Help with getting my Basal

[mikeyuk]

Hi all.

I've been following low carb for a while now, it's helping but it seems I just can't get my basal right and was hoping someone could help.

I originally started off with 26 levemir at night (around 10pm), but found this was leading me to rise around 5-6pm, so I decided to split my doses. Im up to 15 at night (around 9) and 15 in the morning (around 6am), but now I seem to lose coverage at 10pm. I think this is the case, its the only explanation I have for being 4-5 all evening (before dinner, 1hr after, 2hr after) then Bam suddenly at 10pm im up to 7.5. It's intensley frustrating and no matter what I seem to do I just cant curb it.

I've tried to map out the coverage of overlapping doses but find it really confusing, I also read I could try taking maybe 30 at night then a "booster" of a small amount of levemir later on in the day to cover the dip later at night. I tried talking to my Diabetes Doc about it but she was Zero help, doesn't even recommend fasting to adjust basal doses and didn't get back to me with a levemir profile.

Any chance someone here could help me please?

 

[ma5on]

Hi Mikey

I have the exact same problems as you - also taking 30 units of Levemir a day.

I cannot for the life of me suss it out - The other night for example I had been under 7mmol all evening, went to bed at 5.7mmol, woke up at 15.7mmol!!! :shock: Feeling lousy as hell.

One thing I did notice from your post though is that you experience a high at 10pm about an hour after your second injection. I wonder if the morning dose is exhausted by that time and the second one hasn't had time to kick in.....Have you tried a 12 hour split? (Something I plan to try myself!) MAYBE this will help???

Just my two pennies worth....

ma5on

 

[cugila]

Hi guys.

Hopefully we will get some of our T1 and Insulin experts around shortly who will be able to help.

Ken

 

[mikeyuk]

Thanks, much appreciated

 

[loadsaillnesses]

I had the same problem, I use to take my Levemir once a day & discovered I ran out before dinner. When I split the dose, I was told that it needs to be 12 hrs apart. So I take mine 10pm & 10am, that's probably why you are high at 10pm cos you take your morning dose really early & you may have run out over that 3 hr gap. You may want to double check with diabetic specialist nurse.

 

[timo2]

Hi mikey,

Are you covering the protein content of your meals with insulin?

 

[Louise5967]

I've recently started on levimir and have been desperately trying to get the doses and times right-God its hard!!
I give my night dose at 1030pm and am dose at 8.30am-only 10 hours apart but I seen to need more insulin in the am anyway and it does seem to be working with good readings.Last few mornings have been between 4-7 and pre evening meals also the same. Hope I've cracked it! I found when I gave the night time dose early approx 8pm I also woke with Bm's over 10-sometimes up to 15.

I am going on dafne in July and can't wait as from what I have heard it sounds very useful with carb counting-I'm interested to read about insulin for protein-how do you work that out??

Hope this helps

Louise

 

[mikeyuk]

Hi, thanks for the responses. Timo: I currently take around 3-4 units of novorapid per meal. Seems to cover the 1-2 hours readings ok, but perhaps the protein is causing a raise later? Problem is if I take any more novorapid I tend to go low after one hour.

My other thought would be perhaps a "booster" to cover the nighttime? If I was to take another small dose of levemir during the day, what time would be best and how much do you think?

Lastly, I take a 9-hour split at the minute because I read 9 hours was optimal in Dr Bernsteins book, although I dont remember reading why. It also seems to deal with the dawn effect quite well and I dont need any novorapid at all in the mornings if i skip breakfast (altho I do seem to ebb on the low side around 11 or so).

Would a 12-hour split be better and could I expect the Dawn Phenom to be more pronounced in future?

Thanks for the help.

 

[phoenix]

profiles for levemir.... though probably even more confusing since based on original 24 hr data.
http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=3632

Timo: I currently take around 3-4 units of novorapid per meal. Seems to cover the 1-2 hours readings ok, but perhaps the protein is causing a raise later? Problem is if I take any more novorapid I tend to go low after one hour.

This latter rise also happens to me if I eat a very low carb meal . If its predictable, it is possible to give a proportion of the novorapid up front and the rest an hour or more later. ( I have a dual bolus on my pump for this and used to do it sometimes on MDI). I would do this for an omlette with a green salad for example, BUT you obviously have to be very careful about the effect of stacking insulin and monitor your own response .
Personally, I also find that there is far less of an effect if I have a slice of bread with the omlette or some fruit after (ie about 15-20 carbs) and there is very little difference in the amount of insulin I need to take .