i need to start dafne

how strange to say you are strange?! that's the strangest advice ever! :lol: what about increasing your levemir up a notch? it peaks at around 8 hours so could help your morning highs although that could be because of what you are eating for dinner/before bed?

mrsb2b
how about reducing your carbs? Even a littl reduction should show a difference in Bgs. You need to be careul, though and test frequently, because you don't want to cause hypos.
AS a mother and grandmother, i can understand your wish to have a healthy baby.
Perhaps you could get to see the diabetic obsterics team in your area. Ask your GP to see what can be done.
Hana

just increase by x1 at a time!! if you are low at lunch that could be your breakfast dose? you need DAFNE, without a doubt 8)

There is a course run by Bournmouth Royal Hospital diabetic team thats you can do on line, but alas I haven't got the web address, but I know that it's in one of the post either on the T1 forum or the insulin pump forum...

Looking at your night time and morning readings, could have 2 or 3 posibilities,

You could be actually having a hypo over-night, tell tell signs for this is waking with higher BG than the night and feeling like you've got a hang over..

Or it can be the dawn phanonmon effect, where your liver is pumping a lot more into your system eariler morning..

You really could do with testing over night, you don't have to do it all on one night, or even on concecitive nights, start with 2am (this is around the time all hormone activity is at it's lowest ebb, so should be about the lowest point for bg levels) then take a test at 3am working your self through hour by hour, also go the other way, eariler by the hour, until you build a picture what your BG's are doing over night...

Once you see a pattern you can decide what your best options are..

Levimer doesn't actually peak, it's a flat profile to it but can have a slight tail off around the 18 hour mark.. Which for some people hits at the wrong time, so changing the injection time can quite often help...

And sometimes it can overshoot needs and not quite be enough at another point of the day, which is quite often the case if you get the Dawn P effect, also it can actually not last the 24 hours it should do, so spliting the levemir into 2 sperate timed injections can give a lot better results, as you can adjust them individual to suit your needs..

jopar said:

Levimer doesn't actually peak, it's a flat profile to it but can have a slight tail off around the 18 hour mark.. Which for some people hits at the wrong time, so changing the injection time can quite often help...

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really? I'm confused then as I have a leaflet in front of me given to me on my DAFNE course which says it does, including the 18 hour tail off part? perhaps I am reading it wrong? from a personal, none technical note I used to suffer from morning highs, did the night time testing and was advised to increase levemir from 16 to 17 and then 18 - and it worked so actually, that's prob why I think it peaks! :lol: perhaps peak is the wrong word but it's been a long day and I don't have a thesaurus to hand :wink:

There is a course run by Bournmouth Royal Hospital diabetic team thats you can do on line, but alas I haven't got the web address, but I know that it's in one of the post either on the T1 forum or the insulin pump forum...

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http://www.bdec-e-learning.com/
(well worth looking at)

Levimir takes about an hour to start to kick in I think so has a slight raise durning this time, then flat lines it until it hits the 18 hours mark, I've got the DAFNE book as well, there's no actual peak to it's profile same with lantus they are both designed to be flat linners that should last 24 hours, but most diabetics fnd other wise.

I used levimer pre-pump days as my background, I had to split my dose along side having an off set time (not a equal 12 hour split) to get any where near a working basal profile, which still left me with troughs and peaks in my basal profile that were a nightmare to work my quick acting insulin around hence the need of an insulin pump...

Hi mrsb2b,

Get in touch with your diabetes nurse and ask to be placed on the waiting list for DAFNE. Your right, you may have to wait some time before enrolling, but state that you are willing to come at short notice should anyone drop out, this sometimes happens, when people have unexpected circumstances that mean they cannot attend the course.

By all means try the online DAFNE, it may be of use in the time being, I can't comment as I have not seen it, but should it give the basic principles of the course, it should help until such times that you get a placement allocated. The high morning reading, I would suggest that you set your alarm on your meter and test at say 2-3 am, and see what your reradings are like. It could be that you are going low during the night and having a liver dump, or it could be that you don't have enough background insulin in your body. Remember, as others have advised, increse your dose only by 1-2 units at a time and test over 2-3 days before adjusting again.

I know that many on Levimir split their dose, as the insulin profile of Levimir states that it can fizzle out after 18 hours, so by spliting the dose and having one injection in the morning and one at night overcomes this problem, but make sure you try and keep the doses around 12 hrs apart. On the DAFNE course, there is some great information and discussions about insulins and insulin profiles that you will find useful, I've done DANE back in October, and the advice I have given you here is what is suggested on the course for bed-time highs.

Nigel