Apidra and Levemir

lp2103 said:

Hi
Just looking for some advice.
When i changed insulin approx. a year ago from the twice a day i was injecting apidra with breakfast,lunch, dinner then the levemir before bed has advised. I noticed that mid morning my bloods were increasing. I decided myself to ave another shot of Apidra and a snack mid morning and afternoon to prevent my bloods from rising. This gave me brilliant results. When issued with apidra i was advised i didnt need insulin with snacks but this is not the case, something like a cereal bar would put my bg through the roof. Ive now been told im taking too much insulin. What am i supposed to do? If i hve extra apidra with my breakfast to prevent bg goin higher inbetween meals im havin hypos. Anyone experienced this issue?


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Hi

I think that if you were to inject Levemir in the morning as well as before bed, you should slowly find that your mid morning and mid afternoon bg levels will be better balanced and you would only need to eat a small snack and not bolus for it if bg levels allowed it. From what I get from reading yr msg is that you are injecting less bolus to avoid going hypo 2hrs later, but because your bg levels are higher than they should be you are eating a small snack and doing another bolus to correct the problem. Nothing really wrong with this if you are happy to carry on that way but you are giving yourself more injections than you would if you injected the basal twice per day instead. Is your weight ok for the extra carb eaten as that will be something to keep an eye on with the extra insulin?

lp2103 said:

My weight had increased due t the extra insulin/food im havin t stop the bg levels from rising any higher. Would extra levemir in the morning mean that i wouldnt need these snacks im havin, im not actually havin them due t hunger just because of the apidra im injecting...



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Hi

There is an art in using bolus/basal insulin safely and its called carb counting and using an insulin to carb ratio in order to balance bg levels out all ok. Do you know much about using carb ratios because if you dont you should ask your dsn to explain it all to you but there is a lot of info on the forum about it all anyway.

I think you should ask your doctor or dsn about injecting Levemir twice per day instead of just once. Levemir was never meant to last 24hrs anyway so not sure why you have been told to inject it just at bedtime.

Once you get the balance of Levemir to Apidra correct, you might need to eat a small snack if a bit low, but you wouldnt need to do another bolus like you are doing now. Many diabetics practise some fasting in order to determine how well the basal insulin (without eating any carbohydrate), is at controlling bg levels and keeping them somewhere near static.

lp2103 said:

Thank you for that.
Since been on these ive never done carb counting - i predict myself how much i need.
Which i know isnt the best option but me being me i thought that i could manage - i had an appointment with the diabetic consultant yesterday who has referred me to the nurse to discuss carb counting and hoping to get my diabetes under a tighter control.
So fingers crossed i'll pick it up easy enough..

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Compared with twice daily insulins, basal/bolus is difficult to get to grips with especially with just using guess work which is a bit trial and error.

This will probably help you understand it all a bit better
Read Jontyw's msg
viewtopic.php?f=15&t=39091&p=367051&hilit=Jontyw#p367051