How Do You Use Basal Insulin?
When the first long-lasting basal insulin analogs (insulin glargine [brand name Lantus] and insulin detemir [Levemir]) came out, they were supposed to last 24 hours. You injected once a day. That schedule clearly doesn’t work for everyone. Why is that, and what works for you? First of all, what is “basal” insulin? “Basal” insulin is that background level of insulin you need 24 hours a day. It’s not for the food you eat; it’s for everything else insulin has to do in your body. As I wrote here, insulin keeps glucose stored in the liver, fat stored in fat cells, and promotes cell reproduction, along with several other functions. People with Type 1 and many with Type 2 have very low or no basal insulin. Without basal insulin, your liver can pump out glucose all the time. Your sugars can go way up even if you don’t eat, like at night. So the invention of a 24-hour basal insulin was a great advance. It brought people’s A1C levels way down, but it doesn’t always work as advertised. Dr. Richard Bernstein, author of Diabetes Solution, says “In my opinion, there is no 24-hour basal insulin.” Larger insulin doses take longer to absorb. According to Dr. Bernstein, drug Continue reading >>