Levemir Advice

[rubypops]

Good afternoon,

I am a type one diabetic who has been diabetic for 31 years. My current HBa1c is 7.3% and I am trying to reduce this before pregnancy.

I have been on Novorapid plus a single dose of 19 units of toujeo in the morning. I was having severe bloodsugar drops between 2am and 6am most nights. My endo has changed me to Levemir. I am now taking two doses.

I read elsewhere that you should take one third of your dose in the morning and 2/3 of your dose before bed. Is this correct?

Any other advice on the change from toujeo to Levemir? And is one stronger than the other?

Thank you.

 

[Fairygodmother]

There’s no hard and fast rule about the am and pm doses of Levemir. The way you split the Levemir will depend on your own endocrine system.
When I moved to Levemir I was advised to start with a total of 3/4 of the total 24 hour dose of the basal I was moving over from, and halve it for the am and pm doses of Levemir. Don’t change the bolus ratio(s).
I kept a strict record of blood sugars over the first three days, basal testing each 6 hour section of the day, before I began to alter the doses of Levemir. I started with the am dose before moving to the pm dose. I basal tested before moving to the next stage.
It didn’t fall into place for about 3 or 4 weeks.
The eventual result was that I needed just one less unit overnight than I did in the daytime.

 

[Westley]

Good afternoon.
I can only speak about my experience, so this may not be applicable directly.

I came from Lantus(so still glargine like Toujeo, but a little different) to Levemir several years ago. Despite the shorter duration I've liked Levemir much more. It seems more consistent in action and doesn't irritate my injection sites like Lantus sometimes did.

I also used to struggle with night time lows, but do much better now.

Part of it was that in the dark ages of finger pricks only before the Libre I kept mistaking morning highs for insufficient basal dose and increasing it, when in fact I'd been sleeping through lows and bouncing back up, and what I really needed was to lower the basal dose, but bolus first thing in the morning for dawn phenomenon.
Another part of it was that the Lantus appeared to vary in speed quite a lot, depending on exactly how and where it was injected.

I do an even split 12 hours apart, but I know others find different splits work better for them.

The changeover was a bit nerve wracking, but actually went very smoothly. I erred on the side of under dosing at first, and woke for night time checks the first couple of nights. I think I ended up on just a slightly lower number of units than I was on with Lantus.

 

[jonathan183]

The am and pm dose can be quite different (for me one is around 4 times the other), sounds like lowering the pm dose is necessary ... depends what your daytime profile is like whether you need to increase/decrease/keep the same am dose.
I would drop units quickly to avoid hypos ... and increase units slowly to bring glucose profile down.

 

[Tony337]

Hi
I've been on levemir for years and as it doesn't last as long as toujeo or lantus you need to split the doses.
I take mine 12 hours apart and take 10 units at 6am, i'm active during the day, and 14 units at 6pm where i'm asleep for most of the next 12 hours.
My body is sensitive to exercise therefor need less during the day but we are all different.

My sister is type 1 and has a son now 25 who is not a diabetic and i have a 23 year old who isn't diabetic either.
I only mention this as i have always worried about passing my diabetes gene on!

I wish you well

Tony