Some indicators that your long-acting (basal insulin) is not the correct dose include:

• Blood glucose is consistently high or low across the whole 24 hours period
• Blood glucose levels are always high or always low in the morning;

The only insulin working overnight is your basal insulin. Glucose level should stay fairly steady overnight if the dose is correct. If glucose consistently rises overnight, it is likely that your basal insulin dose is too low if glucose consistently falls overnight, it is an indication that your basal insulin dose may be too high.

Another way to assess whether your basal insulin dose is correct is to have a carb-free/ insulin-free lunch, and look at whether your glucose levels rise or fall over the afternoon.  As you have no short-acting insulin on board, any change in glucose must be due to the basal insulin; too little insulin and glucose will rise, too much insulin and glucose will fall.

Once you are sure there is a definite pattern, you could make a small adjustment to your basal dose and recheck. If you are not confident in doing this, then speak with your healthcare team.

Your short-acting insulin (bolus insulin) is what you will be adjusting on a day-to-day basis, depending on the amount of carbohydrate you eat and in response to your blood glucose levels.

If your blood glucose is regularly rising after meals, then it probably means you are not taking enough insulin to cover the carbohydrate eaten in the meal. Find out more about carb counting and insulin adjustment in our 'carbohydrate counting' topic.