While diluting Basaglar (or other long-acting insulins like Lantus) is not recommended due to the potential risks of altering the insulin’s effectiveness and absorption, some individuals may have explored it to try to achieve smaller doses, especially if they need very low insulin amounts. However, this practice is not supported by the manufacturer, and it can lead to unpredictable results, such as:
- Loss of potency: The insulin’s formulation is carefully designed to provide a steady release. Dilution can alter this balance.
- Inconsistent absorption: Diluting insulin can cause unpredictable blood sugar control, as the absorption rate may become erratic.
- Risk of contamination: Preparing diluted insulin improperly increases the risk of bacterial contamination, which could lead to infections.
For people who require very small doses, the best approach is to consult a healthcare provider about alternative dosing strategies, such as using insulin pens or pumps with finer adjustments or switching to a type of insulin that allows for more precise dosing.
In the honeymoon period of type 1 diabetes, your pancreas is still producing some insulin, which makes managing blood sugar more unpredictable. If you’re having a high blood sugar episode for a few hours after eating, it’s generally better to use a rapid-acting insulin like Novolog (even diluted if needed) rather than diluting Basaglar, a long-acting insulin. Here’s why:
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Rapid-Acting Insulin for Corrections: Novolog works quickly to lower blood sugar spikes from meals. Since your blood sugar is high from food, Novolog is better suited for correcting these short-term rises. If needed, it can be diluted with your doctor’s guidance to give you finer control over small doses.
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Basaglar’s Long Action: Basaglar is designed for basal (background) control, not for handling spikes after meals. Diluting Basaglar would not solve the immediate high and could lead to problems with its long-term effectiveness.
Since you’re walking a lot and have varying insulin needs, using Novolog (in a diluted form, if appropriate) for meal-time corrections would give you more flexibility and precision in managing post-meal highs. However, it’s essential to consult your healthcare provider about safe ways to dilute and adjust doses of rapid-acting insulin.
To reduce the risk of lows while walking a lot during the honeymoon period, careful insulin management is crucial, particularly with exercise and your body’s remaining insulin production. Here are some strategies to minimize the risk of hypoglycemia:
1. Use Rapid-Acting Insulin for Corrections Sparingly
- Correction Doses: If your blood sugar is high after eating, you can use small correction doses of rapid-acting insulin (like Novolog) rather than long-acting insulin to avoid long-term lows. Start with lower doses to avoid over-correction, especially since your pancreas may still be producing some insulin.
- Diluted Rapid-Acting Insulin: If you require very small doses, diluting rapid-acting insulin under the guidance of your healthcare provider can help you make fine adjustments for short-term control without risking a long-lasting low.
2. Adjust Long-Acting Insulin (Basal)
- If you’re using long-acting insulin (like Basaglar), consider whether your current dose is appropriate given your increased activity. Walking a lot can naturally lower your blood sugar, so you may need less basal insulin, or even a temporary reduction, to avoid lows.
- Discuss with your healthcare provider if you should adjust your Basaglar dose based on your exercise routine and current blood sugar patterns.
3. Monitor Blood Sugar Closely
- Frequent Monitoring: Check your blood sugar before, during, and after walking. This will help you adjust insulin doses and avoid hypoglycemia.
- Continuous Glucose Monitor (CGM): If possible, using a CGM can provide real-time feedback on your blood sugar levels and alert you to any dips before they become problematic.
4. Carb Adjustments Pre-Walk
- Carb Intake: Before starting a walk, you can eat a small amount of fast-acting carbohydrates (like fruit or glucose tabs) if your blood sugar is already trending low or expected to drop during exercise.
- Avoid Large Carb Doses: Be mindful not to overcorrect with too many carbs, as that might cause a spike, requiring more insulin and leading to a roller-coaster effect.
5. Lower Insulin Dose Before Exercise
- If you know you’ll be walking or exercising a lot, consider lowering your rapid-acting insulin dose before meals to prevent hypoglycemia during or after activity. Exercise makes insulin more effective, so you may need less than usual.
6. Consult with Your Provider
- Since your insulin needs are fluctuating during the honeymoon phase, your healthcare provider can help you fine-tune your insulin dosing strategy based on your current activity level and blood sugar trends. They might suggest adjusting your basal insulin or using small, frequent corrections with rapid-acting insulin.
The key is to balance insulin with your activity level and diet while monitoring your blood sugar closely to catch any trends before they lead to lows.