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When do people take Levemir?

L

Little My

Active Member
Messages
28
Type of diabetes
Type 1
Treatment type
Insulin
I'm a 36 year old type 1 diabetic and was diagnosed Oct 2013. I currently take small doses of Levemir 8am in the morning & 9pm evening (4 units x2 daily)
I am desperate to get tight control of my blood sugar and seem to be experiencing highs in the evenings before my second dose and sometimes hypos around 3am in the morning.I often find I'm on the low side early evening around 4pm too.I'm getting very frustrated as I carb count constantly and try and be as accurate as I can with my fast acting novarapid injections but can't seem to get my hbA1c below 57?!
I have even invested in the Freestlye Libre sensor CGM to track my blood across 24 hours.
I'm about to start IVF as I've been trying for a baby for 3 years now and really want to have the best chance of getting pregnant.
I was thinking of having my evening Levemir earlier to see if that helps?! Maybe 6pm? I read that Levemir can last around 18 hours and sometimes people experience slight peaks around 4 hours after injecting? Do people agree? All advice welcome and I'm interested to know how other type 1 diabetics take Levemir and if they split their doses?! x
 
I've never used Levemir but I'll tag @GrantGam for you as as start.

Have you done a basal test? Are you able to give us an idea of your sugars over an average day?
 
Do you correct for your highs in the evening? That could be why you're getting lows in the early hours? I'm also hoping for children in the next few years so I'm just starting to get a grip on my sugars. I'm on Tresiba which is one injection daily with a lot of flexibility, as in in doesn't have to be injected at the exact same time every day, if you're busy doing something Etc? I don't trust the Libre it would be great but it was very unaccurate for me, telling me I was 2.9 when I was 8.2! Everyone I know who takes levemir do split their doses, just because it doesn't last as long as Lantus or Tresiba. Maybe talk to your doctor person about the possibility of switching insulin? I did it 6 weeks ago and it has worked wonders
I was on Lantus but it was running out early evening, so I changed to Tresiba. Good luck


Sent from my SM-T555 using Diabetes.co.uk Forum mobile app
 
Basically you need to carry out basal testing on each Levemir dose separately......best to start with the evening one....

because you have Libre, that makes the basal testing very easy as you can just look at a graph and see if the dose has held you steady.....then adjust accordingly.....

have you done this before?
 
Good morning
I'm 49 male type 1 for 43 years.
I take 10 units 5.45 am
Then 14 units 5.30 pm
I carb count and novorapid accordingly.
I have been on levimir for around 10 years and do my best to keep 12 hour gaps inbetween.
This was how it was sold to me way back when and I am happy with it.
My sister recently went onto Toujou which is a once a day long lasting background insulin which apparently is stronger than the Lantus equivalent.
She wasn't on Levimir before.
I can't so won't compare my regime to yours as you are on such a low dose in comparison to me.

Good luck with everything

Tony
 
azure said:
I've never used Levemir but I'll tag @GrantGam for you as as start.

Have you done a basal test? Are you able to give us an idea of your sugars over an average day?
Click to expand...

Hi there
Thanks for replying! I have no idea what a basal test is?!
Please could you explain? My sugars are usually range anywhere between 4-11 most days.
 

Hi thanks so much for your reply and advice.I do correct my highs sometimes so maybe that could explain some of the lows at nighttime.I've not heard of Tresiba but I'll look into it?! I find the libre inaccurate for the first 24 hours after putting on the sensor but then for the next 10-11 days it's been getting the same readings as my finger tests.I wear the sensor on my abdomen because it wasn't as accurate on my arm and very unpredictable sometimes!
Good luck with the baby mission x
 
that seems a small amount of levemir but hey we're all different!

Have you learnt that you're dipping low at around 3am since using the libre? Have you backed this up with a blood test? Just wondering if the low at night is a compression low and not an actual low? (also just wondering how many times I can get the word 'low' in one sentence!)

Also what are your carb ratios like and roughly how many carbs do you eat and when.

basal testing is where you don't eat for an extended period of time, so don't take any bolus insulin, and test frequently (hence being easier using a libre) - you libre line should be pretty much stay on the level through out. Obviously if it goes high or low correct as normal and abort the basal test. Off the top of my head your results shouldn't fluctuate more than 1 or 2 mmol. best done over several days doing overnight first, then perhaps evening the next day and then morning/middle of the day a day or 2 later.
 

I've never done a basal test?! What is it and how do I do it? Thanks for replying
 

Thank you!
My ratio is 1 unit to 10g of carbs.I seem to be quite sensitive to insulin so only been on small doses since I was diagnosed. I will defo try and check my basal levels now you've explained what to do.....my GP is useless when it comes to diabetes and I always seem to learn more speaking to people on here! I eat really healthy, don't drink alcohol and have a fairly low carb diet.I've been making a conscious effort to try and keep tighter control over the last 3 months but for some reason my Hba1c has risen from 47 to 57 in 6 months?! I really don't know what I'm doing wrong?!
 
you wont be doing anything wrong.....its just takes to time to initially set up your basal and bolus ratios......

and then trying to keep on top of those doses as basal can change with weight/age/seasons....
 
Highs in the evening could suggest one of two things:

-too little basal insulin taken during the day
-incorrect bolus for your evening meal

In my experience, Levemir has a slight peak between 5-8 hours after injecting - that conveniently fits your 3am hypos and also your slight lows at 4pm. Unfortunately, there is no way to get round the peaks (certainly not that I'm aware of) - I'm lucky mine are very slight. You could always have a small snack (10-15g carbs) worth in anticipation of the peak action. A digestive biscuit or something might help with that. If the peaks are still an issue and you've conducted thorough and accurate basal tests then you may want to speak to your consultant about Tresiba; it's apparently a very good basal.

If I was in your position (and this is only a suggestion), I'd be looking at taking 5u through the day and 3u at night and see if matters improve. As you appear to be pretty insulin sensitive, you may also want to speak to your consultant about getting a 0.5u pen - not only for basal but also bolus. I take an uneven split dose of Levemir as an even split just didn't work.

If you don't mind, it may be beneficial to post some of your Libre graphs on this thread so to allow our lovely forum members to interpret them for you

Edit to add - the change in dose is a suggestion of what I would do, it's not an instruction. Your doses are your decision and not something that we on the forum can instruct you to undertake.
 
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Thank you so much for your advice I really appreciate it! I've been wondering about trying an uneven split of basal insulin so might try that first.Will ask about Tresiba if things don't improve. Will post some graphs too when I get chance that's a great idea as I've started recording my insulin doses & carbs on the libre machine too so I can track my blood sugar and timings of meals/insulin injections.
Thanks again x
 
That's no problem

Basal rate testing and fine tuning your I:C ratios will really improve your management. Also, this is an excellent book that will help you in reducing your HbA1c. It's worth every penny:

https://www.amazon.co.uk/Think-Like.../ref=tmm_kin_swatch_0?_encoding=UTF8&qid=&sr=

It's always a good idea to consult your DSN/care team before adjusting your doses, especially if you're not sure why you're experiencing issues. But, please do let us know the outcome if and when you adjust them
 
Little My said:
Hi there
Thanks for replying! I have no idea what a basal test is?!
Please could you explain? My sugars are usually range anywhere between 4-11 most days.
Click to expand...

Noblehead has already posted the link now. It's tedious doing a basal test but it can be really helpful. Getting your basal right is the foundation of good control

If I was you, I'd concentrate on checking/sorting your basal first, and then move on to checking/sorting your mealtime ratios if you need to.
 
Little My said:
my GP is useless when it comes to diabetes
Click to expand...
By definition they will be, unless they are diabetic themselves.

Have you been referred to a hospital Diabetes clinic? I'd always use my DSN there for anything T1D related if needed, never my GP.
 
Hi, I take Levemir only once, 9 to 10 units just before bed.
 
Hi, my daughter is also on small doses of levemir (4-6 units a day) and we have found that with small doses they only last about 8 hours each. When she was on two doses daily we were getting hypos at night when her evening dose was peaking and then she was running out of basal in the evening before her second shot. So we've been splitting levemir three ways for a year now and find this covers the 24 hour period much better. Just a thought.
 
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