Background insulin (BI)

A lot of people seem to be having issues with the background insulin.
The recommended amounts are based on your body weight; a simple calculation can give you a starting point.
Please remember if you change the BI amounts you will need to test regularly, no seriously you need to.
I’ll use an example from me that I used recently.
I weighted myself on a Wii
My weight was 73.66 kilos or 11st 6lbs

Dafne recommends you need 0.5 – 0.8 insulin per day half being for food intake the other being BI.
So 73.66 x 0.5 – 0.8 is
I’ll give the whole range.

1. 73.66 x 0.5 = 36.8317 / 2 = 18.41585
2. 73.66 x 0.55 = 40.51487 / 2 = 20.257435
3. 73.66 x 0.6 = 44.19804 / 2 = 22.09902
4. 73.66 x 0.65 = 47.88121 / 2 = 23.940605
5. 73.66 x 0.7 = 51.56438 / 2 = 25.78219
6. 73.66 x 0.75 = 55.24755 / 2 = 27.623775
7. 73.66 x 0.8 = 58.93072 / 2 = 29.46536

Before Dafne I was taking 40u of BI (Lantus) once a day at 5am
During the course this came down to 33u which gave me a constant BG during a Carb free meal period which was from my breakfast at 5.30am until 5pm.
I had a recent visit to the hospital which I was told I couldn’t eat any CP or take QA insulin for over 24hrs a long time.
I had a test run 1 week before I went in, I had to stop when my BG fell from 10.2 to 4.2 during the night, the fall was too great to continue.
The question I asked what caused this, with not taking any CP and QA it could only be the BI, but why?
It had been steady since the Dafne course even at work, was it the DP or stress, may well be, but I’m the person who deals it facts not unknown’s, what could have changed to make the BG go low?
I looked at my diary, nothing there, until my daughter said” how did the run go, you’ve lost some weight around your face”.
I checked my weight before Dafne it was 12st 2lb, it was now 11st 6lb, so something had changed.
A quick check in the Dafne notes and on the internet, yes weight is a factor with BI amounts.
You’ll note I took 33u,
Looking at the table above: the closes to that was the 0.8, at 29.46. (30U).
I decided to drop to 30u and keep a check on my weight; in fact I stopped running that week.
The procedure went smoothly with me having small issues only.
Setting your BI depends on your Body (you) that means your lifestyle over the years I.ve played about with the BI up down I’ve tried it.
It’s a case if you don’t have a regularly life style it will change weekly, Dafne helps here.
The above may help those who wish to find the Ideal amount quicker instead of waiting week’s when you have a changing lifestyle.

It’s not perfect but it’s a good starting point.
The BI is for how your body works
QA is for food intake.
Your comments are always welcome
A good idea isn’t always perfect, but can be if discussed
Regards Brian
Type 1 42yrs

thanks for that Brian.........

after years of MDI, most folk should be in the habit of testing their BI every 2-3 weeks......

At the moment i take my evening levemir when i am going to bed which would be between say 10pm - 11pm and then my morning one at around 10am. Would it make any difference if i started to take it at 6am when i get up?

Please and thanks.

Hi

I've forgotten to take my BI this morning! I normally take 14u of Levemir. Any ideas how I can control my BG until I get home? Was hoping for an increased ratio of QA??

Cheers

I would think it would just be a case of correcting as the day goes by........

Do you have a blood glucose monitor with an on board insulin function.....this would allow you to check your BG while there is still carbs and insulin working and correct safely, if the meter thinks you need to.

Hi No I don't have that type of meter unfortunately. Thanks for the reply.

It can be done manually of course, but I think boring you with that is unnecessary for the moment.......

you could maybe try adding on 5% QA on to your meal time doses.......however, this might not be enough, or maybe too much....

professional advice may be needed.........

I have done it before, but I just went through the day a little higher than normal.....

Rafa said:
At the moment i take my evening levemir when i am going to bed which would be between say 10pm - 11pm and then my morning one at around 10am. Would it make any difference if i started to take it at 6am when i get up?

Please and thanks.

Rafa said:
At the moment i take my evening levemir when i am going to bed which would be between say 10pm - 11pm and then my morning one at around 10am. Would it make any difference if i started to take it at 6am when i get up?

Please and thanks.

Carolin said:

Rafa said:
At the moment i take my evening levemir when i am going to bed which would be between say 10pm - 11pm and then my morning one at around 10am. Would it make any difference if i started to take it at 6am when i get up?

Please and thanks.

Hi Rafa,

The DAFNE guidance is that for twice daily BI you take one dose as you get up in the morning and the other dose as you go to bed at night; as long as these doses are >7hr apart any overlaps in action should not be a problem, and in fact the overlap that will occur in the morning is beneficial in controlling the Dawn Phenomenon.

Good Luck,

Carolin