Levimir advice please

[Indiana91]

I'm looking for advice on how much levimir to inject.

I work at a stables giving donkey rides and things so on a working day I work non stop for 11 hours and am very active, so therefore, I need less insulin.

On days off I do absolutely nothing as I'm so tired from work.

I'm not sure how much insulin I need. My morning dose is should be 36u but I've been lowering it when I'm at work to 30u because of hypos.
How long does it take to adjust to this?
On non working days do I inject the normal 36u or does it not make a difference because it's not for one or two days?

I guess what I'm asking is do I reduce my ratio instead of my levimir on working days or inject 30u on non working days and correct it with fast acting? Or do I keep changing the dose of levimir?

I hope that makes sense!

Indiana x


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[Engineer88]

When are you having the hypos Indiana?

Can you give an example day bg?

 

[Indiana91]

It really depends on how busy I am and how hot it is to be honest.
Morning readings are normally fine, around 5.4 so I have a piece of toast with no insulin because then I do the mucking out which burns it off.
Lunch I'm naughty and don't tend to test because there's no time and I just eat on the go. By this time I'm out at a park somewhere and am really busy depending on the weather so I usually eat when I can and inject for it but do 1.5u instead of the normal 2, then if it's hot I'll feel a hypo a few hours later.
I'll have my tea at around 8 when I get in and my levels are good then.
However, on non working days it can be quite high around the 15 mark

Indiana x


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[Engineer88]

So we are looking at hypos post lunch with an unknown bg before lunch. What does lunch consist of?

when is the non working 15 coming in? x

 

[Indiana91]

Yep. Just a sandwich, 35g carb.

Non working 15 is usually after lunch and lasts all day, I'm not entirely sure how truthful this is though because I've had a cold.

I'm so sorry I'm not being very helpful! Now I'm reading it I'm realising how ridiculously careless I've been!

Indiana x


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[Engineer88]

Sometimes it helps just putting it in writing. So you know where your going? test - record - look for patterns.

as my managers say:

SHOW ME THE DATA

 

[Indiana91]

that's what I'm going to do, I'm going to have to find time to test at work!

Thanks for opening my eyes!

Indiana x


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[Engineer88]

If it helps you can get a pack of sterile indivvidual cleaning wipes (i bought them in boots i assume they are cheaper elsewhere) I keep a couple in my meter pack to clean mucky hands quick. Also using Mysugr app helped me when I was on MDI.

 

[Indiana91]

That would be good. I think that's why I don't really want to test, it's a dirty job!

Indiana x


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[Engineer88]

understand - Ive got my first finger infection from testing in 23 years!!

 

[Indiana91]

Doh!!
Hope it gets better soon!

Indiana x


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[petsnponies]

I used to do the exact same job and remember using a lot less insulin in those days - it's hard work!

I agree you need to be testing whilst at work. Take a week or so to test more and write it down. It will be a pain but it will prob give you the answers!

 

[ElyDave]

I'm using a split dose of levemir as well at the moment, adn I vary my doses for long duration exercise. I have found that I am able to change my morning dose for exercise that day with no real issues. Becasue Levemir does not have a full 24 hour action, you shoudl be able to make changes fairly quickly adn easily.

Have you spoken to a DSN on this to get an idea of reductions based on activity, or looked at soemthing like Think Like a Pancreas, it has guidelines on dose variation.

 

[Indiana91]

Have you spoken to a DSN on this to get an idea of reductions based on activity, or looked at soemthing like Think Like a Pancreas, it has guidelines on dose variation.

Not yet no, they're a ****** to get hold of if I'm honest!

Indiana x



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[Spiker]

The fastest way to react to the change in exercise would be to change your quick acting ratios on exercise days, but as Dave says it's probably fast enough to change your Levemir same day, the dose immediately before the exercise.

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[ElyDave]

I do chaneg my ratios (or rather make an exercise based % adjustment) for bolus, but if it's prolonged exercise, a change in basal is probably needed as well.

 

[nigelho]

I'm looking for advice on how much levimir to inject.

I work at a stables giving donkey rides and things so on a working day I work non stop for 11 hours and am very active, so therefore, I need less insulin.

On days off I do absolutely nothing as I'm so tired from work.

I'm not sure how much insulin I need. My morning dose is should be 36u but I've been lowering it when I'm at work to 30u because of hypos.
How long does it take to adjust to this?
On non working days do I inject the normal 36u or does it not make a difference because it's not for one or two days?

I guess what I'm asking is do I reduce my ratio instead of my levimir on working days or inject 30u on non working days and correct it with fast acting? Or do I keep changing the dose of levimir?

I hope that makes sense!

Indiana x


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I am in a similar position to yourself that my work of lifting and carrying as a home shopping delivery driver is heavy work and I reduce my quick acting for my meals on work days. F o r breakfast I use 1:5carb and lunch is between 1:8 and 1:10 for a reasonable day but nothing at lunch if it's a really day. For tea I use 1:4carb ratio. I do 4hour testing as novorapid has done its job by then. I don't adjust my insulatard. On non work days I tend to use 1:4 ratio throughout the day but if I am doing dot Tec I have to reduce my meal ratio. During the work day I don't do any corrections thuggish but wait until tea by which time I am back in single figures.