Levemir - a few questions!

[Fujifilm]

Hello,

On Wednesday I changed from Lantus to Levemir, the good news is I actually feel better in myself.

The bad news is I can't bring my BG down, I started off taking the 10 units evening and morning same as Lantus now I am upto 14 units and still high. Even not eating all day and taking Humalog its staying at an average of 16 !! although its pretty constant all day.

I really don't want to start taking more and more of the Levimir.

Does it take a while to get working properly or am I going to need much more of the Levimir ?

On Friday I woke with a BG of 14.3 took 5 humalog and 14 Levimir and by 1pm I was 16.6 and had not eaten since 6pm the night before? took another 5 humalog and at 7pm just before tea it was 14 !! and I had still not eaten ?????? took 8 humalog and had a light tea and 10pm when I took my next 14 of Levimir I was 5.1

Today so far has been much the same. On the Lantus if I had not eaten in the morning I would have been very low quite quick after taking the humalog. So I am confused! :?

 

[diabetic_tigs]

Hey
I changed from lantus to levemir a few years ago too... i had a big reaction to levemir (lost my eyesight almost completely for a week :shock: ) but from what i can remember, my sugar levels were up aswell and i couldnt seem to get them down..
i dont know if this is a common problem with levemir or what, but i'd definately speak to your doctor/nurse.. seems your doseage may need upping or possibly levemir isnt the right basal insulin for you?
what were your levels like on lantus? and why did you change from lantus in the first place? I changed because i had a big reaction to lantus too :|
hope this helps
tigs x

 

[Fujifilm]

Hi Tigs

With the Lantus it was OK for a few years but then I noticed I was feeling vacant and not feeling well, loads of other syptoms, then after having a massive hypo my BG was all over the place and nothing I did could stop it, also the vacant feeling was increasing and I often felt low when I was not.

The nurse suggested Levimir rather than the pork insulin I asked for. Really do not want to start taking loads more insulin in case I start gaining weight. I do feel a lot better on Lantus but funny you should mention eyes because I am sure mine have gone a bit more blurred but I put this down to BG running high, but after what you said think I will get onto the nurse. :shock:

Today I have not managed to get the level below 10 and again hardly eaten anything.

Thanks for the reply.

 

[iHs]

Fujifilm

Most people using levemir do find that they have to increase the basal dose up compared to lantus but I notice you post this:

On Friday I woke with a BG of 14.3 took 5 humalog and 14 Levimir and by 1pm I was 16.6


To me, your bolus of just 5 units of humalog doesn't seem high enough to correct a bg of 14.3 as your bg was still high by 1pm? Did you not test mid morning?

I think you will have to re-adjust your insulin to carb ratios and correction factor as levemir is milder in its action compared to lantus.

 

[suzi]

Hi Fujifilm,
When Andrew changed from Lantus to Levemir his requirements stayed almost the same, and after being on it several months have know discovered he needs to either split it or add an extra dose of humalog in there after school, of course its all trail and error for children as their constantly growing!
I'm glad you feel much better, Andrew takes 20units at 9pm bedtime and by 4pm next day its running out, i would suggest upping your dose gradually then try adjusting your ratio to carbs in two to three day periods. Remember Rome wasn't built in a day and that it may take a week or two to get things perfect, and all you can do is test, test and test again.
Take care and good luck,
Suzi x

 

[lilibet]

Im about to change to Levemir and Novo from a mixed regime (hooh bloody ray!) and DNS suggested Lantus

Have heard lots of anecdotal stuff about it (funny you should say vacant, Ive felt like that on and off for the year ive been dx and always blamed my insulin but NO ONE listens. Also about the stinging, and that it doesnt always last 24 hours so I requested Levemir as i feel a split in basal might be better to tackle bg across the whole day

I was told by DNS (after questioning why levemir) that the dosage for levemir across the TDD for basal is always higher than lantus so I will need to take 'more' insulin across a full day (concern being weight, hypos etc etc)

 

[Fujifilm]

It is a nightmare, upped it again last night to 16 and still this morning 12? so I have now done another 16 and 10 humalog. See what happens.

Checked at various times during the night and the lowest reading was 4.6 at 4am so no idea whats going on. Humalog would have been burnt out. Six hours later its 12. If I had upped the dose of Levimir at 10pm I would probably have had a hypo between 4am and 10am.

I could maintain better control without taking the Levimir at all. :? :?

Lilibet I hope you have better luck with the levimir and as Suzi says its all trial and error, but paitence is not my strong point.

 

[iHs]

It is a nightmare, upped it again last night to 16 and still this morning 12? so I have now done another 16 and 10 humalog. See what happens.

Checked at various times during the night and the lowest reading was 4.6 at 4am so no idea whats going on. Humalog would have been burnt out. Six hours later its 12. If I had upped the dose of Levimir at 10pm I would probably have had a hypo between 4am and 10am.

I could maintain better control without taking the Levimir at all. :? :?

Lilibet I hope you have better luck with the levimir and as Suzi says its all trial and error, but paitence is not my strong point.

Fuji

Many people find that basal insulins do not always give a full 12hr cover so that is why your bg levels were ok at 4am (4.6) but then started to rise upwards. If you tested again at 7-8am you would have found that the bg would probably have been a bit lower.

You could try increasing the levemir up another unit at 10pm just to see what happens,(many people find it easier to use more basal and eat a bit of carb before going to bed to prevent going low) but do consider getting up earlier in the morning and doing a test and another bolus of humalog, eating some breakfast and then going back to bed. It's worth it just to get your control much better

I recommend for decent control with MDI, that the bolus insulin for main meals should be used every 4.5 - 5hrs along with eating some food. That way your insulin levels are always 'topped up'.

 

[Dillinger]

Hi Fuji,

Are you splitting the dose for Levemir? I changed recently from Lantus and find it gives better control, but it does need to be split.

I also found that I had to increase the amount I'm taking by about 1/3rd. So, used to take 22 units Lantus at 8:00 pm and now take 15 units Levemir at 8:00 am and 13 units at 8:00 pm, also had about 2 weeks 'bedding in' to it.

One of the purported benefits of Levemir is that it allegedly doesn't lead to as much weight gain as Lantus; albeit I haven't really noticed a difference.

All the best

Dillinger

 

[Fujifilm]

Hi Dillinger

I have split the dose and also increased it from the 10 I was taking of Lantus to 16 also I have found that it only lasts 8 - 9 hours so when I take it at 10pm its OK until about 6 or 7 am then levels shoot upwards. At 6am this morning it was 6 then at 8am it was 10 then at 10am it was 15.

I am going to have to take it later at 11 or 12pm to get it to last until I get up at 10am or go back on the Lantus and feel kack, at least I had better control even though it was a bit unpredictable at times.

I am actually starting to find it depressing. But will plod on in the hope it levels out, the last two days I have managed to average single figures only just but its a start.

Its took me a year to lose half a stone, even if I find I gain a few pounds I am dumping the levemir.

 

[janabelle]

Hi again Fujifulm,
You're having a right time of it with your insulins. You don't need to go back to Lantus, you could try another type of insulin. Aside from analogues, there are synthetic 'human' insulins, suchas Insulatard, or animal options suchas Hypurin Porcine or Bovine Ispohane.
Kewgirl listed all the insulins available in a recent posting, I'll have a wee search for it, and list them again if I can
Don't despair Fuji, you just haven't found the right insulin that suits you yet, but I'm sure you will. I know how frustrating it is, and it sounds like you're doing your best to try to manage your sugars. Best of luck and keep us posted
Jus
PS. found it! Here's Kewgirl's list:

Long/intermediate acting insulin’s available in UK – September 2009

Animal Insulin
Hypurin Porcine Isophane
Hypurin Bovine Isophane

Human Synthetic Insulin
Insulatard
Humulin I
Insuman Basal

GM Synthetic Analogue
Levemir
Lantus

 

[Dillinger]

Hi Fujifilm,

That sounds quite familiar to me; I was getting good control and then a big jump in the morning (but not enough to be a liver dump); what I've done is increase the morning bolus insulin when I have breakfast and that seems to cover it. But taking the evening dose later sounds sensible too; but you'll need to watch the early evening levels won't you? Or I guess your evening bolus may cover that?

Give it a couple of weeks though at least. I'm very happy with mine now.

All the best

Dillinger

 

[Fujifilm]

Hi Dillingr - I give up !!

Last night my BG was 4.5 (about 5 hours after taking humalog) at 11pm and I took 16 Levimir but because I thought 4.5 was a bit low to go to bed with, I decided to have a little snack, well I was depressed so I had a good pig out.

Woke this morning at 9am expecting a BG of about 20 and it was 7 :? :? and I have remained at about between 10 all day.

What the hell is going on? If I don't eat my BG goes up and if I do eat it goes down.

There is only one thing for it, chocolate, cakes and biscuits before bed :lol: :lol:

I suppose the good thing is its stabilised although still on the high side but I can work on that.


Jus. I asked DN about Pork insulin and she does not want to prescribe it, no way pedro. She says I have to see the specialist which I can't do until January. Will see how the levimir goes because touch wood apart from the control problems, I actually feel quite good in myself, which proves it was the lantus doing me no good, wish I had done something about it years ago.

 

[rapidyellow]

I am on levemir and take what I consider to be a large amount, 30units 10am, and 30units 10pm, I used to take the whole 60 in one go at night

have always thought that maybe I should be on something else, maybe a bit stronger

 

[janabelle]

I always considered Lantus to be the least effective of anologue insulins, but from the looks of recent postings, it's not on it's own. Lantus and Levemir both claim to have 24 hour flat profiles, but from my and many other's experience this is not true of Lantus. If the Levemir dose also needs to be split, what exactly is the benefit of analogue long-acting insulins, over synthetic 'human' or animal long-acting insulins?
Fuji, glad your feeling better, hope you get things sorted in January
Jus

 

[Fujifilm]

From my readings Levimir lasts for me about 8 hours so seems a bit of a waste of time, not sure where they get 24 hours from, unless by upping the dose the cover will be longer.

I think I could get a better BG average by just taking humalog during the day and having the one dose of Levimir at night. :?

 

[iHs]

You might be ok doing that Fuji but dont be surprised if you find yourself needing to inject a huge amount of humalog in the morning as there wont be hardly any background insulin working and your bg levels will rise up without the increase in bolus.

Although some people basal every 12hrs, loads also inject more basal in the morning (approx 8am) and then inject the next basal dose before going to bed (which for most is about 11pm) so there is a difference of about 15hrs. Its all about doing what is convenient to you and getting decent control of your bg.

 

[sophsmam]

im thinking my daughter's needs to be spilt she takes 29 units of levemir at 8.30pm. she's high at lunch now im wondering is the levemir no longer working.at lunch she is on 7 units of novorapid for 49grams plus 2 extra units to keep her low at tea.then on top of that whatever the correction dose she needs with being over 10.So with her having all that novorapid it's keeping her low at tea then she's back high at bedtime.
The only way im keeping her b/s low in a morning is given her a correction dose at bedtime.the levemir doesn't bring her below 10 if she's high at bedtime.how would i split 29 units if anyone thought that was the case.
I may be wrong totally

 

[suzi]

Hi Sophsmam,
Andrew and i are also in the process of splitting his Levemir, he is fine in the morning, always needs a slight correction dose at lunchtime, after school ok but by 4pm his bs starts to ascend really high. We've tried doing a correction dose at 4pm, teatime he's ok but by bedtime his in the late teens to 20's.
So this is what were going to do at the weekend, he takes 20units at 9pm(and is usually 3.6 at 8am), were going to split it as 19units at 8pm and try with 2-4 units at 8am, i reckon his carb ration may need altered in the mornings. I know it makes sense, i just hate the thought of him doing 5 injections a day, he's really going through a phase of hating his diabetes at the moment and this aint gonna help!
Fingers crossed,
Suzi x

 

[gbtyke]

I have to admit that I am fairly new to Levemir but I am finding that it is working well. I am injecting about 3 1/2 to 4 hours after my last Novorapid each day (As I think that is the time the Novorapid lasts).

I inject the Levemir in the buttocks as that is the place I believe to provide the slowest release and Inject Novorapid in the stomach area or legs if I am going to be using them after the meal to get rapid absorpsion. I do not have a snack after the Levemir. My waking reading is usually mid 5's.

Being on the lean side and fairly low carb I only inject 12 units. I find my meter readings usually in the mid 5's before meals. I try not to have snacks which could affect those readings before meals.