Treated with distain again

jane67

Member
Messages
15
Don't be afraid to ask questions and if you don't understand ask again. The more you understand about your
diabetes the better you will be able to deal with it. Never feel stupid or like you are being a pest , none of us were born knowing everything and the best way to learn is ask and ask again until you understand. Good luck with getting things sorted :)
 
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PaulinaB

Well-Known Member
Messages
594
Type of diabetes
Type 1
Treatment type
Insulin
There is no way that splitting the same dose of Levemir (or anything else) in two, and taking it 12 hours apart, will cause hypos due to the overlap. The overlap is very minimal anyway as Levemir doesn't last much more than 12 hours in any strength, and even at the point of greatest overlap, the overlap between 6 old units and 6 new units is never going to be as strong a concentration as 12 new units. If 12 Levemir isn't giving you hypos, then overlapping 2 x 6 units of Levemir twice a day is not going to give you hypos. Not from the overlap effect, anyway..

Spiker, are you sure about Levemir? I was told it last up to 24 hours (and that's what the leaflet says), though it depends on the person, but 18-20 hours is what it usually lasts for people. I'm taking one injection in the evening and it seems to be working around 20 hours for me.

Thought you're probably right that it's very hard to get a hypo with levemir, it works so slow...
 
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Spiker

Well-Known Member
Messages
4,685
Type of diabetes
Type 1
Treatment type
Pump
I know I am going against the manufacturer claims here. But duration of action is totally dose dependent. With a high enough dose, any insulin will last 24 hours - even regular insulin. The manufacturers basically can't fail in proving a claim that a long acting insulin will last 24 hours, because they can just keep increasing the dose until it does.

In practice, neither Levemir nor Lantus will last 24 hours. And the concentration of insulin attenuates long before then. There is no such thing as a "flat profile" with injected long acting insulin. The purpose of doing two injections rather than one per 24 hours is to make the action curve flatter, by overlapping the two attenuating action curves of each of the two injections. We were shown pictures of this in DAFNE. Maybe someone can find a graph - it makes sense when you see the two overlapping curves creating an overall flatter, more even effect.

Sent from the Diabetes Forum App
 

PaulinaB

Well-Known Member
Messages
594
Type of diabetes
Type 1
Treatment type
Insulin
I know I am going against the manufacturer claims here. But duration of action is totally dose dependent. With a high enough dose, any insulin will last 24 hours - even regular insulin. The manufacturers basically can't fail in proving a claim that a long acting insulin will last 24 hours, because they can just keep increasing the dose until it does.

In practice, neither Levemir nor Lantus will last 24 hours. And the concentration of insulin attenuates long before then. There is no such thing as a "flat profile" with injected long acting insulin. The purpose of doing two injections rather than one per 24 hours is to make the action curve flatter, by overlapping the two attenuating action curves of each of the two injections. We were shown pictures of this in DAFNE. Maybe someone can find a graph - it makes sense when you see the two overlapping curves creating an overall flatter, more even effect.

Sent from the Diabetes Forum App
Ahhhh, I see. That makes sense, thanks :)
 

Spiker

Well-Known Member
Messages
4,685
Type of diabetes
Type 1
Treatment type
Pump
2 x basal.jpg

Here's a picture of a 2 x day detemir (Levemir) injection pattern.
 
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tizzy

Well-Known Member
Messages
256
Thank you for replys you lot do make me feel normal and stronger I am going to write all my question down and yes not leave till I am clearer I also had made up my mind to complain to a patient advice centre if these 2 appointments are again a waste of time. we are not alone my work as a carer has shown me also with family unless you make a fuss you get nowhere which is sad