Working out how long Levemir is lasting

[grant32]

Hello all. Im not new to type 1 (diagnosed 10 yrs ago) but have recently been motivated to get myself under better control. Of course the more reading I do the more questions I have and in the last couple of days the more I have scared myself about it all (particularly after reading the Bernstein book that arrived today). So here's my first question.

I take 13 units levemir before bed. This used to be 15 but would often wake up low, so reduced to 14 then 13. I went to bed after not eating for 5 hours with a bgl of 7.8. I woke at 7.5. I repeated this for a few days and always woke at roughly the same reading as I went to bed with. From what I understand this means my basal is correct. But, is it correct just for overnight? How can I tell for how long the levemir remains active? I have read other people's posts that it lasts anywhere from 6 to 22 hours. I note that many people also split their dose, but I'm a little confused about how to decide if that is a good idea or not.

I'm bound to become an active poster now that I've discovered this invaluable forum. Thanks in advance.


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[mrman]

Hi, your overnight levels seem spot on. Do in the day what you did overnight to see what your base does during the day. Start by missing breakfast and test hourly till lunch. If you are hypo or hyper and need to correct abandon test. 2 days later do a midday to evening fast, so, have breakfast and start test 4 hours later not eating or drinking anything sugary till evening. Again if any correction is needed abandon treat and try again another day. Repeat for evening having lunch and test hourly till bedtime. Record all results and you will have a full 24 hour basal profile and will have a better idea how long its lasting.
so only one mel at a time as going long periods without food may cause your liver to produce extra glucose giving misleading results and you'll be very hungry.
Also, would advise to leave a day in between tests as your body will want to replace lost fuel from fasting again giving misleading results.
Hope this helps and goods luck

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[mrman]

Should add to also test two hourly through the night to make sure you don't drop too low before rising again when you wake.

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[grant32]

Thanks Brett. So in theory, during the tests if bgl rises, then the basal has stopped working? No doubt many other factors to consider as well. I did notice this morning after waking at 7.8, omelette with cheese and ham for breakfast and 2 units novorapid despite no carbs, 2 hours later I was 9.9.

You'd think after 10 years I'd have this sorted. Getting rather fed up with it all but persistence can only be beneficial.


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[mrman]

Yeah, if your bg levels rise there is not enough background insulin in you. Though its not that straight forward to fix by giving yourself more as overnight you don't need any more. This is when some choose to split their basal injection in two, twelve hours apart. The hard thing is to see the split between the two as often it is not 50/50. If you don't have enough during the day start on small doses 12 hours after evening injection and go from there.

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