Levemir

[imtrying]

Hi all,

I just wanted to ask some advice.

I used to be on Lantus, one injection before I went to bed. Then because of problems with my levels when exercising, I've been changed onto Levemir and the dose split - 22u before bed and 7u when I wake up.

This seems to work during the week, when I'm up about 6.30am, but at the weekends it all goes wrong. I am waking at 8.30/9am to levels of about 16/17.

Is Levemir really this sensitive that 2 hours can make that much difference? I really don't want to be getting up early just to inject (one of the main reasons my Lantus was always done in the evenings).

Thanks guys.

 

[novorapidboi26]

Dawn Phenomenon maybe.......................

On a normal day you may have breakfast which switches off the liver.....

The dose should still be holding you steady, so you might expect it to be something other than the Levemir dose........

This is what happens to me anyway, I always expect slightly higher readings at the weekend, unless I have had significant amounts of alcohol..........

 

[imtrying]

Dawn Phenomenon maybe.......................

On a normal day you may have breakfast which switches off the liver.....

The dose should still be holding you steady, so you might expect it to be something other than the Levemir dose........

This is what happens to me anyway, I always expect slightly higher readings at the weekend, unless I have had significant amounts of alcohol..........

Thanks NRB. I don't eat breakfast during the week until about 10am after I've got into work and settled down (can't face food early on!) Does that change your answer?

My levels during the week (when they are behaving) are 6s or 7s...I don't see how 2 hours can increase them by 10mmols!!

 

[everydayupsanddowns]

It *could* be Lev running out but it's very hard to tell...

Larger doses are likely to last longer, and your overnight dose is the larger of the two by some way. There's a 3D graph here: http://www.diabetesdaily.com/wiki/Levemir_Speed_Versus_Dose which suggests how long Lev might be expected to last based on your dose/kg.

Of course you *might* be propping up a slightly underdone basal in the day with larger meal boluses.

Not sure how long you;ve been pattern watching - any chance of an overnight hypo?

The only way to know for sure is to runs some basal tests - which is few people's idea of a favourite pass time!

 

[novorapidboi26]

Does that change your answer?

I would say yes, it does...............

Its a strange one as your larger dose is the one before bed, what time is that usually..........?

Are your nocturnal eating habit different at the weekend?

I know mine are and so this may have an effect on the morning.....!

 

[imtrying]

It *could* be Lev running out but it's very hard to tell...

Larger doses are likely to last longer, and your overnight dose is the larger of the two by some way. There's a 3D graph here: http://www.diabetesdaily.com/wiki/Levemir_Speed_Versus_Dose which suggests how long Lev might be expected to last based on your dose/kg.

Of course you *might* be propping up a slightly underdone basal in the day with larger meal boluses.

Not sure how long you;ve been pattern watching - any chance of an overnight hypo?

The only way to know for sure is to runs some basal tests - which is few people's idea of a favourite pass time!

Mike, how did I know you were going to suggest that!!!!???

But I'm afraid they are definitely rising overnight. Over the past few months I've done 3 2 or 3am tests and they've all been 3 or 4 mmols higher than when I've gone to bed. Then the following morning I'm up to 15, 16, 17, or 18. The problem is it works during the week, and doesn't at the weekend.

In relation to the 'propping' up, I could be wrong, but I don't think I am, as I have had to reduce it from 8u due to whole days spent fighting off hypos despite accurately carb-counting.

I may test next weekend and maybe on Friday night test at 4am, and Saturday night test at 6am or something, see what's happening before I actually get up.

 

[imtrying]

I would say yes, it does...............

Its a strange one as your larger dose is the one before bed, what time is that usually..........?

Are your nocturnal eating habit different at the weekend?

I know mine are and so this may have an effect on the morning.....!

ok, bedtime dose is usually 10.30pm - it's rare for it to change by more than half an hour, absolute tops is an hour.

Evening eating at the weekend tends to be earlier - usually about 6pm - than during the week (tends to be 9pm due to the gym after work every night), but I eat late Friday night, and have the same problem as when I eat earlier on a Saturday night.

Any more answers?! 😱

 

[everydayupsanddowns]

Mike, how did I know you were going to suggest that!!!!???

But I'm afraid they are definitely rising overnight. Over the past few months I've done 3 2 or 3am tests and they've all been 3 or 4 mmols higher than when I've gone to bed. Then the following morning I'm up to 15, 16, 17, or 18. The problem is it works during the week, and doesn't at the weekend.

In relation to the 'propping' up, I could be wrong, but I don't think I am, as I have had to reduce it from 8u due to whole days spent fighting off hypos despite accurately carb-counting.

I may test next weekend and maybe on Friday night test at 4am, and Saturday night test at 6am or something, see what's happening before I actually get up.

Well if you have established it as a deff pattern (my weekends and weekdays are very different too) then given that Lev is more biddable and can be adjusted day to day, could you add a little to your Friday and Saturday night doses?

 

[AJLang]

In the week I have my am levemir (10 units) at 7.30am and most weekend days not until 9.30am - but the two hours don't seem to make any difference to my BGs. Is there any chance that you are eating a larger evening meal at the weekends which could be sending your BGs up in the early hours of the morning?

 

[imtrying]

In the week I have my am levemir (10 units) at 7.30am and most weekend days not until 9.30am - but the two hours don't seem to make any difference to my BGs. Is there any chance that you are eating a larger evening meal at the weekends which could be sending your BGs up in the early hours of the morning?

oh yeah, that's a thought....

At weekends our meals are the same size as during the week, but I do tend not to eat any evening meals during the week now because of being at the gym every night....so, it could be that....

But....I didn't always used to do that, and my levels before didn't seem to do this during the week (not that that necessarily means anything now!)

 

[imtrying]

Well if you have established it as a deff pattern (my weekends and weekdays are very different too) then given that Lev is more biddable and can be adjusted day to day, could you add a little to your Friday and Saturday night doses?

yeah, I think the only difference really is that during the weekend I'm likely to be going to bed maybe 2 hours later than during the week (although still taking my Levemir at 10.30pm) and then getting up 2 hours later in the morning.

I'm going to ask my DSNs and see if they can see anything, or see what they think I should do...and I'll report back!