Splitting levemir

[sophsmam]

Tried everything so we didn't have to split so she didn't have to have the extra injection.we solved her morning and lunch readings but hard to control her tea and bedtime readings.She was at the hospital yesterday and she suggested splitting it.So its 19 units bedtime and 18 units morning.

My question is after 3 days if she is high on a morning do we decrease her morning dose or increase her nightime dose.Forgot to ask that question and no one there till monday.

Her Hba1c was 6.2 but going off her readings they expected about 7.2.so they think she may be having night time hypos so have to check her twice a night again.

 

[Jen&Khaleb]

Khaleb has an uneven split of 6.5 units in the morning and 4 units at night. I tend to increase the night dose to fix the afternoon and the morning dose to fix the night/early morning. It really is trial and error though. It is really going to depend on what time you inject, meal times and every other thing that affects levels. This is one of those cases that every one could be different. If I need to increase/decrease I do it and monitor for 3 days and then decide if it was the right thing or not. You might need to adjust snack times to suit the split also.

Sorry you're back to getting up through the night. Last night was my first night of sleep in ages. Khaleb's levels have really settled after the rough patch that came with the Thyroxine. Fingers crossed they stay like this - even just for a little while.

 

[suzi]

Great Hba1c result. If you find Sophie is not having nighttime hypos and her morning readings are high, then its her bedtime Levemir that you increase. I would do that in periods of 1 unit every 3 nights until you get correct morning bs levels. I know its not easy with kids, Andrew has been a nightmare of late and i can't even guess what his readings are going to be, as there so random ( :x puberty!!!) If she is infact having nighttime hypos, then reduce betime dose (1 unit every 3 days) or even try increasing her carbs at suppertime, until her morning levels are good.
Best of Luck,
Suzi x

 

[sophsmam]

suzi would i just increase her nightime dose and leave her morning dose at 18 units.Don't think i explained myself right she is on 37 units at the moment,would i decrease the morning one and add it on the bedtime one so it still works out as 37 unit.puberty is a nightmare.
todays reading was 16 but it is only day 1.

 

[suzi]

Leave her morning dose alone and just increase bedtime units and that should, over time reduce her morning readings.
If it was her lunchtime and evening readings that were high, then you would increase her morning dose.
Hope that explains it, let me know how you get on over the next week,
Suzi x

 

[suzi]

opps, having a senior moment day!!! if you increase her nighttime dose by 1 then reduce her morning dose by 1, so that you still equal 37units.
Only if her lunchtime/evening start to go higher would you then consider leaving her morning dose alone, then you may find her carb ratio changes throughout the day. Its all so complicated, isn't it, if only they were all text book and one size fitted all!!
Suzi x

 

[sophsmam]

thanks suzi .Did i read somewhere that andrew tried it but it didn't work for him.

 

[suzi]

Tried splitting it equally didn't work at all, even tried a 70/30 split, complete disaster. So his consultant agreed that i could try giving him his usual 23 units at bedtime and top him up with 4 in the morning(said Andrew was unusual in his requirements, but if it worked for him, to go ahead). That worked for a while over Christmas (spent New Yrs Eve in hospital with DKA, because of vomiting and diahhorea, Hba1c in Jan, down to 9 from 9.7) But when he returned to school those 4 units where causing bad hypos before lunch. So we are now back to the drawing board and giving a correctional dose when needed at 4pm when his Levemir runs out, plus increasing his insulin/carb ratio at dinner time.
Suzi x

 

[sophsmam]

Sorry to hear about andrew hope he is ok.Sophie was having trouble at teatime so i added on 1.5 units at lunch which did work.but then she started having hypos on a afternoon so we had to stop that.Now its a problem at tea and bedtime they werent happy to increase her insulin/carb ratio at teatime with her already being on 1 unit per 5 grams.So they suggested splitting im not expecting this to work but have to try.i just hope she's ok at school today. Just a constant worry.

 

[MuhammadII]

Can i just say you guys are brilliant with your understanadin and attitude towars your kid's treatments.
(Reminding me of my mummy)

I usually stick to the idea of correcting the levemir by 1 unit a time.

High mornin sugars (not caused by night hypo's) means adjusting the night one.

Not intending to add more difficulty in the matter, but I used to split the dose. It worked for a while (before I restarted uni), but then I reverted to the single. For me I guess less doses of long acting insulin means a decresed likelihood of overinjecting and an easier correction when they go high.

Stress levels increased and sleeping times were all over the place, thought it was the better.

Think so far the hardest years of my life were 12-17. After that I got the nick of it and am self controlling well (I think! )

Have to thank my mum though, she helped me a lot throught the transition towards self control and always taught me that education was important. Now its got to a stage that if you ask her what insulin I'm on, I'm sure she wouln't know. Lol

Maybe in the future if I have kids and they're diabetic, I can be as good as my mum and you guys.

Good luck

 

[suzi]

Muhammad,
That was both touching and reassuring, thankyou,
Suzi x

 

[MuhammadII]

Thanks.

I have a personal opinion that parents are the real unsung heroes in aiding their kids with management.

I don't know if your children appreciate it now, but believe me your care is priceless.

 

[sophsmam]

not working at all the split so i think it's going to be back to 37 units at bedtime.sophie is only low at lunchtime the rest of the time high.

 

[suzi]

Hi Claire,
Sorry to hear the split hasn't worked, its so frustrating isn't it. Andrew is still running way too high at teatime and bedtime and i loathed to increase his 4pm injection as it will only overlap with his teatime one.
Don't know about you, but i'm getting so fed up with the constant juggling, we never seem to get it right lately, and i've blamed Andrew for eating when he hasn't, he can be sneaky, but he's always honest, bless him. His forehead has broken out in spots, so i'm assumming puberty is playing a big part in his bs numbers, but whats the magic formula??
Andrew has been diabetic 4yrs now and i'd have thought it would have been a breeze by now, but something new is always being thrown into the equation .
Sorry, i'm just feeling totally p*ssed off today, between that 'time of the month' and lack of sleep from my back ache, i'm not in good form.
Suzi x

 

[sophsmam]

Oh Poor you. it's just a nightmare you've got the same problem sophie's high at tea and bedtime that was before the split.I really did hope it would work but this morning b/s of 16.
It was there school photo today so we forgot to do her levemir so tonight it's back to 37.But since the split she's been having bad hypos after tea,so it's back to the drawing board maybe back to given her dose after school.But its bedtime thats the problem too she would be about 15 but by morning in the 4's so can't really give her a correction dose.
Sophie's got spots to same place definetely puberty she is a nightmare to live with.You always get the good days when you think you've cracked it then the next back to square one.
Hope you feel better soon

 

[MuhammadII]

I remember those days; everytime you try something, another things pops up.

I remember that corrections took at least a week and that regular tests at the same time every day gave a good picture.

That's the challenge I guess. Most Dr's Nurses think my life is a simple routinte, for any teen this isn't the case and we know what its like with Diabetes in the equation.

You tried keeping the meals the same?

You guys done DAFNE?

 

[suzi]

Hi Claire,
Looks like Sophie and Andrew are experiencing the same diabetic nightmare at the minute. Back to the drawing board, there just at that age.
Feeling better-ish now,done something i haven't done in ages, took painkillers and went back to bed for a couple of hours, at least its taken the edge off the pain and i'm not as tired.
Think this week i'll just try and stay on the ball the whole time and make sure his numbers stay good, even if it means more injections. I know he feels like cr*p when he's running higher as his whole attitude changes (know puberty usually gives them a personality transplant) but when high Andrew just is so not placid!!
Plus i'm gonna increase his carb/ratio at dinner time see if that helps and if it doesn't, i'll phone his DN for a chat.
Fingers crossed that by the end of the week, were both experiencing better control, good luck to us both,
Suzi x

 

[Jen&Khaleb]

(know puberty usually gives them a personality transplant) but when high Andrew just is so not placid!!

Hi Suzi,

I think puberty has given my 15 year old a frontal lobe lobotomy. I'm hoping whatever was between his ears before grows back. I'd like to think I wasn't a sleepy, moody teenager but maybe I'd have to ask my Mum. :roll:

Even my sons Grade 9 teacher said Grade 9 boys just really struggle.

So very glad he's not the diabetic one as I have enough trouble getting him to clean his teeth. Argh!

I do wonder what Khaleb will be like as the years roll on. You deserve a medal.

Jen.

 

[suzi]

Its not all bad Jen, Stephen is 13 1/2 has hair in most places (so iv'e been told) his voice has broke,n his feet are size 9-10 and he eats like a horse. Spots everywhere and his grunts are usually said in the right places, he's started to clean his teeth (must be a girl) and he has now taken to tidying his bedroom at the weekend (usually a 2 hr job) Wonder what he's hiding! Don't think i want to know :roll: Must say, he is after a £65 Superdry coat, cause everyone in his class has got one!! So maybe thats the reason behind the effort.
As for Andrew, well he's not shy, bit of an exhabitionist, so along with the spots on his forehead he is definately showing signs of puberty in other places Bs have been a nightmare this past week, but wer'e working on it.
Hope Khaleb is well and things are still settled with him, take care,
Suzi x

 

[Jen&Khaleb]

I wish 15 yr old son had size 9-10 feet. Sadly they are already size 14 so he can no longer get shoes in the mainstream as they only go up to 12. For a teenager he's been quite good this week. I think it has something to do with the Xbox being RROD (apparently this stands for Red Ring of Death). I don't let him use the computer through the week unless it is for school either. I'm sure the screen time rots his brain.

Jen