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Levimir split dose

Discussion in 'Insulin' started by lely, Nov 12, 2014.

  1. lely

    lely · Well-Known Member

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    Hi does any one use levimir on a split dose. Wondering if it would help my control
    I have high bloods in morning if I have dose in morning and high bloods in night if I do dose in night.
    Seeing my DSN and dietitian tonight at carb counting course so will ask the professionals. But looking to to if it works for anyone else and helped round the clock control.
     
  2. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    A split basal dose is in my opinion best, and that's with any insulin you use..........

    your needs overnight are different from your needs during the day and splitting allow you to deal with the day and night separately, where as before if you changed your single dose to help with waking levels you may have found that change upsetting your day time requirements......

    an ideal dosing scenario is getting your background needs covered as close to perfect as you can and then giving as little of the quick acting stuff as you can.........

    it worked great for me, in comparison to Lantus anyway.............now on a pump............so have even better basal success..........
     
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  3. alaska

    alaska · Well-Known Member

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    If you're getting high readings before your single Levemir dose -and that happens regardless of which part of the day you have your injection (ie morning or night), it would seem to imply the dose is wearing off before the next one.

    If doses are wearing off before your next one, note this could could raise the risk of ketoacidosis, particularly if a dose ever got delayed for some reason.

    It is this reasoning which makes me wonder why doctors put people with type 1 on non-split Levemir doses.

    I'd certainly suggest putting the question to your diabetes specialist nurse but would also advise speaking with a consultant if you can. Whilst DSNs help people with basics, their all round understanding of diabetes tends to be lacking, I've personally found.

    Let us know how things go lely.

    Ed
     
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  4. jack412

    jack412 Type 2 · Expert

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  5. drahawkins_1973

    drahawkins_1973 Type 1 · Well-Known Member

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    Hi Lely,

    I've recently had a simialr problm where it seems like my levemir is no longer lasting the full 24 hours. From about 4pm my sugars are startin g to rise. I'm doing my first split levemir dose today so hopefully that will work.

    Others have suggetsed that maybe moving to Lantus may help so I am going to ask my dr about this too.

    Andrea
     
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  6. noblehead

    noblehead Type 1 · Guru
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    Or (as discussed yesterday Andrea) Tresiba insulin might be another option than using levemir, both lantus and Tresiba are worth asking about if you want to stick with a single dose basal insulin @lely.
     
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  7. lely

    lely · Well-Known Member

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    Thanks all
    Went to the carb counting course last night and spoke to DSN about split dose, she'd advised me to hold out on changing that for 2-3 weeks as we are adjusting my ratios and she thinks doing on thing at a time is more sensible. (I do agree). My Hb1c was taken last week at the I'm at 11. It's never been below this since diagnosis. I'm hoping for a 9 in February with better management and understanding from the carb counting. I'd be happy with a 9. 9 would be progress.
     
  8. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    Everyone is different of course, but Levemir is certainly not marketed to last 24 hours, well it say up to 24 hours, but its dose dependent........

    the larger your dose the longer it theoretically will last......:)
     
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  9. drahawkins_1973

    drahawkins_1973 Type 1 · Well-Known Member

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    I'm only taking 4 units and I'm finding its harder than it sounds to split! Form my basal testing the levemir is lasting about 20 hours but if i split 50:50 to take 2 units and 2 units thats means for 8 hours of the day i'll only be 2 units (whihch isnt enough) but if split 3 units and 1unit then 1 isnt enough to stop my sugars rising when the 3 dose has worn off.

    If I up that to 3 units and 2 units then I'm having too much overnight! (I can just about manage 4units but anymore and i get nightimt hypos).

    Its a bit confusing so hopefully i've explained it ok.??
     
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  10. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    on such small doses of basal, it would be beneficial to have a single dose like Lantus............

    would be good to get a basal test throughout a full 24 hours though to see exactly whats happening.

    has it always been this low?

    are you recently diagnosed?
     
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  11. drahawkins_1973

    drahawkins_1973 Type 1 · Well-Known Member

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    I was only taking 3 unitl recently when I added in the extra one to help with this fall off in the evening. I've done quite a lot of basal testing recently and my sugars hold perfectly until about 20 hours after my levemir dose.

    I've been diagnosed since April last year so just over a year and half I guess. I dont think I'm still honeymooning as about 6- 7 months ago my need for Novorapid when I eat changed drastically from 1:25 g carb to 1:10g so I assumed this was the end of the honeymoon phase. But I've never had an issue wiht my levemir unitl recently.. Really one unit of levemir has a massive effect on me so its hard to change such small doses. I've book in to see my GP next week to discuss swapping to Tresiba (fingers crossed) or lantus.

    Sorry Lely, I let you have your post back now!
     
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  12. noblehead

    noblehead Type 1 · Guru
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    A drop to 9 or 9.9 would be progress Lely.

    See how you get on with changing your ratio's post DAFNE, still think it's worth changing to lantus or Tresiba if things don't improve, I found levemir to be a difficult insulin to get right and despite split-dosing I couldn't get my fasting levels under control.
     
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  13. nikkid

    nikkid Type 1 · Well-Known Member

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    I recently switched to twice daily levemere due to spikes in late evening. I have had my ratios sorted fora long time but the switching of my long acting regime has knocked them out slightly and I've had to adjust. Might it be worth starting as you mean to go on?
     
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