Levemir - Advice Please :)

[-Artemis-]

Hi All...

So... the monitoring and experimenting continues.... currently I've switched from Lantus to Levemir - mainly as I am hoping to have a baby in the not so distant future and my consultant said that Levemir is better during pregnancy - but also as I want to ba able to adjust my basal around when I do/don't exercise... I was on 8 units of Lantus; so have switched to 8 units of Levemir - 5 at 9am and 3 at 9pm.

Overall I feel better on Levemir - I had insatiable hunger on Lantus that stopped as soon as I switched - however - my blood sugars are not nearly as even. I understand this is cos the Levemir has a peak and the Lantus is flat - but I don't know how to manage this.

I'm waking up anywhere between 7's and 9's (if I sleep in anywhere past around 7am then I'm higher) - and in the pm I'm going to bed around 9's also... In the am it takes until midday for either my basal or bolus to kick in; which means I'm generally rising to around 10/11's midday - but then dropping to the 5's for lunch.

I also drop to the 5's or 6's by dinner-time... and inbetween I'm in the 7's.... so I don't *think* my bolus (which is Novo) needs adjusting - I *think* it's that my Levemir isn't kicking in till around 4hrs after I take it, then peaking between 4-6hrs and trailing out of my system again at 8-ish hrs.

All of this means I don't necessarily want to increase my Levemir; as I think I may find I hypo between 1pm and 6pm - and possibly between 1am and 6am too.... but I do want to level out the peaks I'm getting - any suggestions / ideas....??

I think I saw that some of you take Levemir three times a day - which I'm happy to try - but if I try and take it 8hrs apart that will mean taking, say, 3 units at 7am, then 2 at 3pm, then 3 at 11pm.... and will also mean I can never lie in or go to bed early ;-) and I also don't know if I'd be possibly 'stacking' if I did that....? Grateful for any thoughts....

 

[-Artemis-]

PS: @Spiker - I think I read at some point you posted a really cool graph which showed peak rates for Levemir....? I can't find it now - but I'm pretty sure that cos I'm on a relatively low dose, it means it's only likely to last around 6-8hrs in my system - do you remember if I've got that right...?

 

[novorapidboi26]

carb free testing of your Levemir will provide you with a good insight as to whats going on.......

you say you go to bed in the 9s, and your waking in the 7-9s, so the PM dose seems nearly there, no?

there seems to be some confusion as to what dose may be responsible for what highs etc..........so a basal test is essential........

did you do any when you switched over form Lantus?

 

[noblehead]

As said you night levels look fine as your going to bed and waking on the same bg level. To determine if your AM levemir dose needs adjusting you will need to do some fasting checks I'm afraid, if your levels remain pretty much stable and within range then you need to look at your bolus dose.

When I switched from lantus to levemir my DSN said that I would probably need a higher dose which turned out to be true, but looking at your levels your not too away. The difficulty with including a third dose is remembering to take the extra injection more than anything else, howver there has been members on the forum before who have done a 3x dose of levemir.

 

[Daibell]

Levemir doesn't last as long as Lantus which is why many do a split does or even three. I don't split it but do the single dose at night this means my peak insulin effect is in the morning and I don't do a breakfast bolus unless it's a heavy breakfast. This saves injections and minimises insulin shots before driving in the morning and the higher risk of going low. This works for me but we all have to find our own way thru.

 

[-Artemis-]

Good advice as ever - thanks all

- not done any basal testing yet; think my 'ladies holiday' was affecting readings so wanted to wait for that to settle... ;-)

I think I'm getting there - thanks partially from all the help on here!


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