I work in a SNF (Rebhab). We have a patient who gets 35 units of Glargine at bedtime. One morning when the patient's BS was 87, her POA has asked that on nights when she does not eat an evening snack, that we give her only 20 unites of glargine so that her blood sugars aren't too low in the morning.
I guess my question is, since glargine is a long-acting basal insulin with no real peak, is there any logical reason to give only 20 units instead of 35? It seems to me that the dose should be consistant. If the POA feels like 35 is too much sometimes then maybe the whole dose should be dropped to 30 or 25.
I thought i'd ask the question here since, Diabetes is so complex and I only have a very basic understanding of the different insulin types and responses.