Levemir Split Dose

Dweeden

Newbie
Messages
2
Type of diabetes
Type 1
Treatment type
Insulin
Hi all

T1 for 11 years now, have had on/off trouble with my levemir long acting over the years, I also get dawn phenomenon so body produces a lot of sugar in mornings, at some times seemingly more than others. For the most part I’ve always taken 1 dose at night to try and reach glucose reading of 7 for the morning, seems to be an impossible task at times and sometimes I then keep dropping low later in the morning. Have had it mentioned to me in the past and also recently by nurse about split dosing the levemir, so one dose at bedtime and another the next day, whenever I’ve tried this in the past I used to do it 12 hours later. So at 2100 and then 0900. Ive also only ever split the dose evenly so same number of units at night as 12 hours later, never got on with it and ended up back at single dose. When I spoke to nurse recently on review they said most people don’t do it like that, didn’t really get any pointers from the nurse at the time though! So I’m just after any pointers really from all you other lucky T1s - would be helpful if I can find out what are other people doing, like how are you splitting the dose, 75% 25%? Or any other common ratios, and what sort of time difference are you using?

Thanks in advance

Dave
 

SimonP78

Well-Known Member
Messages
536
Type of diabetes
Type 1
Treatment type
Insulin
It's a shame there aren't some tools available to help with this. I used to take all of my insulin pre-bed, but used to run low overnight, so switched to an even split pre-breakfast and pre-bed, which I think fixed that, it was a long time ago and things change.

I tried making a model earlier this year (https://forum.diabetes.org.uk/boards/threads/insulin-adjustment-mdis.106149/#post-1260351) for use in reducing my active insulin while cycling during the day. I'm not sure how good it is, it's quite hard to validate it (aside from saying that, yes, I didn't seem to go as low as I otherwise would have).

It may not be in a very useful form, and it's also designed for my basal (abasaglar - lantus.) More than happy to turn it into something Excel based and to add other types of insulin if that would be of use.
 

Ushthetaff

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I use to be on Lanctus one injection 24 units before bed , I’m now on Levimir and have been for quite a few years , I split my dose 12 am 12 pm , I try to take them 12 hours apart but not religiously , after a bit of “ experimentation “ I now take 14 units am and 10 pm , seems to work for me
 

Sallyw

Active Member
Messages
33
Type of diabetes
Type 1
Treatment type
Insulin
Hi!
I’ve been Type 1 for 67 years; since I was 2.
I am now attending a DAFNE course on the recommendation of my new diabetes health care professionals, since moving from Devon to Hertfordshire. Very intense and quite different to how I have been managing my diabetes. My last HB1ac was 7.4 and at my first review with diabetes nurse I was told that my control was “unusually good “.
I have been using Freestyle Libre 2 for 5 weeks and my results don’t seem to be nearly as good as before I had it!
My main concern is that it has been suggested by the DAFNE team that I change from 20 Lantus am, to Levemir twice a day. I can’t find any data to support doing this. Any advice appreciated!
 

EllieM

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My main concern is that it has been suggested by the DAFNE team that I change from 20 Lantus am, to Levemir twice a day. I can’t find any data to support doing this. Any advice appreciated!

My understanding is that because levemir doesn't last 24hours splitting it allows you to have different basal rates in the day and night, which helps some people. (I'm not a big lantus fan because I find it a little unpredictable and would love to trial levemir, but it's not available where I live). But you'd have to ask the DAFNE team why they think levemir would be better for you personally.

 
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Sallyw

Active Member
Messages
33
Type of diabetes
Type 1
Treatment type
Insulin
My understanding is that because levemir doesn't last 24hours splitting it allows you to have different basal rates in the day and night, which helps some people. (I'm not a big lantus fan because I find it a little unpredictable and would love to trial levemir, but it's not available where I live). But you'd have to ask the DAFNE team why they think levemir would be better for you personally.

 

Sallyw

Active Member
Messages
33
Type of diabetes
Type 1
Treatment type
Insulin
Thanks very much for your reply. I have my 3rd DAFNE meeting tomorrow so will ask then.
 
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SimonP78

Well-Known Member
Messages
536
Type of diabetes
Type 1
Treatment type
Insulin
Hi!
I’ve been Type 1 for 67 years; since I was 2.
I am now attending a DAFNE course on the recommendation of my new diabetes health care professionals, since moving from Devon to Hertfordshire. Very intense and quite different to how I have been managing my diabetes. My last HB1ac was 7.4 and at my first review with diabetes nurse I was told that my control was “unusually good “.
I have been using Freestyle Libre 2 for 5 weeks and my results don’t seem to be nearly as good as before I had it!
My main concern is that it has been suggested by the DAFNE team that I change from 20 Lantus am, to Levemir twice a day. I can’t find any data to support doing this. Any advice appreciated!

Interesting that you don't find your results as good - might just be random changes/a bad month as we all get, or perhaps you're now paying attention to the libre rather than going with you previous methods (the libre can also over-read, which may not help things when you compare with actual finger prick tests). I guess only your next HbA1C will tell you whether it's actually worse or you just feel that way.

In any case, I think I'd be suggesting to those telling you to change insulin words to the effect of "if it's not broken...."