Levemir and split dose question

[Saka]

Morning all, I'm T1 diabetic and use Humalog and Levemir. My Levemir is a split does, 8u on a morning (7am) and 13u at night (7pm), which, after lots of fine adjustments, seems to be the perfect ratio for me.

However, since I've started using a FreeStyle Libre (Privately funded FWIW), I notice my levels are perfect all night but every morning at 5:30 my levels start to creep up and by the time I get up at 7:00 my level is between 8-10.

A bit of Googling tells me that Levemir lasts for between 18-23 hours so I think what I'm seeing is my Levemir running out and my level starting to rise. I don't need any more Levemir at morning or night as this will lead to fasting hypos so I think I have two options, move to a single Levemir dose at midday so when it starts to run out I will have some Humalog in my system which will counteract the effects or potentially move to Lantus.

It's another 8 months before I see my diabetes consultant but if the opinions of the good folk on here tell me I may be better on Glargine I will seek to see my consultant sooner. I would be prepared to go to a single Levemir dose without speaking to my consultant, without being big headed, he very rarely tells me something I don't know so I'd be willing to trust my own instincts on this.

Many thanks
Ian

 

[Deleted Account]

Your morning rise sounds like Dawn Phenomenon to me - it is perfectly normal and any long lasting insulin which assume your insulin requirements are constant will have problems to manage different needs at different times of the day.

Basically, it is your live dumping glucose into your blood stream to give you the energy required to start the day.
It happens to pretty much every one. The difference between some one with diabetes and some without is that a healthy pancreas will dump some insulin to convert that extra glucose into the required energy.

Take a look around the forum at the meany many many threads on "Dawn Phenomenon", "DP" and "Liver Dump".

 

[Saka]

Your morning rise sounds like Dawn Phenomenon to me - it is perfectly normal and any long lasting insulin which assume your insulin requirements are constant will have problems to manage different needs at different times of the day.

Basically, it is your live dumping glucose into your blood stream to give you the energy required to start the day.
It happens to pretty much every one. The difference between some one with diabetes and some without is that a healthy pancreas will dump some insulin to convert that extra glucose into the required energy.

Take a look around the forum at the meany many many threads on "Dawn Phenomenon", "DP" and "Liver Dump".

Lovely, thanks for the reply. I'll look into it

 

[urbanracer]

If it helps, I am on the same insulin combination as yourself.

I was struggling with overnight highs, usually starting around 3am. I now take my main dose (14u) at 20:00hrs and a top up (6u) at midday.

This is keeping 'my' levels pretty flat. For me, Libre shows that my Levemir lasts about 18hrs,

 

[Saka]

If it helps, I am on the same insulin combination as yourself.

I was struggling with overnight highs, usually starting around 3am. I now take my main dose (14u) at 20:00hrs and a top up (6u) at midday.

This is keeping 'my' levels pretty flat. For me, Libre shows that my Levemir lasts about 18hrs,

Thanks for the reply, I never thought of taking my night time Levemir a little later in the hope it may reduce the 5am sugar level rise. This seems like a pretty low risk change so I may try it. Many thanks, Ian.

 

[smc4761]

Dawn phenomenon is a fairly common thing with some Type 1 me included.I am on Novorapid and levemir although i take much higher doses.

I found that when i upped my levemir taken around 10 pm that my DP has now almost cleared. I upped my dose by around 10%, now this worked for me, it may be worth a try. Best thing really is trial and error and lots of testing. Once you get the basal doses correct the rest pretty much falls into place

The issue i really have is I have late DP, which means my morning BG will rise steeply around 2 hours after i take my Novorapid before dropping back in time for lunch

EG this morning woke at 6.45 to a BG of 5.6, but by 10 am this had risen to 11.3, and now at 12.30 it is sitting at 6.4. This is fairly typical for me