Levimer splt dose

Nanaclaire said:

Hi there can anybody help ,I have recently (2wks) been switched to Levimer from lantus been having mega problems with my diabetes (kidney problems ) taken off 1500 mg of Metformin in August & no other meds replacing it.
Splitting dose to 40 units at bedtime & 40 units in morn, 34-38 units of nova rapid @ mealtimes, my BS are all over the place but dropping rapidly around 4pm (3.6)hence correcting a hypo my GP increased me to 46 le emir at night on tue but still morning BM is 14 + when is the best time to take my Levimer in the morn. I am at lose as no what to do nothing appears to be working I have been seeing DSN every two weeks due to see her next week any advice would be much appreciated.

Nanaclaire

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I've always been told to give the split Levemir doses 12 hours apart, so I do them at 8.30 am & 8.30 pm because it suits my routine. Once the Levemir doses are correct and at the right intervals, if you are getting lows at the same time each day, that is most likely to be down to too much Novorapid at the previous meal. Generally, Novorapid will be acting on your blood sugar for 2-3 hours after being injected.

Examples: If you inject and eat at 1pm and have low sugar at 4pm (before your evening meal) you need to lower your lunchtime Novorapid.
If you inject and eat breakfast at 8am and are low at 11am, it would be the breakfast Novorapid that needs reducing.

However, if you are experiencing lows at different times throughout the day then it is likely to be your AM Levemir that is too high. And likewise lows at night are usually down to too much evening Levemir. It is easier to sort out your control by bringing high blood sugar levels down than trying to get low levels up, because most hypos are followed by a high rebound.
I've just spent many months trying to do this exact same thing, but I'm pretty much there now.

You don't mention how much you eat. If you are only eating small portions and are not overweight then there may be scope for eating a little more to prevent the lows, but generally it is better to lower the insulin to suit your food intake,rather than eating to your insulin requirements.