BI dose

5 posts, 4 contributors

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John Marrable DAFNE Graduate
Norfolk and Norwich University Hospital
11 posts

Hi All (and happy new year!)

I have taken this week off work to experiment with my BI dose, exercise regime and then QA ratio's and would welcome any help/insight you could offer.

In terms of my current state I am taking 20u of BI (lantus) before bed. What I am noticing is that when I test in the morning my blood glucose level has dropped over 2-3 mmol/l. To me this suggests that the BI dose of 20u is too high.

However, the problem I have is that my blood glucose level rises between waking up (7am) and lunch time (12-1pm) even without any carbohydrate portions. Therefore my concern is that dropping the BI below 20u will cause my blood glucose levels to rise even higher before lunch. What I should mention (which may be a factor) is that I exercise 20-30 mins (weight lifting) each morning between 7-7:30am. I am not taking any carbohydrate portions or QA insulin between waking up and lunch (I am only exercising).

Any help would be greatly appreciated

Garry DAFNE Graduate
North Lincolnshire
328 posts

Hi John. I am not a HCP and am a Graduate like yourself.
Perhaps your exercise is strenuous enough to increase your insulin resistance, contributing to the rise. We of course release Epinephrine, or adrenaline for 'Fight-or-Flight' and this makes us insulin resistant.
You may wish to consider splitting the BI between morning and night too.
Regards
Garry

John Marrable DAFNE Graduate
Norfolk and Norwich University Hospital
11 posts

Thanks Gary, that is very helpful.

I wondered whether the rise after weightlifting may be due to my liver releasing glucose as a response to the high intensity exercise and that due to there being no QA insulin present the glucose is not able to be converted into energy hence causing the rise. As such, my plan is to inject 1u of QA insulin immediately before exercise (even without any carbohydrate portions to see what impact this has). Any thoughts on this as a potential solution? Of course I will carry hypo treatment (just in case it swings the other way!)

John

dunkers7 DAFNE Graduate
NHS Lanarkshire
24 posts

Hi John,

Again not an HCP, but I do exercise anaerobically. Consider your weightlifting as anaerobic exercise.

Anaerobic exercise can increase your BG, it sounds likely that the weight session is the cause for your BG increase rather than BI. Probably worth testing your BG on a rest day morning anyway though so you can isolate what's happening with your morning BG when you don't do weights.

One thing to be aware of is that, with Anaerobic exercise, it does increase your BG initially, but your BG may begin to drop 1-2 hours later because your liver needs to replenish it's glucose supply, so do be careful not to over correct with QA insulin.

Warwick DAFNE Graduate
Diabetes Australia-Vic, Melbourne, Victoria
389 posts

Hi John,

Half or 1 unit before weight lifting would certainly be worth trying. Ginger Viera in her book Your Diabetes Science Experiment does the same for her weight lifting competitions.

Try it and see how you go. As dunkers7 points out though, do increase your testing afterwards as you may go low then.