levemir Cut in two halfs

[Kloe]

So I went for my diabetic check up today and my doctor was talking with me about my Sugar levels that they seem to rise more later in the day , she said to cut my levemir in to two halfs (from 36units at 11pm) to (18units 11pm and 11am ) to see if it helps with the rise of my sugar in min day as it could be wearing off by then . But my worry is now I've cut it down so much at nice I will wake up high, dose anyone else do this we there levemir if so how did it help/affect your morning readings and did it help keep sugar under control more throughout the day ?

 

[TorqPenderloin]

I would dare to say that the majority of us who use Levemir have it split into morning/evening doses. Most data I've seen suggests that Levemir is consistently absorbed for about 16 hours before it begins to lose its effectiveness.

That can be a good thing as it allows us more ability to control our basal. For example, I give myself 10 units at 8pm and 5 units at 4am. The higher evening dose made sense for a number of reasons (for me), but the short answer is that I was going high at night/morning and low in the afternoons.

To address your question, I doubt it will be as simple at splitting your 36unit dose into two 18unit injections Then again, you have to remember that 36units once a day apparently wasn't the right dose in the first place (otherwise you wouldn't be in this situation).

What I did is literally draw a 24 hour timeline and map out exactly where I was going high or low. I then did the same thing and mapped out the timing of my two Levemir injections and compared the two.

The end result is that I give myself a 10u injection at 20:00 which should last until about 12:00, and a 5unit injection at 4:00 which should last until about 20:00. In theory, I have the most insulin in my system between 4:00-12:00 which is where I had issues going high, and I have the least amount of insulin in my system in the afternoon/evening just before my 8pm injection.

 

[Kloe]

Okay thank you , I'll do it how my doctor said for a few days and if it don't help I'll maybe try how you do it by mapping it out

 

[GrantGam]

I would dare to say that the majority of us who use Levemir have it split into morning/evening doses. Most data I've seen suggests that Levemir is consistently absorbed for about 16 hours before it begins to lose its effectiveness.

That can be a good thing as it allows us more ability to control our basal. For example, I give myself 10 units at 8pm and 5 units at 4am. The higher evening dose made sense for a number of reasons (for me), but the short answer is that I was going high at night/morning and low in the afternoons.

To address your question, I doubt it will be as simple at splitting your 36unit dose into two 18unit injections Then again, you have to remember that 36units once a day apparently wasn't the right dose in the first place (otherwise you wouldn't be in this situation).

What I did is literally draw a 24 hour timeline and map out exactly where I was going high or low. I then did the same thing and mapped out the timing of my two Levemir injections and compared the two.

The end result is that I give myself a 10u injection at 20:00 which should last until about 12:00, and a 5unit injection at 4:00 which should last until about 20:00. In theory, I have the most insulin in my system between 4:00-12:00 which is where I had issues going high, and I have the least amount of insulin in my system in the afternoon/evening just before my 8pm injection.

I see you have now switched to a staggered split dose of Levemir rather than your previous 1-2u QA correction on waking to counter DP.

How are you finding this new approach?

Grant

 

[Robinredbreast]

So I went for my diabetic check up today and my doctor was talking with me about my Sugar levels that they seem to rise more later in the day , she said to cut my levemir in to two halfs (from 36units at 11pm) to (18units 11pm and 11am ) to see if it helps with the rise of my sugar in min day as it could be wearing off by then . But my worry is now I've cut it down so much at nice I will wake up high, dose anyone else do this we there levemir if so how did it help/affect your morning readings and did it help keep sugar under control more throughout the day ?

I have never split my Levemir dose, I take 9 or 10 at night. I understand your concerns, you could try and see what the effect is or maybe your daytime Insulin needs tweaking. Good luck.

 

[TorqPenderloin]

I see you have now switched to a staggered split dose of Levemir rather than your previous 1-2u QA correction on waking to counter DP.

How are you finding this new approach?

Grant

Great question, and thank you for bringing that up.

For those who aren't aware: I had previous issues with (what I considered to be) dawn phenomenon, and previously had to give myself a 1-2unit injection nearly even morning or I'd see a a jump to 10+ without even touching a bite of food. I believe it was @tim2000s who suggested that it might not be dawn phenomenon and that I should consider a change in my basal injections.

To answer your question: the new approach is working GREAT and I rarely have to give myself a morning bolus anymore. HOWEVER, I have made other necessary changes as well. It seems my morning blood sugar increases were largely attributed to eating healthy (25g+) amounts of protein just before bed. While that satisfied my hunger, the theory is that my body converted the excess protein into glucose (gluconeogenesis) only to be released by my liver in the mornings when I woke up.

I increased my morning basal injection (from memory I think it was 1-2 units), try not to eat so much protein just before bed, and I try to get at least 3-4 miles of running in everyday (in addition to my heavy weight lifting). The running is sometimes a pain in the a**, but it has done wonders for keeping my insulin requirements and blood sugar readings low (in a good way of course).

In contrast, if I do have a big meal the night before, I'm likely to get the morning spikes and will need to give myself a small (~1u) bolus. My insulin needs also change significantly (as much as 50%) during the weeks I'm less active.

 

[GrantGam]

Great question, and thank you for bringing that up.

For those who aren't aware: I had previous issues with (what I considered to be) dawn phenomenon, and previously had to give myself a 1-2unit injection nearly even morning or I'd see a a jump to 10+ without even touching a bite of food. I believe it was @tim2000s who suggested that it might not be dawn phenomenon and that I should consider a change in my basal injections.

To answer your question: the new approach is working GREAT and I rarely have to give myself a morning bolus anymore. HOWEVER, I have made other necessary changes as well. It seems my morning blood sugar increases were largely attributed to eating healthy (25g+) amounts of protein just before bed. While that satisfied my hunger, the theory is that my body converted the excess protein into glucose (gluconeogenesis) only to be released by my liver in the mornings when I woke up.

I increased my morning basal injection (from memory I think it was 1-2 units), try not to eat so much protein just before bed, and I try to get at least 3-4 miles of running in everyday (in addition to my heavy weight lifting). The running is sometimes a pain in the a**, but it has done wonders for keeping my insulin requirements and blood sugar readings low (in a good way of course).

In contrast, if I do have a big meal the night before, I'm likely to get the morning spikes and will need to give myself a small (~1u) bolus. My insulin needs also change significantly (as much as 50%) during the weeks I'm less active.

I'm glad it's working for you

The last thread I posted a while back wrt staggered split basal doses was interesting as some said it worked wonders for DP, whereas others said a 12hr split with QA correction in the morning was the only way round it. Both are clearly viable options, but I do find unless you wake extremely early (~0400-0700) to administer the bolus; it can often be too late. Meaning that QA dose is purely a correction rather than prevention.

Gluconeogenesis sounds like a possible factor, especially if you're low carbing?

I'm going to have another go at the staggered split dose and see how I get on. DP is becoming more and more evident and frustrating for me, between 0400 and 0700.

Apologies if I have semi-derailed this thread.

Regards,
Grant

 

[No1DeadlyPoison]

I've had to split mine to the same times you have it actually. They say that Levemir is 24 hour working, but when I was with my Diabetic nurse she did say it is more like 20-22 hours, so sometimes splitting it helps with the level control. So you might find your levels in the morning won't be as high as you think they will. Just test it out for a week, to see what happens, you might find that you will need to up the evening dosage a little but keep the morning the same or vice a versa. Hope this helps a little. Good luck.

 

[donnellysdogs]

It may be a case of playing around with times too..

Although I'm off levemir now I found that a 12hour split waan't right for me.

I have the same issue with Insulatard. I have two injections, one at 8.30am and one at 4.30pm. This allows the peaks for me to occur at the times I need them....

I had similar on levemir...but my levemir was 10pm and 8am....

Not 12 hour splits..

 

[Daibell]

Hi. I don't split my Levemir. Yes it doesn't last 24 hours but so what - just increase the Bolus as the Levemir runs out. It saves one injection and makes balancing it easier.