LEVEMIR PEN

[Bonecrusher]

Hello does anyone use this type of insulin. I am trying to find out the maximum daily dosage.

 

[gavin86]

When you say "maximum daily dosage", do you mean how much can it give in a single injection?

 

[Jaylee]

Hello does anyone use this type of insulin. I am trying to find out the maximum daily dosage.

Hi @Bonecrusher ,

Welcome to the forum!

Are you having issues with your diabetes managment?
Your first "port of call" regarding a question like this, would be your health care professional..

 

[catapillar]

Hello does anyone use this type of insulin. I am trying to find out the maximum daily dosage.

Why are you trying to find out maximum daily dosage? There is no such thing as a maximum daily dosage. It's entirely individual and about finding the right dose to manage your blood sugar. Person A might take 8units am and 6units pm and that might keep their blood sugar nice and stable. Person B might take 70units am and 100 units pm and that's what they need to keep their blood sugar stable. Obviously person Bs dosage is well above the maximum that it would be sensible for person A to consider taking without encountering some pretty serious hypos. The important thing is does your dosage work for you.

There are starting points for working out a basal dosage. Things like weight, so a conservative estimate of total daily dose would be 0.6u / kg. then the basal bolus split is supposed to be 50/50. But that would be a really very rough starting point. That would need starting off 20-30% lower and basal testing to actually find the right dosage.

Here's some info on how to basal test - https://mysugr.com/basal-rate-testing/

 

[Bonecrusher]

Hi @Bonecrusher ,

Welcome to the forum!

Are you having issues with your diabetes managment?
Your first "port of call" regarding a question like this, would be your health care professional..

Why are you trying to find out maximum daily dosage? There is no such thing as a maximum daily dosage. It's entirely individual and about finding the right dose to manage your blood sugar. Person A might take 8units am and 6units pm and that might keep their blood sugar nice and stable. Person B might take 70units am and 100 units pm and that's what they need to keep their blood sugar stable. Obviously person Bs dosage is well above the maximum that it would be sensible for person A to consider taking without encountering some pretty serious hypos. The important thing is does your dosage work for you.

There are starting points for working out a basal dosage. Things like weight, so a conservative estimate of total daily dose would be 0.6u / kg. then the basal bolus split is supposed to be 50/50. But that would be a really very rough starting point. That would need starting off 20-30% lower and basal testing to actually find the right dosage.

Here's some info on how to basal test - https://mysugr.com/basal-rate-testing/

I appreciate what you are saying but quite obviously there must be a maximum daily dosage. I monitor my blood levels very closely my wife has been a diabetic since she was seven so I am aware of how the whole thing works. Basically I will be introduced to short acting some stage soon but my Doctor wants to delay this as long as possible. I was taking 18 once a day and now am taking 40 twice a day. I can keep increasing it but had some concerns about how far I could take this. I will of course listen to the professionals but thought I might get some feed back if someone was or is in the same position as I find myself.

 

[azure]

@Bonecrusher Whatbare your blood sugars like n your current dose?

How long have you been diagnosed?

Your profile says you're Type 1 - is that correct?

 

[Bonecrusher]

@Bonecrusher Whatbare your blood sugars like n your current dose?

How long have you been diagnosed?

Your profile says you're Type 1 - is that correct?

I have a very unusual type so I am informed. It has been getting worse for the last ten years. I was introduced to insulin about a year ago and was then given the tag Type 1. I currently use long acting twice a day but in the year has gone from 18units once a day to 40 twice a day. It is struggling to control my sugar levels and so my only option at the moment is to increase the units.

 

[catapillar]

I appreciate what you are saying but quite obviously there must be a maximum daily dosage.

I don't know how to say it differently. There is no such thing as a maximum dose of levemir. You say obviously there must be, but, quite simple, there isn't. The dosage requirements vary, broadly, between individuals. If your levemir dose isn't causing hypos then it can't be said to be too high. If you are type 2 and only taking basal insulin you might be on a dosage that seems very high in comparison to a type 1 wife on a basal bolus regime. That doesn't mean you are exceeding any maximum, it just means that's what you need to control your blood sugar.

 

[azure]

I have a very unusual type so I am informed. It has been getting worse for the last ten years. I was introduced to insulin about a year ago and was then given the tag Type 1. I currently use long acting twice a day but in the year has gone from 18units once a day to 40 twice a day. It is struggling to control my sugar levels and so my only option at the moment is to increase the units.

That sounds very similar to LADA @Bonecrusher if you've been told you're Type 1. LADA is a form of Type 1 that comes on slowly.

If you're taking the basal (Levemir) and your blood sugar isn't controlled, you might find you get better results with both a basal and a bolus (meal) insulin. Then you might be able to reduce your Levemir possibly and cover your meals with a fast acting insulin.

 

[Bonecrusher]

That sounds very similar to LADA @Bonecrusher if you've been told you're Type 1. LADA is a form of Type 1 that comes on slowly.

If you're taking the basal (Levemir) and your blood sugar isn't controlled, you might find you get better results with both a basal and a bolus (meal) insulin. Then you might be able to reduce your Levemir possibly and cover your meals with a fast acting insulin.

Yes you are correct in what you are saying I know I will need to take bolus in the end. I would prefer to make that change now but my Doctor wants me to continue on this regime for now (until my HBA1C goes through the roof again). He held off introducing Levemir for over a year although I knew I would benefit from it being introduced earlier. I see your point Catapilar, I guess injecting large amounts seems daunting as I have only been injecting a relatively short time. In the beginning I did drop low a couple of times and have Hypo like symptoms but now never get anywhere near that situation.
That's for all your input I do appreciate you taking the time to answer.

 

[azure]

Yes you are correct in what you are saying I know I will need to take bolus in the end. I would prefer to make that change now but my Doctor wants me to continue on this regime for now (until my HBA1C goes through the roof again). He held off introducing Levemir for over a year although I knew I would benefit from it being introduced earlier. I see your point Catapilar, I guess injecting large amounts seems daunting as I have only been injecting a relatively short time. In the beginning I did drop low a couple of times and have Hypo like symptoms but now never get anywhere near that situation.
That's for all your input I do appreciate you taking the time to answer.

I'd push your consultant if I was you. It's not right that Younhave to,wait to get high sugars to get a bolus insulin. High sugars can cause damage, as I'm sure you know.

A basal/bolus regime gives more flexibility and should give you better sugars than just a basal.

If you're not happy with the care you're getting, ask for a second opinion or change consultants/hospitals. It's your health in the end.

 

[Jaylee]

Hi agian @Bonecrusher ,

Are you prescribed any other diabetes medication (pill form.) other than Levemir?

Another thought. Are you taking any steroid bassed medication too?

 

[Bonecrusher]

I'd push your consultant if I was you. It's not right that Younhave to,wait to get high sugars to get a bolus insulin. High sugars can cause damage, as I'm sure you know.

A basal/bolus regime gives more flexibility and should give you better sugars than just a basal.

If you're not happy with the care you're getting, ask for a second opinion or change consultants/hospitals. It's your health in the end.

Thanks Azure I think you have hit the nail on the head. I am not under the hospital or a consultant. Its a GP at the local surgery who is named as the specialist Diabetes Dr. Problem is its him that would need to refer me to the hospital. I will look into this, your information has been useful I had never heard of LADA Diabetes.

 

[azure]

Thanks Azure I think you have hit the nail on the head. I am not under the hospital or a consultant. Its a GP at the local surgery who is named as the specialist Diabetes Dr. Problem is its him that would need to refer me to the hospital. I will look into this, your information has been useful I had never heard of LADA Diabetes.

That explains it. Ask for a referral. If you're Type 1, you should be seen by a consultant.

Don't be dissuaded from getting the care you need.

 

[Bonecrusher]

Hi agian @Bonecrusher ,

Are you prescribed any other diabetes medication (pill form.) other than Levemir?

Another thought. Are you taking any steroid bassed medication too?

I am taking Metformin and Stigliptin I am not aware that either of these or any other medication I take is steroid based.

 

[Jaylee]

I am taking Metformin and Stigliptin I am not aware that either of these or any other medication I take is steroid based.

The drugs you named are not steroid bassed...
However,
Steroid bassed drugs can raise BS though. Hence my enqirory...

Thanks for your reply.

 

[Daibell]

Hi. As others have said there is no maximum dose of Levemir. The increase you have seen could be due to eating too many carbs and gaining weight and then developing insulin resistance. Also you may be going thru the LADA honeymoon period where the beta cells slowly decay. See a consultant at the clinic if you can but I have only ever been treated at the surgery but they do have some good DNs. Don't let them delay insulin as my surgery GP did. Get a bolus started as soon as you feel the need for better control. I suspect you may be having large shots of Levemir to compensate for the lack of Bolus. Get the Levemir Basal balanced (ask for advice if needed on this) and push for the Bolus needed.