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<blockquote data-quote="alaska" data-source="post: 636482" data-attributes="member: 14213"><p>I'd suggest reviewing your Levemir doses with your doctor. The time at which you split them may not be a problem. The doses of each, however, might be. Whilst Levemir is pushed as having a flat profile, research indicates that the profile is not as flat as we're told.</p><p></p><p>Here's a graph which shows the profile of Levemir (medical name: insulin detemir)</p><p><a href="http://www.lantus.com/hcp/about-lantus/vs-detemir" target="_blank">http://www.lantus.com/hcp/about-lantus/vs-detemir</a></p><p></p><p>See how there's a pronounced hump between 4 and 12 hours. So when you take your 21 units of Levemir at 10pm, most of this insulin will be acting between 2am and 10am. This offers a decent explanation as to why you may be getting such a big drop during the night.</p><p></p><p>My solution to the problem would be to gradually decrease the evening basal dose and keep monitoring to see how sugar levels are affected. If you reduce your evening basal dose and you start getting high readings in the morning, you could start to reduce your target evening level to below 10 mmol/l.</p><p></p><p>Given the profile of Levemir, as shown in the graph, you may not need to make any other adjustments. If you find you are going higher than normal before lunch, you could consider upping your morning Levemir a touch to compensate.</p><p></p><p>Agree any changes with your doctor/consultant before going ahead with them.</p></blockquote><p></p>
[QUOTE="alaska, post: 636482, member: 14213"] I'd suggest reviewing your Levemir doses with your doctor. The time at which you split them may not be a problem. The doses of each, however, might be. Whilst Levemir is pushed as having a flat profile, research indicates that the profile is not as flat as we're told. Here's a graph which shows the profile of Levemir (medical name: insulin detemir) [url]http://www.lantus.com/hcp/about-lantus/vs-detemir[/url] See how there's a pronounced hump between 4 and 12 hours. So when you take your 21 units of Levemir at 10pm, most of this insulin will be acting between 2am and 10am. This offers a decent explanation as to why you may be getting such a big drop during the night. My solution to the problem would be to gradually decrease the evening basal dose and keep monitoring to see how sugar levels are affected. If you reduce your evening basal dose and you start getting high readings in the morning, you could start to reduce your target evening level to below 10 mmol/l. Given the profile of Levemir, as shown in the graph, you may not need to make any other adjustments. If you find you are going higher than normal before lunch, you could consider upping your morning Levemir a touch to compensate. Agree any changes with your doctor/consultant before going ahead with them. [/QUOTE]
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