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Levemir split dose - am I weird?

Discussion in 'Type 1 Diabetes' started by Levy, Aug 31, 2017.

  1. Levy

    Levy Type 1 · Well-Known Member

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    Hi all, haven't posted in a very long time but I've recently (thanks to the Freestyle Libre) got back in to taking a very active interest in managing my diabetes again (yay me!)

    Anyhow, I was reading the book "Think like a pancreas", and in the bit about basal insulins I noticed it said for Levemir most people take either an equally split dose twice a day, or tend to take a higher dose during the night than during the day as insulin requirements tend to be higher due to hormones released during the night.

    Now, I seem to be the complete opposite! For ages, I've been taking 18u in the morning, and 14u at night (but I'm about to reduce that to 12u because the Libre is showing me I drop quite a bit during the night). This seems quite a difference.

    Is this really weird? Do other people experience the same? And I think another question I had, because I was looking at potentially asking about Tresiba because I've heard great things about its stability, is that due to my very differing need in day/night time basal, am I right in thinking Tresiba would not be right for me?
     
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  2. noblehead

    noblehead Type 1 · Guru
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    Nothing weird about it at all, there's no blueprint when it comes to how much insulin we need as individuals.

    Tresiba would be a better option IMHO, heard so many good things about the insulin, put it this way if I was to return to injections that would be the basal I'd be asking for.
     
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  3. GrantGam

    GrantGam Type 1 · Well-Known Member

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    The important thing is that your basal doses are correct and keeping your fasting BG's in check. Whether you're a weirdo or not has nothing to do with your basal requirements:)

    I currently take 10u at night and vary my daytime dose depending on activity levels - but I'm normally around 6u-8u.

    I was taking more basal insulin during the day for a while, I - like you - thought myself a little strange because of it. I think it was uncertainty around a new job and a possible stress response that made me need more basal insulin during the day than at night. Being the new guy and all.

    Just because your needing more basal during the day shouldn't be a cause for concern. The main thing is that it's keeping your diabetes in check!
     
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  4. Levy

    Levy Type 1 · Well-Known Member

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    From what I've read I also really want to enquire about it but am scared it might not be for me if my requirements during the day and night aren't equal.
     
  5. hboyt

    hboyt Type 1 · Well-Known Member

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    Like you my units of levemir were always more in the day and less at night....that was before i went on the pump
     
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  6. noblehead

    noblehead Type 1 · Guru
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    Like most things we can only find the answer when we actually try something, nothing ventured nothing gained so to speak.

    Maybe just see how you get with adjusting your levemir doses for now, if you get the dosage right then there's little need to change basals.
     
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  7. mike123topcat

    mike123topcat Type 1 · Newbie

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    HI,

    I take 12u morning, & 14u at night 12 hours apart
     
  8. Daibell

    Daibell LADA · Master

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    To be honest there is an enormous amount of guesswork that goes on with Basal dosing having seen many posts over the years. Personally I only inject once day at night as I've never really seen the point of split dosing (yes, I know Levemir only lasts 12-18 hours but I just change the Bolus ratio nearer to the 24 hour point). Having a single dose makes it easier to get the Basal balance right and saves an injection but perhaps I'm weird.
     
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  9. Levy

    Levy Type 1 · Well-Known Member

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    Not weird at all! I'm only doing split doses because my consultant told me to. If it works, it works I guess!
     
  10. Levy

    Levy Type 1 · Well-Known Member

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    That's very true. I suppose part of me was hoping I might be able to go back to 1 daily basal injection because it's more convenient, easier to remember (I will forget to take it if I don't set alarms on my phone) and it'll be easier on my injection sites.
     
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  11. noblehead

    noblehead Type 1 · Guru
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    I doubt many people will be able to get away with one injection using levemir @Levy , personally I didn't get on very well when I changed to levemir despite trying different combinations at getting the dosage right.

    The beauty of Tresiba is it lasts up to 42 hours but is injected once a day, with that duration it's highly unlikely that anyone would have to split-dose the insulin :)
     
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  12. Levy

    Levy Type 1 · Well-Known Member

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    Yes, that's what I meant @noblehead sorry! The single injection was my reasoning for wanting to try Tresiba, I realise I won't be able to get away with it on Levemir. But you're right, if I can get the dosage right there should be no need to change really. In the grand scheme of things I haven't been on Libre long so I've got plenty of opportunity to fine tune!
     
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  13. Shannon27

    Shannon27 Type 1 · Well-Known Member

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    Tresiba has been fantastic for me, one injection daily and the main advantage is that it lasts longer than Lantus which was giving me highs when it ran out after 22 hours. The pens are easy to use as well, I mean they all are to some extent but I find Tresiba's delivery system much more... shall we say, 'pain free'?
     
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  14. steve_p6

    steve_p6 Type 1 · Well-Known Member

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    I'm weird too! I split Tresiba as well but it works far better for me than Levemir ever did.
     
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  15. slip

    slip Type 1 · Well-Known Member

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    They say the general rules of T1D insulin dosages:

    When split dosing basal, do 50/50 split, or slightly more at night than the morning.

    Total daily Basal and Bolus dosages should be 50/50 split too.

    Inject bolus just before eating.

    I think we can all at some point in our time completely disagree with some of those statements!

    Reality:

    Do what works for you!
     
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  16. CJa

    CJa Type 1 · Member

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    I use Levimir and thought it was a wonder drug. After reading this post I am calling my GP now to ask for Tresiba.:)
    I find my levimir dose changes mostly because of temperature but usually stay near to 50/50.
    I also find a single unit of levimir makes a huge difference in my blood sugar control. I aim for my fasting result to be between 3 and 4. That way, my daytime control is much easier.
     
  17. noblehead

    noblehead Type 1 · Guru
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    My goodness that's low @CJa and is in hypo territory, if you continue with that practice you'll fast lose your hypo awareness symptoms.
     
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  18. Kbarbaracollins_

    Kbarbaracollins_ Type 1 · Well-Known Member

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    I use Tresiba and still split the dose morning and night which Dr Bernstein recommends. It gives me a much more stable reading through the night than Levemir. I also take a slightly higher dose at night than in the morning which seems to work for me
     
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  19. CJa

    CJa Type 1 · Member

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    Hello @noblehead. I have now been using the Tresiba for about six weeks. So far i feel that its amazing. My fasting resuts are typically between 5 and 6 and I seldom rise above 8, unless I forget to inject.
    I was previously on around 40units of levimir but am only needing 23units of Tresiba. My humolog demands have risen to compensate.
    I do seem to have lows sugars around 4pm and I haven't yet worked out why, nor what to do about it. I am currently enjoying a mid afternoon chocolate break .
    Lookng forward to my next Hbac1.
    Chris
     
  20. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

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    Heard good things about Tresiba. Tried Levemir for a month, didn't work for me, I still use Lantus 25U in the morning.
     
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