When is Levimir at it's weakest??

Without wishing to sound flippant or like an typical HCP - "We are all different" - what is the case for one person will not necessarily be the case for another.

It may be worth logging your blood glucose levels in order to determine the profile that the Levemir is giving. To do this, divide your day up into, say, four six hour periods, concentrating on one such period per 24 hours, making sure that you have not eaten or taken any short acting insulin five hours prior to each period - that way, the only thing reducing your blood glucose level will be the Levemir and there will be no food in the system to raise it. (The only thing raising your BG during the target six hour period will be your liver). Now ... take BG readings every hour and write them down. Over a week or so, you should be able to get a pretty good idea of how your Levemir alone is acting in the absence of any quick acting insulin and food.

The foregoing is a "basal test" - something which those on insulin pumps will be well aware of.

Hope this helps and is a reasonably concise and accurate explanation - I await the comment of others!

Alan

As Alan says it's a difficult one to answer...

I wouldn't say that people like to split Levimer, it sort of done as being the best option...

You say that when working is the period when you suffer most hypos, I ponder if Levimer is your main problem!

With bacground insulin we are looking to create a flat basal profile, this in many respect is almost impossiable to achieve, so we look to create the flatish possible, sometimes spliting and adjusting timing makes the difference to how flat we can achieve... But we will be left with a certain amount of peaks and troughs to the profile line through out the day...

Having a reasonable idea where these lay within 24 hours is quite important, as these will help determin how best to adjust dose of Quick acting insulin when were are eating/exercising... As you can adjust your carb:insulin ratio to include peaks and troughs.. Same goes for corrections..

It may well be that you are actually injecting too much quick acting insulin on a work day!

As alan says, you need to work out your basal profile, if correctly set then this shouldn't deviate +/- 2mmol/l of your starting point there are a couple of things to remember though about testing as follow;

Only test on rest days, don't attempt to test when doing pysical exercise etc so work day not good idea..
Keep hypo treatment, meter and insulin near to hand
Stop testing if hypo or hyper, treat as appropiate and test on another day..

Once you've got your picture on whats happening with the basal profile, and hopefully sorted you should be able then to work out, what, when and how any carb:insulin ratio, correction changes you need at any point of the day or with particular meals etc etc.

I feel mines runs out at times round about the 5pm mark (I take it at 8am so it gives me 9 hours too). At other times though, it lasts until I take it at 8pm

Ive tried taking it later to tackled fbg but it then has me in double figures by 9pm so I went back the way. Taking it at 8am my levemir seems to be at its most potent around lunch time - so if my morning sugars are rubbish it seems to give it a 'bit' of a helping hand. In saying that, on mixed insulin lunch time was also prone to be my lowest period of the day so I dont know if perhaps physiologically thats something pertinent to my body

If you arent taking any fast acting during the day, and getting hypos with levemir the best way to tackle this I think is to look at the timings of the levemir as I dont know about weakest points per se as it is meant to be flat - ish

Try moving the injection times, or as suggested, fast and try to find out what it does across the course of a day