SIX

Basal Insulin Dosing

A kind and steady heart can make a grey sky blue, And a task that seems
impossible is quite possible for you.
—Peter Gabriel, “That’ll Do”

Once you have settled on an insulin program that meets your needs, the next
order of business is to determine the right doses. Think of yourself as a giant
lump of clay that needs to be molded and sculpted into fine art. (My personal
self-sculpture is a cross between Rocky Balboa and Bond, James Bond.) Any
artistic creation takes time, so be patient. Make one adjustment at a time,
evaluate the results, and then fine-tune before moving on.
Another truism about fine art: beauty is in the eye of the beholder. What
works for some may not work for others. When looking at dosing patterns
and formulas, use them only as starting points. Individual needs may—no,
will—vary.
Let’s start with the fine-tuning of basal insulin. Basal insulin serves as the
foundation for your entire insulin program. With a solid foundation, you can
build something great. With a cracked or crooked foundation, you will
struggle to get anything to work right. In diabetes terms, it is difficult to know
what is causing out-of-range blood sugars unless you have already
established the proper basal insulin levels. That’s why Chapter 6 comes
before Chapter 7: it’s best to fine-tune your basal doses before attempting to
regulate the mealtime or bolus doses.

It’s best to fine-tune your basal doses before attempting to