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<blockquote data-quote="alaska" data-source="post: 636468" data-attributes="member: 14213"><p>Levemir can be a pain to balance right if you find it doesn't last a full 24 hours. I find Levemir lasts me about 18 hours which seems to be about average.</p><p></p><p>On a single daily dose, this of course means 6 hours of the day will be covered by no basal and therefore is ketoacidosis waiting to happen.</p><p></p><p>If split 12 hours apart, you won't get the high ketoacidosis risk but what you will get is 2 periods of overlapping basal doses a day. Take this example:</p><p></p><p>00:00 - Pre-bed Levemir dose taken</p><p>12:00 - Midday Levemir dose taken</p><p></p><p>If your Levemir indeed only lasts for an 18 hour duration you'll have:</p><p></p><p>00:00 to 06:00 - both bed-time Lev and previous days midday Lev doses acting</p><p>06:00 to 12:00 - just the bed-time Lev dose acting</p><p>12:00 to 18:00 - both midday Lev and the previous bedtime Lev doses acting</p><p>18:00 to 00:00 - just the midday Lev dose acting</p><p></p><p>So, in this case you'd have two different 6 hour periods in which two basal doses are acting at the same time and another two 6 hour periods whereby just one basal dose is acting.</p><p></p><p>About 3 years or so ago I was getting frustrated with having some areas of the day when I was going too low and other periods of the day where I kept going too high. Having worked out the above, I decided to go onto 3 basal doses per day split 8 hours apart. My consultant think it's unusual but it's worked for me. However, this certainly won't be for everyone and could be hard to manage.</p><p></p><p>If you're finding you're getting a similar pattern of high levels before a basal dose and low levels within a 6 hour or so period of taking a basal dose, it could be brought on by the split Levemir doses. The easy option out of this is to request to go onto Lantus as that insulin usually has a 24 hour duration in most people and therefore doesn't need to be split.</p></blockquote><p></p>
[QUOTE="alaska, post: 636468, member: 14213"] Levemir can be a pain to balance right if you find it doesn't last a full 24 hours. I find Levemir lasts me about 18 hours which seems to be about average. On a single daily dose, this of course means 6 hours of the day will be covered by no basal and therefore is ketoacidosis waiting to happen. If split 12 hours apart, you won't get the high ketoacidosis risk but what you will get is 2 periods of overlapping basal doses a day. Take this example: 00:00 - Pre-bed Levemir dose taken 12:00 - Midday Levemir dose taken If your Levemir indeed only lasts for an 18 hour duration you'll have: 00:00 to 06:00 - both bed-time Lev and previous days midday Lev doses acting 06:00 to 12:00 - just the bed-time Lev dose acting 12:00 to 18:00 - both midday Lev and the previous bedtime Lev doses acting 18:00 to 00:00 - just the midday Lev dose acting So, in this case you'd have two different 6 hour periods in which two basal doses are acting at the same time and another two 6 hour periods whereby just one basal dose is acting. About 3 years or so ago I was getting frustrated with having some areas of the day when I was going too low and other periods of the day where I kept going too high. Having worked out the above, I decided to go onto 3 basal doses per day split 8 hours apart. My consultant think it's unusual but it's worked for me. However, this certainly won't be for everyone and could be hard to manage. If you're finding you're getting a similar pattern of high levels before a basal dose and low levels within a 6 hour or so period of taking a basal dose, it could be brought on by the split Levemir doses. The easy option out of this is to request to go onto Lantus as that insulin usually has a 24 hour duration in most people and therefore doesn't need to be split. [/QUOTE]
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