Levemir - a few questions!

[suziesue]

Hi Fujifilm

Just thought I'd put my twopennyworth in!

I had been on Lantus for years and was changed to Levemir about a month ago as my specialist said it was a much 'smoother insulin'. At that point I was having 4 units morning and night of the Lantus so 8 units total per day and was told to have the same amount of Levemir. WRONG! After trial and error and my bs readings being up as high as 23 at one point I am now pretty stable on 8 units in the morning and 7 at night so double what I needed of Lantus. One thing I have noticed though, is that on Lantus I had more room for error with the diet so if I occasionally had some chocolate or a bigger meal my blood sugar would still stay at an acceptable level, without any adjustment to my Actrapid. BUT with the Levemir no way, even an extra potato or glass of fruit juice caused a major rise in my bs level. This is a little frustrating as you definately have to think more about what you eat but saying that I do feel much better on the Levemir and am now also trialing the Low Carb diet way of thinking and it all seems to suit me much better, bearing in mind I am 46 and have been Type 1 for 40 years I now have a new lease of life!!!!

I would stay stick with it and try and keep the diet as set as possible and if you need to eat extra think about the amount of quick acting insulin you inject as this will propably need to be adjusted.

Hope this helps.

Good Luck.

 

[suziesue]

Hi Fujifilm

Forgot to say I have my doses at 7.30am and around 6.30pm and this seems to work fine.

 

[Fujifilm]

Hi Suziesue

I am upto 16 units evening and 16 units in the morning and seem to have stabilised at around 9 but have noticed that just having a biscuit sends it up quite a bit. But I will press on with it.

I looked at the low carb diet business and to be honest I would lose the will to live counting carbs. :lol: Have cut down on the amount of bread I was eating but not much else.

 

[fergus]

I looked at the low carb diet business and to be honest I would lose the will to live counting carbs.

Steady on Fujifilm!
Frankly, any diabetic with good, stable control is only going to have achieved it by knowing how much carbohydrate they're eating. The big advantage of low carb is that there's a lot less counting!

fergus

 

[Fujifilm]

Steady on Fujifilm!
Frankly, any diabetic with good, stable control is only going to have achieved it by knowing how much carbohydrate they're eating. The big advantage of low carb is that there's a lot less counting!

Hi Fergus, somehow I managed to have achieved a reasonable stable control since 1989 without knowing much about carbohydrates, let alone counting them, beats me how I have survived. The only carbs I have ever been interested in are under a bonnet :lol:

I know the C word is a bit contentious on here, and to be honest I am still trying to get my head around all the arguments for and against a low carb diet, (both arguments have good and bad points) so I am not knocking anyone who is sticking to it or trying it and achieving good results. I just know its not something that excites me, personally I think my diet is pretty healthy and balanced (sometimes :twisted: ) and thats good enough for me.

 

[Jen&Khaleb]

Khaleb has 7 units Levemir at around 6.30am and 4.5 units at 5.30pm. He has 1 unit of Novorapid at each meal and half unit corrections if required occassionally. I don't find Levemir to have a flat profile and that when it kicks in there is a noticeable sudden drop. I try to time morning tea with the kick in. I find the Novorapid harder to manage as 1/2 unit will drop Khaleb 15mml so it is used with care. Khaleb is only 3 so his low body weight would have something to do with the problems of trying to stay in range.

Finding the right dose to be on is the hardest. As Khaleb is growing this amount is changing every few months and I try to only change any one thing every 3 days. Funnily enough Khaleb went through a stage of a few months having much larger than normal amounts of insulin but he has steadied again now. I guess it was just a growth spurt.

I do think that as Khaleb gets older I will probably need to reduce the amount of Levemir and increase the Novorapid with meals.

Jen.

 

[megan]

finding this interesting and confusing at the same time...

I take levemir split....20 in the morning and 24 at night.

I'm on about 2 units of novorapid per 10grams of carbs...

normally take 1 unit of novorapid to correct blood sugars by two numbers.

2 metformin tablets with breakfast and two with dinner.

I do remember feeling that there have been improvements over the past couple of years...but more so with other health conditions.....

the diabetes is still very much a battle.......I had a week of feeling GREAT...about 18 months ago.....

any thoughts?

 

[janet keys]

I have been on Lantus for nearly 10 years. I take 18 units in the morning. My bolus is Humalog and I adjust that according to my pre meal blood glucose reading and of course how much carbohydrate I am going to eat. My breakfast is Tesco's Oat crunch which has a high fibre content this lasts until about mid afternoon. Sometimes I skip Humalog at lunch if I am particularly active and if I have to drive on motorways because I like to have a blood sugar of above 8. I am just about to change to Levemir and will start on 18 units in the morning before breakfast. When I first started on Lantus I took it before my evening meal and found I was low during the night. When my blood sugar is below 12 at bedtime I can't get to sleep and it drops rapidly at about 4 am. Also if my blood is higher than 15 before sleep, I can't sleep because I feel too hot and energised. It is a tightrope controlling diabetes and everyday life affects it enormously. I wish I could just forget for 24 hours. It is a very stressful condition.

 

[Fujifilm]

Thought I would add an update as I have been on the Levimir for a couple of weeks, its been a ****** to stabilise but the last few days I have been in single figures and I actually feel OK.

The only down side is I itch on my face and arms and I am sure its the Levimir causing it, also my sleep pattern has got worse, its always been bad but I now find I cant sleep until 5 in the morning then wake up at 10 totally knackered. But still can't sleep at night.

Oh and I have put on half a stone :? but don't eat any more than I did before, if anything I eat less.

Apart from that I am OK.

As long as I wake up in the morning I have a fighting chance :lol: :lol:

 

[Dillinger]

I am just about to change to Levemir and will start on 18 units in the morning before breakfast.

Hi Janet,

I recently switched to Levemir and am liking it a lot; you would probably need to split your doses though; one in the morning and one at night. That way you can have a reduced night time dose to cope with any blood sugar drops whilst you sleep. You will probably need to increase the Levemir dose as well (mine went up by about 1/3rd).

Going to bed with blood sugars of 12 is not great though! Hopefully you could get that down to 6-8 with a bit of tweaking. The breakfast is also probably not helping much; I've found everything so much easier and less stressy by avoiding those types of foods.

All the best

Dillinger

 

[kewgirl]

Hi Fujifilm

Thanks for the update on Captain's Log, Star date: Life with Levemir :lol: :lol: – isn’t it strange :shock: that both long acting basal analogues begin with “L”!!

The itching sounds like a possible allergic reaction is occurring. Although allergic reactions to insulin are rare they can happen and the macromolecular (what a fab word ) size of insulin is that the molecules of insulin are large & as such large molecules can act as complete antigens.
I experienced large welt like blisters on my abdomen from using Levemir so after 4 days I ended up in A&E & ditched the Levemir – well at least I tried it!!

Re the weight gain - if the Levemir dose is significantly different from your Lantus dose then it would be easy to blame the weight gain on increased insulin dosage but…….. you could be experiencing water retention from the Levemir. :shock:

In conversation recently with one of the Specialist Registrars from our Local Diabetes Team he has observed water retention occurring in some diabetics using Lantus & Levemir.

The water retention you would think would be easy to spot as typically this manifests itself with a person getting swollen ankles. But it appears that water retention from analogues is rapid weight gain & not always accompanied by swollen ankles & you cannot feel water sloshing around your insides. Thus unfortunately we do not know what internal damage might be being caused to organs such as kidneys & hearts with this water retention.
When I changed back to Porcine Animal Insulin from using Lantus & briefly Levemir I peed :shock: for England, Wales, Scotland in fact the Universe!
Why water retention affects some diabetics using long acting GM synthetic analogues and not everyone using them is a mystery.

But it is good to know you’re ok & we look forward to further updates!

Best wishes

Txx

 

[Gazhay]

I didn't read the entire thread.

That said, are you sure you aren't rebounding in the night?
You are increasing Leveir dosage and still being high in the morning, I would consider checking a few times in the night to see if you are going low.

 

[Fujifilm]

Hi Kewgirl

Water rentention could be the cause and I will certainly bring this up with the Doc when I see him in November, I am going to do my best to get off the devil juice and get onto Porcine Animal Insulin

Will keep up the log

 

[lilibet]

Hi
I just moved from premix to B/B in order for to give more flexibility and eat a bit more as only way to manage premixe and get good A1c IMHO is to be very low carb on premix. Dont anticipate being a pasta monster on MDI but a yoghurt now and again would be nice

Funny re the comments of feeling 'not right' - amazing how many DSN wont take it on board because its not a 'known' side effect. Anyway, to levemir

I split it 5 and 5
Lower doses are less potent and last less time. Apparently is quite high percentage less potency than lantus, though this will be good for kiddies, small TDD's. I find however that it doesnt last as long as its meant to, and doesnt help tackle DP if you dont take quite early in the morning. Also trails off at dinner time which is fine if you are eating and topping up with the rapid acting but if you have a later dinner (like you are meant to be ABLE do on b/b) then readings might be higher

Ive only ever been on Novo Nordisk insulin but if I dont start to feel 'well' - after a year, and good HBA1c's I think I will at some point change to other insulins as medics unable to say why I dont feel 'right'. Of course, no one blames insulin . DNS today told me its just what I didnt have but im sure I didnt have aspart molecules or hydrochloric acid or cresol in my pancreas!

 

[sophsmam]

can anyone help i've had to increase our daughter's levemir by 2 units over the past week.and still unable to get them below 10 on a morning and today she's been over 10 every mealtime.so today she's had a lot of novorapid, with carb counting if her b/s is over 10 she gets a correction dose on top of her normal dose.
her levemir is 31 units for every 7grams its 1 unit of novorapid.
her correction dose if 10 is 2 units,this morning her b/s was 10.8.not sure if it works like this would it be possible she needs an extra 2 units of levemir.
I was going to split her levemir but then her b/s were very good until now.

 

[lilibet]

HI Sophsman

Try splitting levemir, you might find its not lasting and you have to constanly top up, and then chase the higher bg all day,. Also, if basal isnt set right, makes it much harder to find ratios across the day

Of course, the Sun could just be in Mercury for the sense this bloody condition makes at times!

 

[Fujifilm]

Of course, the Sun could just be in Mercury for the sense this bloody condition makes at times!

:lol: :lol: :lol: Thats funny and you could well be right.

 

[sophsmam]

She was on 29 units of levemir and if she was high at 10.30pm, she would have some novorapid because i knew she would be high in the morning. so i decided to increase her levemir to try and stop that extra injection.iv'e increased it by 2 units and still no change maybe she needs more.Last night she had novorapid to cover her supper plus her 31 units of levemir.
woke up with a b/s of 7.8.

Is it possible she needs that extra bosal instead of increasing her levemir.we've tried adding it on at teatime but then she goes hypo.maybe we should spilt the dose at tea but then its an extra injection.

 

[lilibet]

I would still try a split
It doesnt need to be equal so you could have higher at night than morning, or whatever

Once its set (and its hard to get young uns to skip meals to check) you could look closley at ratios?

 

[sophsmam]

took a risk last night increased her levemir by 3 units she woke up with b/s of 6.8.