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Bedtime readings

N

N-J-C

Newbie
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2
Hello
I'm having a little difficulty getting my glucose levels right and was wondering if anyone can help me.
I was diagnosed as type 1 in February and was originally put on two doses of novomix a day. I switched to basal bolus with three doses of novorapid and one dose of levemir each day about a month ago. When I was on novomix I didn't have any trouble getting my blood glucose levels right but since switching I have been having a lot of trouble with my readings just before I go to bed. If I take four units of novorapid with my dinner then my bedtime reading goes up to about 10 but if I have five units then I have a hypo within about an hour of dinner. I have a small snack about midway between dinner and bed and I can't go without or I get really hungry and as it is I'm a bit underweight so I don't want to start eating any less, besides which I took the same approach when I was on the novomix and I didn't have a problem.
Is it possible that when I'm having the evening snack both the novorapid and the levemir have worn off even though I try to make sure I have the levemir about the same time each day?
Any suggestion would be appreciated.
Thank you.
 
Hi N-J-C, welcome to the forums. I am afraid that as a Type 2 I can't advise you but I am bumping your post in the hopes that someone more knowledgeable will see it.

If you still haven't had any responses by tomorrow try reposting in the Type 1 Diabetes section where you will no doubt get a reply.
 
Hi N-J-C!

I don't use Levemir myself, but several others on the forum do and many find that it lasts about 18 hours rather than 24, so it might well have worn off before you have your evening snack. You might find that splitting the dose and taking some in the morning and some in the evening 12 hours apart helps, but obviously speak with your diabetes team before you try this. If you do split the dose, be aware that it will mean for some periods of the day you have one active dose working and for other periods you have two active doses working, so you might need to adjust your Novorapid ratio to account for this. Many of us do split the basal dose so it is a fairly common thing to do.

Are you carb counting to work out how much Novorapid you need? You normally count the carbs in your meal and inject the Novorapid according to whatever ratio you are. So, for someone with a 1 unit Novorapid to 10g carb (the common ratio to start on), a 40g carb meal would mean injecting 4 units Novorapid; a 50g carb meal would mean 5 units and so on. You can also get Novorapid pens with half units on them, so you could try 4.5 units which might avoid your hypo/high problems. Speak to your DSN about getting a pen with half units.

Smidge
 
Thank you for your help, that's really useful.
I haven't started carb counting yet; I have an appointment in August and I think they're going to suggest that then so hopefully that combined with asking the nurse about splitting the levemir dose should make things a bit easier.
 
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