I wondered if anyone can give me some guidance. My 6 year old has even having erratic bg through the night. After doing lots of testing we noticed that shortly after going to bed at 8pm his bg would rise significantly, going from about 6 mmol to 12mmol at around 10/11pm. We tried upping levemir but found he was then going very low later and through the day. We came to the conclusion that his levemir which is administered at 7.30pm did not start working for a few hours and hence in that time his bg would rise due to lack of basal insulin. We therefore decided to switch the injection time to the morning as this would mean that we could cover the delay in the basal insulin by giving extra bolus with breakfast. We have done this for the past 2 days and tested a lot over the past few nights. results much better, ranging between 5 - 6mmol from 8pm until 5 am when his bloods started to go up resulting in waking bg at 7.30am of 11mmol. We think that not only is the bg increase due to a bit of the dawn phenomenon, but also the fact that perhaps the levemir is also wearing off as I understand that it doesn't always cover for 24 hours. We haven't yet split the dose as he is only having 4 and a half units, but I now wondered whether she should split it giving half at night and the other half in the morning or whether anyone can offer any more advice on the matter or has had the same sort of problem. Thank you.
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Dawn Phenomenon 6 year old boy
- Thread starter leggott
- Start Date
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catherinecherub
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I am bumping this up for you Leggott.
jopar
Well-Known Member
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It can take up to 2.5 hours for Levimer or lantus to start working, and by what you'll saying that it's also isn't lasting 24 hours..
Sometimes when falling short changing times so the short fall, falls at a time when the basal would be naturally on the lower side works...
Splitting can work and is more helpfull if you need to adjust in two areas (evening/morning) to gain better control.
I would discuss this with your DN before splitting, as they may be able to work out a better time to for a single injection rather than a split meaning an extra jab a day, or if splitting looks like the best option, they will be able to guide you on might prove to be the better split percentage
Sometimes when falling short changing times so the short fall, falls at a time when the basal would be naturally on the lower side works...
Splitting can work and is more helpfull if you need to adjust in two areas (evening/morning) to gain better control.
I would discuss this with your DN before splitting, as they may be able to work out a better time to for a single injection rather than a split meaning an extra jab a day, or if splitting looks like the best option, they will be able to guide you on might prove to be the better split percentage
Jen&Khaleb
Well-Known Member
Hi Leggott, Khaleb has always had his Levemir split so I don't know what a once a day dose is like. I still find that I have to change the time of his Levemir as well as the dose every now and then and also the amount of carbs needed as supper varies over the seasons. I know this isn't that helpful, but I can sympathise having to do all that trial and error (bad readings over weeks) until you hit the jackpot.
Now Khaleb's well his Novorapid with dinner is lasting until his Levemir starts and he's been under 8 all night and quite stable. I'm quite impressed and hoping Khaleb stays healthy long enough for me to enjoy - 2 days so far and counting.
Now Khaleb's well his Novorapid with dinner is lasting until his Levemir starts and he's been under 8 all night and quite stable. I'm quite impressed and hoping Khaleb stays healthy long enough for me to enjoy - 2 days so far and counting.
Splitting the levimir worked better for me...though I moved straight from single dose lantus to split levimir. Sometimes, it is not a case of a 50:50 split...but I guess if he is only on 4 units, you don't hav emuch room to play with. Like Jopar said...check with the DSN. I *thought* it was more ususual to split levimir...although I don't know that for a fact, so it may be worth just checking that there was not a good reason in your sons case why they didn't do this.
FYI for me, splitting levimir was a great deal beter, but still not great, so I ended up on a pump...which is fab.
FYI for me, splitting levimir was a great deal beter, but still not great, so I ended up on a pump...which is fab.
Jen&Khaleb
Well-Known Member
Just wanted to let you know that 2 families here managed to get pumps for both their kids. They actually had to do a bit of lobbying through the government channels as the funding in this country didn't cover more than one diabetic child per family. Hope you manage to get them if that is the way you want to go. Some actually say there is more work to the pump than needles though :shock: .
I get the feeling that they are stalling us! I can understand their concerns as we have had families in this area who have been given pumps which they couldn't get on with. I will of course trial a pump before going for it. They know we are committed parents and that our main reason for a pump is to overcome the night control with my son. After months of night testing making small changes, we've come up with a split of 3 1\2 units at night and 2 1/2 in the morning. He is now going to bed with a bg around 7, bouncing between 4 and 6 between the hours of 8pm - 4 am and then gradually going up to about 8/9mmol on waking around 7am. if we up levemir any more he is dropping too low at around 3 am. We are just so tired of being up at all hours and although we would like him to wake with a bg a little lower, we realise that the majority of the night he has excellent control and he is only going up in the early hours. Fingers crossed for a 'YES' in 2011...
