should be able to spend a whole day without eating and without having low.Fast insulin serves to cover the hydrates of each meal.That is why we need to put insulin every time we eat.Basal-bolt therapy imitates the functioning of healthy pancreas.

Thank you!!Graaaciaaaas !!Finally someone clarifies it to me.

By the way, based on that ... I think that many people, most types 1 that I know - especially those who take many carbohydrates in their meals - have the very badly tight basal.:/

At night only the basal acts and that is when its adjustment is best seen.

But then, I don't understand why they can give the hypos at night.For example, I get 7 of Novorapid for dinner about 22.00 and 14 of Lantus before bed at 24.00.According to my educator, the novorapid only has an effect of about 3 hours, then it is already in a fall layearly morning?Adding that normally before bed I have to take 1.5 rations.

I think you are wrong, without encouraging.Basal insulin does not serve to maintain glucose between meals, nor to act at night.

Basal insulin, which does not even have to be nocturnal, is an extra slow insulin that can last from 8 to 20 hours (generally).

It works between meals and between non -meals.That is to say if it lasts 8 hours and you put it at noon, it will last you until 8 in the afternoon, it does not matter or that you do not eat, the insulin will work the same during all those hours (and most of them do not have action peaks.

And what is the basal for?As you know, insulin is like a key.The brain, muscles, cells ... all that needs energy in the form of glucose to work, but they cannot get it because their door is closed, so insulin is responsible for opening that door so that the glucose of the glucose ofBlood becomes used by cells.

And this, neither more nor less is it for that, to allow the body to use blood glucose for its functions.From there you don't eat for 2 days, you will have hypoglycemia.Because all that glucose is used thanks to the slow.

That is, it is not to keep the glucose between meals (Ponte 100 de Levemir and you will see that glucose you will maintain ...- Do not do it-) nor "at night only the basal acts", because the basal works when youYou put it.And if you want you can wear ultrarapide bowling at night.

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And regarding your question, a advice before, you have said "abdominal fat."The slow one should not put it in the abdomen since that area is of rapid absorption, it is exercised and that you nose, that site should reserve it for the ultrarapids.Check the punctured or teaching you the diabetes educator, but you should put the slow one on the gluteo.

That said, your question.Read this: Link

And yes, the basal is hypoglycemic for what I have already explained, what happens is that by skipping a meal nothing happens to you.And if it happens it is because you have too much basal.

I believe that basal insulin is what our body needs when the pancreas is not stimulated ... that is, to live you need to maintain a certain insulin level, that in healthy people the pancreas is gradually releasing, regardless of whetherEat or not .., that is, if you did not eat in 24 hours you would need basal insulin ... in people with type 1 diabetes that insulin needed to live is administered by slow insulins (lantus, less less) if the therapy is with multiple injections, or by insulin pump, with fast insulin (Humalog, Novorapid, Apidra) constantly released over 24 hours.
The problem is that there are a thousand factors that affect our glycemia levels, starting with absorption and ending by any intercurrent disease ... So the most complex task is to perfectly adjust insulin doses.In theory, slow injected insulin (Lantus) produces a flat effect ... but it is pure theory, it is known that it has a peak of action within a few hours of putting it.Apart from that it does not work for everyone in the same way, theoretically lasts 24 hours, but it is shown that it is not always the case ... apart from the fact that the needs of that basal can also be different throughout the day.
@values, you can have a low at night for several reasons:
Coincidence with the Pico de Lantus
Excess of Lantus, if you are getting a higher dose than you need.
Intense exercise previous (even a few hours before)
Excess bolus (fast insulin) at dinner.The rapid impluine does not last 3 hours and already ... its maximum cmienza effect approximately 45 minutes to inject it and lasts up to 1 hour later, but the total, variable action for each one, can reach 4 or 5 hours...

If you have hypos at night, you can go better by putting Lantus in the morning, because, in its last hours, the Lantus acts less, and matches you the hours you sleep.
Farstar, I understand that the basal is needed to control the glucose that continuously releases the liver, although you do not eat anything.
And, at night, only the basal acts when you do not eat or get fast, of course ..

You say that basal insulin is needed to control the glucose that releases the liver, and it is just the opposite.If your cells cannot take the glucose of the blood due to lack of basal insulin, they will demand that energy and the pancreas expel glucose in small quantities for dars it (rebound effect when they are serious hypos)

But how will the glucose pancreas explode?Glycogen is deposited in the liver.I don't understand anything you tell me

As??Basal insulin has to be always ... neither lasts 8 hours nor 2 nor 24, depends on the insulin that you inject.The important thing is that there is always an amount (more or less constant in the body) a healthy pancreas works like this and we have to get our insulin pattern to look like that.What is the basal insulin for?To maintain constant blood sugar.When fat is burned to get energy, it becomes part of hydrates, there are hormones that increase blood glucose (the growth hormone that soles makes in adolescents) glycogen that free the pancreas releases the glucose deposits of the liver ...

The greater the patient's weight or the lower the exercise, the greater the amount of basal insulin that is needed.Basal insulin is different from ultra -e over insulin.If basal insulin is well regulated and flat (Lantus, Levemir or insulin pump) it should not be necessary to eat.The problem of not eating, is that more fats are burned and the need for basal insulin increases.(Prolonged fast)

It is very dangerous not to prick Basal insulin, one of the biggest risks of the pump is an object and being a few hours without basal insulin.It has happened to me, and it is one of the most unpleasant sensations that I have had in my life ... I noticed that I lost knowledge, my body all I wanted was to sleep ... You can't get the needy energy of glucose andIt begins to burn fat producing ketone bodies.In very serious cases, you can reach ketone coma (or diabetic coma)

I laid Regina: P I talked about the liver.The pancreas does not expel glucose, not xD but as Tica says, the basal is needed to transform into energy all that glucose that manufactures the body by itself, which increases the less basal you put yourself

The control of Lantus

Notmy said:
I am type 1 and every time I ask a diabetic fellow the following, he looks at me with a rare face:
The rapid amount of insulin you click has something to do with the amount of slow insulin you take?
That is, suppose that a person is punctured 18 of slow a day, and quickly 10 at breakfast, 5 in loan and 8 at dinner (hypothetical case).If one day he eats more at breakfast and click 12 fast, is it expected that slow insulin does not work so well for the rest of the day, having to increase it too?Or on the contrary, slow insulin only depends on the body weight and the patient's abdominal fat?
I have read some articles that say that basal insulin should not have any hypoglycemic effect ever, always keeping glucose stable even if you jump a meal.In fact, they say that the way to prove if your basal insulin is correct is skipping a meal and checking if the glucose remains stable.Is that true?

Hello good morning notmy, I wanted to provide you with my information, and that is that the lantus must monitor every 2 - 3 days, if your sugar level is still high (for example if you put it at dinner, the answer you have at breakfast), Then you go up 2 units and if it is hypoglycemia you lower 2 units.I have seen for some issues that were put up to 15 units of fast!It's beastly!This is not!Ideally, get 7 - 8 or less.

My father is 52 years old and is diabetic since the age of 22, that amount was more or less put and this summer was in the hospital because he raised the fever and discovered being admitted to the 3 days that it was because his body did not have the necessary insulinIn his body and acetone was generated, in the end they took 32 units of Lantus to 42!after 4 days higher hospital and with a quick dose of 2, 3, 4 units depending on the sugar level.

It also depends on your lifestyle clearly.

I hope it has been helpful, or clarification.All the best.

Look, I just use Lantus in the morning, 12 units, and with that I control myself all day.With ma food and exercise I keep it

I am currently with 10 of Lantus before dinner, metformin and sitagliptin at breakfast and dinner.Exercise and diet (1750 calories).The truth is that I cannot complain, I am not doing badly ... I have managed to lower the glycosilada from 10.60 to 6.40 in three months.Good numbers for all.

It has nothing to do.If you pass in the food you have to climb the fast and the slow to leave it the same.

In a very gross way and simplifying a lot, there are 2 sources of glucose in our body:
1) Our warehouse the liver ---- we metabolize with slow insulin
2) Food ---- We metabolize with fast insulin

The liver releases glucose throughout the day and that is why we need basal insulin, to metabolize that glucose.Why does this?Because our lungs, brain, heart ... do not rest and need gasoline.

Why can a hiccup occur?Because even if our slow insulin is very flat, our liver may not release that glucose flat.Hence, for example, in the basal of insulin pumps we do not normally have the same insulin units per hour throughout the day.

When we eat, we need rapid insulin to metabolize that glucose we eat.

Very interesting.I use twice a day to let's be bassal and give me hypos the days that I ceno suvito (fish and vegetables) at 4 hours of putting the levemir.I do not do sports abusing that in summer the blood glucose is low and I allow myself not to lunch my snack.Winter touches the full set: 5 meals plus sport to have acceptable values.
The basal can produce hypos and although well adjusted in the end you have to eat, you cannot make prolonged fasts

Glanes said:
I have managed to lower the glycosilada from 10.60 to 6.40 in three months.Good numbers for all.

HallucinoI understand that to get that you have to change many things (medication, diet, exercise ...), but could you comment a little how have you done it?Thanks and congratulations.

Albertot said:
Why can a hypo?Because even if our slow insulin is very flat, our liver may not release that glucose flat.Hence, for example, in the basal of insulin pumps we do not normally have the same insulin units per hour throughout the day.

Related to that, when drinking alcohol the liver takes preference to metabolize it and almost does not produce glucose.Meanwhile the injected basal insulin that we have continues to work at full performance.

Also if you inject glucagon does not work while you are metabolizing a lot of alcohol.