Splitting levemir injections

[noblehead]

@anna29 that's interesting, I have never heard of anyone on three doses of basal a day but clearly it's working for you. Your DSN sounds very creative - thinking outside the box.

Sure Smidge was on 3 basal injections a day not so long ago, but we have had members post before that they inject levemir 3 times a day to get a better coverage.

 

[smidge]

Yes, I found the only way to get Levemir to last long enough for me was to split into 3 injections 8 hours apart. Just did it as an experiment to see if it would hold me steady - and it did to some extent but was really inconvenient. I found Levemir wasn't lasting 12 hours - probably closer to 10 - so on two Levemir jabs I was getting bad, double-figure fastings which I was correcting with my breakfast bolus and bad rises in the late afternoon which I was correcting with my dinner bolus. The only way to prevent the bad fastings was to take 1.5 unit shot of Apidra before bed. It was all a complete nightmare of extra boluses or a 3-way split Levemir. That's why I changed onto Insuman in the evenings - using Levemir in the morning, Insuman in the evening and Apidra for meals worked much better, but juggling 3 different insulins was fraught with danger, trying to get the timings right so they peaked at different times and coincided with meals etc.

The change to Tresiba feels better. I've pulled back to 9 units now to try to sort out the odd low I'm still getting, but I feel my BG is much more stable for more of the time.

Smidge

 

[nigelho]

I have recently changed from taking levemir from once a day to twice, the first few days seemed to be alright with sugars between 4 and 7 but now I have finding I am having a lot more hypos, seems to be at the same time as well, I am currently taking 7 units at night and 5 in the morning, I take the night time one between 9-10 and the morning one at 5:30 in the morning getting up for work, and 8:30 during the weekends, my first thought was is it because the injections are two close together, as anyone had teething problems with 2 injections ?

Hi Padders, All your posts suggest that the levemir might be the cause of your mid morning hypos. However, you haven't said what you eat for breakfast, how many carbs in the meal and how much novorapid you inject for your meals. Are you on fixed amounts of novorapid ... regardless of how much carbs you eat or do you carb count and what novorapid ratio do you use. To be honest, I wouldn't have thought that the amounts of split levemir you take would put you into hypo, it's probably more likely too much novorapid for the breakfast you eat. What do you do in your job? Is it physical in any way i.e. lots of lifting/arm activities? If you're in any doubts ask your DSN to put you on the DAFNE course. It seems that you don't have breakfast, hence the reason why you are hypoing between 9-10am. Levemir is background insulin but without eating since the previous evening then with your night levemir then 5.30am levemir, I'd say that your body needs some carbs otherwise even if you don't hypo liver dump can occur sending you high. I'd consider just having a piece of toast but have the right dose of novorapid and the hypos should stop. It's a juggling act to get the insulins to fit in with your life style.

 

[videoman]

I have been on split Levemer now for 5 years and all is going great and this is after 55 years of being a type 1

 

[Padders91]

Hi nigelho, I went on a dafne course back in 2009, and found it beneficial to me as like you mentioned befor the course I was just injecting regardless of how many carbs I was having, kind of like a inject and hope , I try to carb count as accurately as possible, I must admit though I have never weighed food to find out the carb count, for example for my breakfast I have a mixture of 3 cereals, weetabix, shreddies, and bran flakes, I normally count the carbs with a tablespoon, so would inject approx 8-9 units plus any correction doses that maybe needed, I tend to have the same foods as I know what the carb count is, I work in a warehouse currently 8 till 2, some days is busier then others so is difficult to know weather to reduce the novo rapid or not, as mentioned in previous posts I go on walks everyday to try and get the right balance, of food and excercise.

 

[anna29]

Me , hubby and my DSN put our heads together .
We worked out 3 x 8 = 24hours .
As I was kept waiting too long on the split dose only regime .
The onset time was too slow for me like this .
My BG levels were rising too highly and for too long awaiting
the insulin to kick in with myself.

So this is what I do now triple dose with lowered Levemir units .
It does keep me covered longer and better as a basal insulin and my
response to the onset time is better now .

As it works well for now with myself - will stick with it .
Shows how individual we can be with our Diabetes needs and therapy .