Advice on timings please

[vicky1974]

Hi again

I posted yesterday about morning spikes with my insulin and everyone was so helpful.

I’ve spoken to my GP today about switching to Levemir. He’s advised I try and stick with the Lantus for now and try having it at teatime instead of am

My question is how do I do this? Take none tomorrow and then my usual dose at teatime (use more novorapid if needed) or do I have to do this gradually?

I know I should have asked him but I’d already taken up to much time asking about my fit note for work.

 

[Tdm]

You could leave a gap in your basal and use correction doses of novorapid, or move back gradually through the day.
I' d do correction of novo but then i'm only 2 basal

 

[Tdm]

As for the morning spikes, have you tried prebolusin? I need a 35 min prebolus at breakfast (15 min other meals).
I also find a 15-20 min walk after breakfast helps (i set off as bs rise and stop walking when bs start going down)

 

[mashedupmatt]

Hi again

I posted yesterday about morning spikes with my insulin and everyone was so helpful.

I’ve spoken to my GP today about switching to Levemir. He’s advised I try and stick with the Lantus for now and try having it at teatime instead of am

My question is how do I do this? Take none tomorrow and then my usual dose at teatime (use more novorapid if needed) or do I have to do this gradually?

I know I should have asked him but I’d already taken up to much time asking about my fit note for work.

Hi again @vicky1974 - I think a switch from morning basal to evening is something worth trying in the first instance - if it were me, I'd skip the usual morning dose of Lantus and keep a close eye on BG Levels and take correction doses of Novorapid if neccessary, and then take the Lantus in the evening (and see how this works) - you are much better off taking corrections before meals and not inbetween (so just take a bit more than usual for your meal) - otherwise you could end up with two (or more) lots of insulin working at the same time (known as "stacking") and this can cause lows - I hope the switch works for you

 

[Inka]

@vicky1974 I’d do it gradually over a period of days. I think that would make you feel more reassured and would be a smoother change IMO. I’d move the Lantus in two hour increments. So, two hours later the first day, then another two hours later the second day, etc, until you reach your new time.

An alternative way, which is quicker, is to take half your Lantus at your usual time (morning) then the other half at your new time (evening) on the first day, then on the second day, just take the full dose in the evening at your new time. This method is quicker but you might get some highs over that first day or two.

 

[mashedupmatt]

On reflection, I think @Inka suggestion for a more graduated approach would make more sense - I'm on relatively low doses of basal insulin myself so such a big gap between doses wouldn't prove too troublesome for me - good luck with whichever way you go - really hope it works - fingers crossed

 

[everydayupsanddowns]

Good luck with the switch @vicky1974

Keep a close eye on things, and maybe consider setting a phone alarm to remind you of the new time - doses are just such an automatic ‘backround thing’ for me I’d be almost certain to forget my new dose time after a few days when the novelty had worn off! 🙄

 

[vicky1974]

Hi again @vicky1974 - I think a switch from morning basal to evening is something worth trying in the first instance - if it were me, I'd skip the usual morning dose of Lantus and keep a close eye on BG Levels and take correction doses of Novorapid if neccessary, and then take the Lantus in the evening (and see how this works) - you are much better off taking corrections before meals and not inbetween (so just take a bit more than usual for your meal) - otherwise you could end up with two (or more) lots of insulin working at the same time (known as "stacking") and this can cause lows - I hope the switch works for you

 

[vicky1974]

You could leave a gap in your basal and use correction doses of novorapid, or move back gradually through the day.
I' d do correction of novo but then i'm only 2 basal

Thank you

 

[vicky1974]

As for the morning spikes, have you tried prebolusin? I need a 35 min prebolus at breakfast (15 min other meals).
I also find a 15-20 min walk after breakfast helps (i set off as bs rise and stop walking when bs start going down)

You could leave a gap in your basal and use correction doses of novorapid, or move back gradually through the day.
I' d do correction of novo but then i'm only 2 basal

As for the morning spikes, have you tried prebolusin? I need a 35 min prebolus at breakfast (15 min other meals).
I also find a 15-20 min walk after breakfast helps (i set off as bs rise and stop walking when bs start going down)

Thank you

 

[vicky1974]

@vicky1974 I’d do it gradually over a period of days. I think that would make you feel more reassured and would be a smoother change IMO. I’d move the Lantus in two hour increments. So, two hours later the first day, then another two hours later the second day, etc, until you reach your new time.

An alternative way, which is quicker, is to take half your Lantus at your usual time (morning) then the other half at your new time (evening) on the first day, then on the second day, just take the full dose in the evening at your new time. This method is quicker but you might get some highs over that first day or two.

 

[vicky1974]

Thank you, I think I’d prefer the quicker way and will do that. Half am and pm and then change to pm the next day x

 

[vicky1974]

On reflection, I think @Inka suggestion for a more graduated approach would make more sense - I'm on relatively low doses of basal insulin myself so such a big gap between doses wouldn't prove too troublesome for me - good luck with whichever way you go - really hope it works - fingers crossed

Thanks Matt I think I’ll try what Inka suggested and try to split tomorrow’s dose.

 

[vicky1974]

Good luck with the switch @vicky1974

Keep a close eye on things, and maybe consider setting a phone alarm to remind you of the new time - doses are just such an automatic ‘backround thing’ for me I’d be almost certain to forget my new dose time after a few days when the novelty had worn off! 🙄

 

[vicky1974]

Thank you, that’s a good idea. Will set an alarm

 

[mashedupmatt]

Really hope it all goes ok