3614-BD Insulin Adjust Workbook

ADJUSTING THE BASAL INSULIN DOSE
Adjusting the basal dose is more
challenging than changing the bolus
dose. Basal insulin is designed to always
be working in the background to keep
your blood glucose steady when you are
not eating. The basal insulin has the
major job of keeping your blood glucose
normal during the night, if you do not
eat or if you delay a meal. Insulin used
to provide a basal dose include Lantus ®
and Ultralente insulin and the basal
setting on an insulin pump. This section
will help explain how to make changes
to your basal insulin.
Testing the Nighttime Basal
Adjusting the basal insulin is done
much less often than the bolus insulin
corrections. The best way to check your
basal insulin is to look at your nighttime
and morning glucose readings first. It
is easier and more important to be sure
that the basal is correct at night, since
you may be hypoglycemic (have a low
blood sugar) at night but not know it!
Many people become less sensitive to
insulin between 3 AM and 7 AM. As
a result, you could have a high blood
glucose value when you wake up in the
morning or you could have a low blood
glucose level in the middle of the night.
How to Test and adjust The Basal
Insulin To Normalize Your Morning
Blood Glucose
1. Check your blood glucose at bedtime,
at 3 AM and in the morning before
you eat.
2. Pick a day when your bedtime
glucose is close to your goal range.
3. Set your alarm for 3 AM and write down
your blood glucose value after you test
(it is too easy to go back to sleep and
forget the reading you got at 3 AM).
4. In the morning check your prebreakfast
reading.
5. Using the graph below (Figure 4),
put a dot that matches each of your
blood glucose readings - at bedtime,
3 AM and fasting (pre-breakfast).
6. Connect the dots.
Blood Glucose
Bedtime 3:00 AM Pre-Breakfast
Figure 4
Graph for Adjusting Basal Insulin
400
300
200
100
0 Bed 3 AM
Time
Fasting
35