Levemir - rapid rise?

[girtongardner]

Morning.
Been type 1 for 25 years, pretty good control. I have adjusted my levemir dosage(morning and evening ) a number of times with success and I know what works for my body and how to adjust.

Well I thought I knew. I was taking 18 at night (9pm) and 12 in the morning (6am) for ages with no issue. Then suddenly my bloods started rocketing in the night - before the dawn phase, around 1am. By 3am it would be 18 .

I have increased my levemir and whilst it’s brought it down , it’s still high. But what’s confusing me is I’m now on 26! That’s a increase of 8 units which seems a lot!! Have others had to increase dosage this much , this quickly?

 

[In Response]

@girtongardener what time period is the change from 18 to 26?
Is it within the same batch of Levemir? I am wondering if it is a dodgy batch.
Are you unwell? It is possible to need 50% more insulin when unwell as our liver dumps more glucose.
Likewise if stressed - either mentally or physically (e g. fighting an injury).
How are you sleeping? A bad night's sleep can push up BG
You mention increasing your night time basal? How is your BG throughout the day? Have you needed to increase your bolus or daytime basal
What are you eating for your evening meal? For me, some higher fat and carb meals such as pizza, pasta or curry can have a delayed rise which appears to be night time rise of I do not not split my bolus.

Sorry for all the questions, I am thinking allowed about possible causes although "my body just needs more"l sometimes" and "we need as much insulin as we need" come to mind.

 

[girtongardner]

Thanks for the detailed reply , much appreciated.

I have gone up this much incrementally over a week, I will raise it again tonight as it still went a little high. Although not as much.

Stressed somewhat, bad sleep yes , plus I was dealing with 3 hour jet lag. Although that was 2 weeks ago so I’m imaging I’m over it now. Plus, the travel lots for work , I have a somewhat stressful job and I’ve never been a great sleeper, so these aren’t new issues. And like I said. Whilst I have had to increase my dosages before I am just surprised it’s gone up so much in a week. This is my second batch of Levemir - I worried the first was bad - but same issue.

My levels are notably more spikey during the day for sure, which I’m guessing is linked. I’m correcting with nova rapid which works but is a pain and sometimes leads to hypos. I’m a healthy eater and on a low carb diet. Last night a had a halloumi salad with no carbs so I don’t think it’s that.

 

[In Response]

@girtongardner I just read a post from @LWA who mentioned "Levimir was good for many years but over time & needing ever increasing amounts I was professionally advised that I was no longer responding to it so switched to Tresiba several years ago - this turned out to be a game changer in my control."
His dose seems to be lower than yours - maybe some elaboration on his comment may be helpful for you.

 

[girtongardner]

Ah interesting- yes I was wondering if I needed a change. I’ve been on this for at least 15 years. I’ll speak to my doctor. Thanks so much for the replies and making the connection