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Levemir question.

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Ka-Mon

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Can anyone tell me anything about levemir please?

Is there any point in injecting 2-3 hrs after meals or is that a waste of time?

Thanks
 
While you wait for the experts to come along Ka-mon..

My daughter was on Levemir for over a year. She injected it approx half an hour before bedtime so I guess it is one of the slow acting insulins?

We weren't told that it had to be given at a set time after eating but sure someone will be able to advise you better. :)
 
Ka-Mon said:
Can anyone tell me anything about levemir please?

Is there any point in injecting 2-3 hrs after meals or is that a waste of time?

Thanks
Click to expand...

What do you mean Ka-Mon?.........with basal insulin's it's best to try and stick to in and around the same time each day.

Nigel
 
I don't want to hijack the thread but can I just ask..what is Bolus? I have seen "basal/bolus" frequently but haven't a clue what they are.

thanks
 
ladybird64 said:
I don't want to hijack the thread but can I just ask..what is Bolus? I have seen "basal/bolus" frequently but haven't a clue what they are.

thanks
Click to expand...

It's the insulin (quick acting) you give before or immediately after eating your main meals.

Nigel
 
My 80 year old mother has been on Levemir for around a year and a half but hasn't had much success with it. I've finally got her to cut down on carbs but now she has hypos in the morning before breakfast. After lunch she is always in the high 10's and in the 20's after supper, she has also had some readings in the 30's.

Right from the beginning she was told to inject at 10am and 10pm regardless what times she eats. But, if she eats supper at around 7/8pm and injects at 10pm then:

1) is it not too late to do her any good injecting 2-3 hrs later
and
2) could the reason why she has hypos in the morning is because she injects so late?

I went with her for the first time today to see her GP and after telling him about her problems he now suggested that she injects just before eating. He said to try this out for 6 weeks and if she still has high readings he will then put her on 4 injections per day, one injection just before each meal and one at bedtime. But if it's a "background" insulin, will it help?

Another problem which is not helping is that she now has visits from nurses for a few weeks but they don't keep to the injection times, they give her the injection whenever they arrive which could be anywhere from 8-10pm.
 
Hi Ka-mon

Levemir is a long acting insulin and essentially has a slow release, so it comes on slowly and lasts for a long time. As the others have said, basal insulins are supposed to deal with the daily trickle of glucose coming from the liver, not the spikes that come from food. Because of that, it shouldn't make any difference when in the day you take it as in theory it lasts all day long (although most find levemir works best split into two doses). If you do split it, then the doses are supposed to be 12hrs apart. I haven't heard of anyone saying take your background at times to follow your meals before. Because it's 12 hrs apart, you're really left with early-mid morning and early to mid / late evening depending on when you get up and go to bed.

IMO the hypos in the morning would be more likely to be caused by the amount of the 10pm levemir. You usually start with a 50:50 split with levemir, but I think lots of people change the split. For example, I take 3u am and 12u pm. I guess her pm levemir is too much and her am not enough, but that's only my view. I dropped my am dose because I was going hypo before lunchtime and again before tea. However I'm still a little high in the mornings, hence the 20:80 split.

My guess is that when the doc says four injections, he means a multiple daily injection routine, i.e. Apidra / novorapid plus levemir (basal / bolus). I could be wrong but that would be my guess. That way your mother will get some insulin to cover the meals as well as the basal rate
 
Levemir (Detemir) is supposed to have a flat profile but as you may see from this graph it is not completely peakless... so the time of day when you take it, can make a difference. I agree that ideally the doses should be around the same time each day. But I think Russ has given the best advice.. she may need to alter the dosage and not make it a 50% 50% split.

basalinsulincomparison.jpg
 
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