Being confused of sugar levels reading

[kitan]

Hello, I've been type 1 for 3 years (I'm skinny person, 75kg, 187 cm height).
I started struggling with my sugar levels from April this year.

I take 19 units of levemir before sleep, which gives me a readings around 6 - 7 in the morning (I go to bed when my sugar is at least 6.3).

When I wake up and don't eat my breakfast my sugar is usually going up to 11-12 (which is probably normal, due to hormones release in the morning etc.) . When I eat the breakfast I noticed my carbs ratio is 1:5. After 2 hours my sugar is around 7. Then I have a lunch at work, today I had just 45 of carbs, injected 4 units of novorapid, two hours after my sugar was 18.6 (really high). Yesterday for example a had 80, injected 6 units of novorapid. My sugar two hours after was 9, then in third hour dropped to 3.5, this scenario happens very often, even if I have a snack after 2 hr, or even banana still goes low.

As you can see is like a rollercoaster. I'm struggling to make my BG stable, that makes me so tired. Should I ask my doctor to change an insulin? Maybe novorapid doesn't work well on me and the peek time is moved?

 

[urbanracer]

I take Levemir and when using the Freestyle Libre I was able to determine clearly that it doesn't last in the body for 24hrs. At best I was getting 18hrs out of it, but often even less. So I'd see my glucose levels creeping up from around 15:00hrs most days.

As a result I split my doses and take 10u, 12hrs apart, and as far as I can tell, most folks here also split the dose and it seems to be more effective.

With more basal in your system you may need to reduce your evening bolus BUT PLEASE CONSULT with your diabetes team if not fully comfortable with making the change yourself.

 

[kitan]

I take Levemir and when using the Freestyle Libre I was able to determine clearly that it doesn't last in the body for 24hrs. At best I was getting 18hrs out of it, but often even less. So I'd see my glucose levels creeping up from around 15:00hrs most days.

As a result I split my doses and take 10u, 12hrs apart, and as far as I can tell, most folks here also split the dose and it seems to be more effective.

BUT please consult with your diabetes team if not fully comfortable with making the change yourself.

What time do you inject levemir?

 

[urbanracer]

What time do you inject levemir?

Approx 06:45 and then I aim for 19:00 but it can be a little later.

 

[kitan]

From tommorow I'll try to inject 14 units at 20 00, then about 7-8 in the morning. Or you recommend to split the dose like 50/50?

 

[ert]

I split my Levemir dose and take it at 7 am and 10.30 pm. These times are recommended by Dr Bernstein's Diabetes Solution for Levemir.

 

[kitan]

I split my Levemir dose and take it at 7 am and 10.30 pm. These times are recommended by Dr Bernstein's Diabetes Solution for Levemir.

How much levemir do you take in total? How should I split if I take 18-19 at 10 pm? 10 - 11 at 10pm then 7-8 at 7 am?

 

[urbanracer]

From tommorow I'll try to inject 14 units at 20 00, then about 7-8 in the morning. Or you recommend to split the dose like 50/50?

People do different things to reflect their own needs. For myself I tried 60/40, 25/75 etc. Right now I'm doing 50/50 because it seems to suit me. Think about your activity levels and when you might need less insulin on board.

When you make basal changes like this, it can sometimes take the body 2 or 3 days to settle into a new pattern so don't get disheartened if there's no immediate improvement.

 

[ert]

How much levemir do you take in total? How should I split if I take 18-19 at 10 pm? 10 - 11 at 10pm then 7-8 at 7 am?

Your diabetes consultant should be able to help you with your dose based on your insulin sensitivity.
My insulin sensitivity was 500% by the HOMA formula, so it was suggested by my consultant that I started with 3 units am and 2 units pm of Levemir. On the first day, I injected at 7 am and skipped breakfast and lunch and held a blood sugar line without moving more than 0.5 mmol/l up or down, (from Dr Bernstein's Diabetes Solution) which means I hit the ideal dose straight away. For the night dose, I set the alarm every hour 4 - 6 hours after taking it, and missing dinner, for the same. I increased my night time dose to 3 units.

 

[Diakat]

No one on the forum can give dosing advice- you need to work with. Your medical team.

 

[Fairygodmother]

If you’re happy doing a basal test then you could begin to work out whether you need more Levemir in the daytime or whether you need to adjust your ratio for lunch.
This is a fact sheet produced by UCLA which sets out the basics. If you’re using a libre then you’ll get a picture of where your BG rises/falls/stays fairly steady. It’s important to test regularly during a basal test so that you know how the basal behaves.
Like @Diakat says, you really need to have advice from your medical team. Since you’ve only had T1 for three years it’s possible that your insulin needs are changing.

 

[Fairygodmother]

https://www.uclh.nhs.uk/PandV/PIL/Patient information leaflets/Basal and bolus testing.pdf

 

[Marie 2]

When you are first diagnosed, you enter what we call a honeymoon phase. It means you make insulin until you slowly don't.
So over time your insulin needs will go up. But they also will be erratic as sometimes your body will decide to still make some insulin. It just makes it harder to control and adjustments have to be made. This could be what is going on. I say could because other things can cause fluctuations too. Stress, lack of sleep, infections etc.

Call your diabetic team for suggestions on dosing. But I would also keep a thorough log for a few days, testing 8 times a day so they can help you better.