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Type 1 - Levemir question

C

char87

Active Member
Messages
39
Location
London
Type of diabetes
Type 1
Treatment type
Insulin
Hi

Apologies for the long post but am looking for some help! I have had type 1 for 18 years and in recent years I have struggled a bit with my control. I go to the gym a few times a week and run and often have hypos in the middle of a night after exercise, which then results in me eating too much to treat it and having higher levels.My last HBA1C was 8.2% - I have read up online and saw that the DAFNE course advises doing a no carb day to see if the background insulin levels are right. . So today I have done a no carb day and my readings seem to be increasing late evning- I woke up 9, fell to 4.7 before lunch, was 3.5 5 hours after lunch and I have now gone to 16. I ate 4 glucose tablets to treat the hypo which I thought was appropriate but it just seems to be continuosuly rising since, and I havent eaten any other carbs since(salmon and lettuce salad for tea) I take 18 units of Levemir at night and 12 in the morning- does anyone have any advice on which dose I should be changing? I thought as I had a hypo I needed to reduce the AM dose but I seem to be running out of background insulin now so am very confused!

Thanks for taking the time to read this!
Char
 
Hi,
My BMs did exactly the same while I was on my DAFNE course. As I was having my doses exactly 12 hours apart, the nurses suggested I have the night time levermir sooner. What time do you have your levermirs?

Ash
 
Thanks for the reply. I usually take the morning levemir at 8am and the evening at 10.30-11pm. I hadn't really been advised on timing just to take in first thing in the morning and last thing at night- do you know what the recommended wait between doses is?

Thanks!
 
I'm not sure I agree with the advice given by DAFNE. I'm a low carber so notice the difference "carb free" food makes. Firstly, very few meals are carb free (even lettuce has some) and secondly, your body converts protein into glucose too. In addition, just the act of eating stimulates glucogen production in anticipation of the meal that you are eating.

The only way to tell if your basal is correct is by not eating or taking bolus 4/5 hours before bed and comparing overnight levels. If they change by more than 1.6 mmol/l then change your basal by 10% accordingly.
 


The advice is to miss one meal at a time when doing a basal test, for example you would have breakfast (make sure it's low in fat) then miss your lunch and then eat your tea, you start testing 4 hours after breakfast when your QA insulin is all but exhausted, in theory your blood glucose shouldn't go up or down above 1.7mmol, if it does then increase or decrease your insulin accordingly.

It's also recommended to do the test on days where your not more active than normal or stressed, just drink plain water in-between and test every 1-2 hours, repeat the same the next day but miss another meal out.....so say have lunch then skip tea right up to supper time.

Personally when I made a brief change over to levemir I couldn't get decent control despite injecting nearly double the amount of insulin I was taking with lantus, if things don't improve try changing to an alternative basal to see if this helps.
 
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