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Insulin advice please

Natalie1974

Natalie1974

Well-Known Member
Messages
871
Location
Kent
Type of diabetes
Type 1
Treatment type
Insulin
I'm having a bit of bother with my blood sugars today...I forgot to take my Levimir last night, so took a half dose this morning 13 units compared to my usual 26, not sure if this was the right thing to do or not. When I checked my sugars this morning it was on 21.6mmol, this is quite unusual for me except in times of illness so I think maybe I'm coming down with something. Normally I would take 6 units with my breakfast but this morning I took 10 to try and correct it. When I tried again a couple of hours later it was 22.8mmol so I took a further 4 units but it's still creeping up, it's now 24mmol and I've not yet had my lunch. At a bit of a loss for what to try next...any ideas? I'm worried that the insulin will catch up with me all of a sudden and I'll find myself in a bit of a mess.
 
Skipped lunch and blood is now 25.6...I'm wondering if there's a problem with insulin, although it was fresh out of the fridge a couple of days ago. I'm ok...but panicking a little now :(
 
Hi Natalie

I don't have enough experience of Levemir to give advice on a missed dose. Hopefully someone more knowledgeable will be along shortly.

As far as the high BGs go, you are right to be cautious about stacking insulin, but bear in mind that you will need a bigger correction dose than normal when you are trying to come down from the 20s. Also, is it possible that the insulin in your fridge could have frozen at some point?
 
I did the same a couple of weeks ago and forgot to take my levemir.

I did what you are doing and tried to correct with my novorapid. Its hard as not only are you trying to correct but also compensate for the lack of basal in your system. Like you the quick acting i was taking was only really keeping me level and not dropping me down but its scary and potentially dangerous to give yourself lots of insulin when not eating . I just tested and was careful not to have more than one QA shot every 4 hours.

Once I took my next shceudled shot of levemir things settled down pretty quickly so hopefully you will be ok. I hope that you get back to normal when you take your dose this evening. Do you have a new pen to use just to be on the safe side?

Can you take your levemir a little earleir than you would normally do so you are not without your basal for so long?

let us know how you get on.
Andrea
 
Have you checked for Ketones, and where is your blood sugar currently?
 
I've taken another small dose from a spare pen I keep in the fridge at work...blood sugar still sitting at 22.1mmol. I've not checked for Ketones but will do so when I get home...hopefully in the next half hour or so. Thanks for your help all of you, I will let you know how I get on.

Just out of interest, what is the correct practice if you forget to take a dose of levimir?
 
I'm on lantus and was told if I forget to take my evening dose I had to take half the following morning (much as you have) and take corrective doses of QA insulin where necessary, I'm sure once you take your evening dose tonight your bg levels will settle down tomorrow, but do keep and eye on your levels tonight and check for ketones when your back home, any problems ring your out of hours gp service or NHS Direct.
 
I'd split the Levemir dose and correct blood sugars with short acting.

Might be an idea to split the Levemir anyway going forward; it's a cleaner action if you do.

Do you have a standard correction dose? Meaning do you know how much 1 unit of rapid acting will drop your blood sugar by (all other things being equal?).

If not then you need to figure that out by testing yourself in the middle of the day when you have no active rapid acting insulin present.

I find if there are problems and my blood sugars rise above about 14 I'll need to factor in extra insulin to correct that.

Try a final correction dose as soon as you get home to try and ensure that it clears your system by the time you go to bed as you obviously don't want to have a fast drop whilst you are asleep.

Good luck!

Dillinger
 
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