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How do I split a Levimer dose

O

O_DP_T1

Well-Known Member
Messages
458
Location
United Kingdom
Type of diabetes
Type 1
Treatment type
Insulin
Hi all,

Currently I take Levimer 17u at about 8:30pm, I feel that this is running out by 5pm as I am seeing spike in my levels post 5pm without eating or drinking anything. Am thinking shall I spit the Levimer to see if this helps. How does one split and set the dose timings?
 
A good place to start is 50/50 with a 12 hours gap in between the doses.....

that can be tweaked as you get information in from you basal testing......

I was on a dose at bedtime and then one at breakfast, so not an equal split of time, but it helped with the dawn phenomenon....
 
novorapidboi26 said:
A good place to start is 50/50 with a 12 hours gap in between the doses.....
Click to expand...
Thanks for the reply, but a wouldn''t a 50/50 split 12 hours apart have the same issues, i.e insulin running out at about 4-5pm? Or am I missing something. Sorry for be dumb I am still learning this MDI stuff on the fly.
 
O_DP_T1 said:
Thanks for the reply, but a wouldn''t a 50/50 split 12 hours apart have the same issues, i.e insulin running out at about 4-5pm? Or am I missing something. Sorry for be dumb I am still learning this MDI stuff on the fly.
Click to expand...

Well, Levemir is marketed to last between 18-26 hours, but back when doing DAFNE I was told 12-18 hour duration...

So if you stick with a dose at 08:30pm and then one at 08:30am, each of those doses should be working until the nest one is due, 12 hours after....giving you a full 24 hours coverage.....

each of those doses will need to be tested and adjusted separately to accommodate for different needs during the day/night.....

no question is dumb here, my answers might be...;)....but we are here to help each other best we can....

does your team know of your plans to split...?
 
O_DP_T1 said:
Thanks for the reply, but a wouldn''t a 50/50 split 12 hours apart have the same issues, i.e insulin running out at about 4-5pm? Or am I missing something. Sorry for be dumb I am still learning this MDI stuff on the fly.
Click to expand...
Reducing the dose does not reduce the time during which the insulin works - it reduces the concentration of the insulin over the same period.
So, reducing the dose will not run out quicker ... or increasing the dose will not extend the life.
 
Well, it has been said that the more units you take the longer it lasts, however its still within the advertised action time....

so 2 units would likely only last the minimum time, where as 37 units would be up a the other end of the scale.....everyone reacts differently though so that's why testing is important.....
 
Sorry @helensaramay Levemirs action time is also dependant on the dosage size to body weight ratio - just to confuse matters - in theory half you normal dose won't last half as long as the normal dose (but it will be there or there abouts).

I was thinking about this the other day, if x units doesn't cover you for 24hrs why should splitting it help, you obviously need more so you'd think x+? would be better, and splitting it would help avoid a levemir induced low. But we rarely see an increase in total dose when someone splits it - our bodies are not normal :D

And of course your bolus ratios may well change..........
 
If you basal test when making the change to split doses then you’ll be able to juggle the amounts you take to fit your own needs.
I found that even the timing of the doses helped with any decline in coverage towards the end of the 12 hour period: giving the evening dose at the same time as the evening meal means the bolus can carry me through the 2-3 hours before the evening Levemir comes in, and the morning dose, 12 hours later, is then at a time when I’ve already bolused for the dawn phenomenon. The breakfast bolus also helps to smooth out the 2-3 hours before the morning Levemir kicks in.
 
I was on 40u Levemir once a day at 6pm.
Diabetoligist told me to split into 20u before work at around 6am and another 20u at 6pm.
Been working week for me since splitting the dose 50/50.
 
helensaramay said:
Reducing the dose does not reduce the time during which the insulin works - it reduces the concentration of the insulin over the same period.
So, reducing the dose will not run out quicker ... or increasing the dose will not extend the life.
Click to expand...
Hi. If you Google the web for Levemir graphs you will find a 3D diagram showing that large dose changes do change the effective timing. Personally I don't really see the need to split Levemir. Yes it doesn't last 24 hours so just increase the ratio for the last Bolus dose to compensate - simples.
 
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