I split my basal insulin TODAY and suddenly my bolus ratios are very different? PLEASE HELP

[Riley124]

(I will not be taking anything as a medical advice, i just need some help! So dont worry)

Hello! So im typing this in a panic. I was on one single nightly dose of levemir at 16 units but it dropped me greatly at night and didnt last me a whole 24 hours so after so much contemplation i decided to split my basal.
I took 7 units of levemir this morning. It shouldve been 8 units if i was doing an equal split but i kept it 1 unit less to be SAFE. My bg was sitting at 300mg/dl when i took levemir so i decided to take 1 unit of novorapid to correct my bg.
NOW usually novorapid would drop me by 50mg/dl but it dropped me ALL THE WAY DOWN from 300 to 90!!!

PLEASE HELP! I dont know how to proceed from here. My questions are:

Is there any logic to this? Should i not have split my insulin by taking help from diabetics online? My doctor was against it as he believed it is a 24h insulin, but it works only 16h for meee :'(.

what should be my next step? How should i change my nightly dose? I have no clue if the huge drop was novorapids doing or the cumulative effect of both the insulins in which case 7units of levemir is said to not have a peak. So how could it also have been a culprit?

 

[Juicyj]

Hey @Riley124 y12

You were right to split you dose the profile of levemir, it's duration is 16-20 hours, was this doctor a GP or Diabetes Specialist as they should know this, also right the tread the side of caution when making an adjustment to insulin, however with any insulin adjustment you need to see repeated patterns to determine if a dose adjustment is required. In regards to your novorapid drop, there could be many reasons for the drop, it's not linked to the levemir dose per se, but if you'd eaten fat for this meal for instance and taken novorapid then the carb absorption would be a lot slower so it could in theory cause a sudden drop. A one off doesn't tell you anything but a trend/pattern to this will.

Key to all of this is look for patterns, night time trends are easier to spot without the presence of carbs and quick acting insulin on board, but for daytime you should try some basal testing to check if your dose is working as it should. I look for the same pattern at least a couple of times to determine if any changes need to be made.

 

[Antje77]

I was on one single nightly dose of levemir at 16 units but it dropped me greatly at night and didnt last me a whole 24 hours so after so much contemplation i decided to split my basal.
I took 7 units of levemir this morning.

Did you take your usual 16 units last night?
If so, you still had lasts nights insulin active and you added more to that, which could be the cause of your drop.

 

[Riley124]

Did you take your usual 16 units last night?
If so, you still had lasts nights insulin active and you added more to that, which could be the cause of your drop.

Nope i took some NPH last night and it doesnt really last me longer than 8 hours

 

[Riley124]

Hey @Riley124 y12

You were right to split you dose the profile of levemir, it's duration is 16-20 hours, was this doctor a GP or Diabetes Specialist as they should know this, also right the tread the side of caution when making an adjustment to insulin, however with any insulin adjustment you need to see repeated patterns to determine if a dose adjustment is required. In regards to your novorapid drop, there could be many reasons for the drop, it's not linked to the levemir dose per se, but if you'd eaten fat for this meal for instance and taken novorapid then the carb absorption would be a lot slower so it could in theory cause a sudden drop. A one off doesn't tell you anything but a trend/pattern to this will.

Key to all of this is look for patterns, night time trends are easier to spot without the presence of carbs and quick acting insulin on board, but for daytime you should try some basal testing to check if your dose is working as it should. I look for the same pattern at least a couple of times to determine if any changes need to be made.

I understand. This does make sense. I did take 2 days off college to monitor my bg and be safe. Levemir is giving me a lot of problems. I just took my 6u of evening dose exactly 12 hours apart. Now again i took 2 units less than what i should be taking and my CGM shows it starts dropping me right as i inject it? And 1.5 hour later its continuing to drop me even more so. I made my blood sugar be at 270 on purpose just to give myself a safe margin to see how the evening dose plays out for me but im dropping.
The recent peak you see in this pic is when injected levemir and im continuing to go down