High blood sugars - low dose of Levemir the culprit??

mr_maroon

Newbie
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Hi,

I've been diagnosed T1 since last Christmas and have come out of the honeymoon period within the last few months. My BG control has been okay while at home, but has significantly worsened since I've returned to uni. I take Levemir and Novorapid.

Over the last few weeks, my BG has been untenably high for a good portion of the day (talking into the 20s post dinner!), and it's starting to become a very real concern for me. I really don't want to lose a leg or my eyesight or whatever. Although my diet's **** (too many carbs - though I'm working on it), I always appropriately account for it using carb counting (passed on from my Mum's DAFNE course knowledge). I usually take 1 unit per 10 grams, but have begun to increase that to 1 per 8g. I'm about 6'1", 12 and a bit stone. However, I always seem to find myself having to take corrective insulin after meals.

However, after a bit of panic googling after particularly high reading just now, it appears people seem to be taking way more Levemir than I'm accustomed to. I understand that everyone's different, but I've been taking a split dose of 7 units in the morning and 7 in the evening. Is this, as I suspect, a very small dose? My BG remains high overnight and throughout the day, unless I'm engaged in some high energy activity.

I'm just wondering if I should take this to my diabetic nurse/consultant, or if this is something that's more to do with my control? I'm in the dumps about this whole thing, and I'm wondering whether it's more to do with my lifestyle choice and lack of responsibility therein, or insulin levels. I'm also wondering if I'm somewhat insulin resistant, as Novorapid doesn't seem to be having the desired effect = surely, at 10/8g to 1 unit, even if that ratio is slightly off, my BG shouldn't be so outrageously high after meals?!

I suppose I just need some advice from someone more experience than I!

Cheers!
 

Fallenstar

Well-Known Member
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Hi Mr Maroon
welcome! Sorry to hear about the sudden rise ,you are right though you are probably out of the honeymoon period this can be more of a gradual process for some, sudden and overnight almost for others :shock:
I really think you should get an appointment with your DSN ASAP so they can set you some new levels to take away and tweak until you are back to where you were with your readings.

It probably is your Basal insulin which is a bit low, I'm not on a Hugh dose of Levimir, 12 AM, 8 PM and you are right we are all different. I have recently moved from years on Lantus to Levemir,a happy change for me but I found I did need more of the Levemir and may have to start to slightly increase it.

You could try a couple of unit increase on your split dose and wait a few days to give the insulin chance to adjust and see how your fasting and post meal reading are. you may now need a much bigger increase of it if you are dose adjusting your Bolus for carbs and your two hour reading seems good but then you are creeping up . If this seems to be the case really do go and get professional advice because a forum can't really help you safely with adjustments . You are at an important stage now with your Diabetes,get the right help. Maybe your Bolus to carb ratio needs have also changed?
So go get some proper help! :D

All the very best, I'm sure you will be back on track soon :D
 

Wendywu

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We all have different ratios for mealtimes; for instance I take 1 unit of humalog per 3g of carb at breakfast, but only 1 unit per 12g at dinner.

I agree with Fallenstar that you need to see your DSN for advice on the basal, because if you're OK when you go to bed but high in the mornings then it's the basal at fault. Also, if you carb count and inject for what you eat but still spike after meals then the ratio needs correcting.

If you're not confident about adjusting your own doses then definitely see your DSN for advice.
 

Jen&Khaleb

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My nearly 5 yr old is on 7.5 units Levemir morning and night (split dose) and has between 2-3 units Novorapid with meals. I'd be guessing you might be coming out of the honeymoon and you may need to start increasing your basal dose so you aren't having to correct after meals. If you have an illness/fever you will also find that blood sugar levels can go very high/low. Like the above has already written - if you aren't confident to adjust your own dose get some help from your clinic. If you are high for long periods you should do the odd ketone test.
 

jacks69

Member
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16
Hi I am on 34 units of levirmir before bed and 14 units in the morning and my morning levels are always high. Spoke to my doc bout this and he has given me something to try before rushing in with adjusting my insulin levels.
He explained that my meals times need adjusting - I eat at 6.30 in eve and dont have breakfast til around 9am - he explained that 12 hours between eve meal is just acceptable but because its so long between eve meal and breakfast that your liver takes over the production of sugars to keep your body going in the long time between each meal. Therefore it could be that when testing its due to the amount of sugar that my liver is compensating for.
He therefore suggested having a light snack before bed a carbohydrate such as a slice of toast and bringing my breakfast time a little earlier. Am testing this theory for 2 weeks but he thinks it should help - as i quite often have very haphazard meal times it is possible this is the cause. Will keep posted - a lot of people make their own adjustments to insulin levels but end up chasing insulin - the more u take the more u end up taking - and the hungrier you feel - making it diff to control levels - best to get full support of diabetic spec for controlled adjustments and advice
 

noblehead

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jacks69 said:
Hi I am on 34 units of levirmir before bed and 14 units in the morning and my morning levels are always high. Spoke to my doc bout this and he has given me something to try before rushing in with adjusting my insulin levels.
He explained that my meals times need adjusting - I eat at 6.30 in eve and dont have breakfast til around 9am - he explained that 12 hours between eve meal is just acceptable but because its so long between eve meal and breakfast that your liver takes over the production of sugars to keep your body going in the long time between each meal. Therefore it could be that when testing its due to the amount of sugar that my liver is compensating for.
He therefore suggested having a light snack before bed a carbohydrate such as a slice of toast and bringing my breakfast time a little earlier. Am testing this theory for 2 weeks but he thinks it should help - as i quite often have very haphazard meal times it is possible this is the cause. Will keep posted - a lot of people make their own adjustments to insulin levels but end up chasing insulin - the more u take the more u end up taking - and the hungrier you feel - making it diff to control levels - best to get full support of diabetic spec for controlled adjustments and advice


Your gp is right Jack, try eating breakfast upon waking to prevent the mid-morning highs.

Nigel
 

jacks69

Member
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Thanks Nigel am a carer so always get caught up in doing that role before sorting myself out but am adjusting that now