I am having to take 96 units of Levemir in a single injection in the middle of the night to manage severe dawn phenomenon. I am feeling a bit like a freak! I know if I need that number of units then I have no option but to take them but is there anyone else out there on such a high single dose? Bizarrely if I take even 2 units of Levemir at bedtime I go hypo which is why I only take one injection of it per day. I am struggling with this emotionally at the minute as I had been on 82u up until a couple of days ago but that was not keeping my BGs at the correct level. I am not even sure if it is going to have to go even higher. I was wondering what other people's experiences have been. Thanks.
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High number of Levemir units in one injection
- Thread starter Josco
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Pumper_Sue
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- Type 1
All I can say 😱 to the dose and timing of the dose.
Have you ever split your dose or tried a different basal insulin or even injected it at breakfast time.
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Hi Josco
How does the balance of your basal to boluses shape up? In general I believe that 'you need what you need', but a non-D would typically produce roughly a 50:50 percentage spilt for background insulin and meal/food insulin.
People with D typically are in the range 40:60 to 60:40. If you are injecting significantly more than 60% of your TDD (total daily dose) in levemir it might suggest it is not working quite right for you.
Have you ever tried Lantus?
How does the balance of your basal to boluses shape up? In general I believe that 'you need what you need', but a non-D would typically produce roughly a 50:50 percentage spilt for background insulin and meal/food insulin.
People with D typically are in the range 40:60 to 60:40. If you are injecting significantly more than 60% of your TDD (total daily dose) in levemir it might suggest it is not working quite right for you.
Have you ever tried Lantus?
Pumper_Sue
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Glad you liked the emoticon, it's one of my favorites 🙂
Have you tried animal insulin? If not well worth considering it.
That is an interesting way to think of it Mike. I have never been asked that question! I use carbohydrate counting so the number of quick acting units per day is very variable. But the answer to your question would be that my Levemir way exceeds the number of units of Novorapid I would have per day. In fact it is probably more than double what I would take in QA insulin. I was on Lantus but suddenly, and for no reason that the diabetologist has been able to work out, I started to have two hypos a night. Within two weeks I had halved my dose and was still going hypo every night. So that was stopped and I was started on Levemir. I did the DAFNE course in February and my BGs etc. were looked at twice every day in the group and I just seem to be an anomaly (which is the polite way of saying I am a weirdo!!). My current regime is the best they can come up with (I also take Metformin) but my BGs are all over the place and my HbA1c is never below 8 no matter what I do. They said I seem to have both Type 1 and an element of Type 2 which I have never heard of. I will be getting an insulin pump but they do not expect the funding to be available for that until next summer. The idea of struggling every day with this is getting me down a little at the moment. I so envy you your 6.6 reading 🙂
That is not something that has been suggested Sue. I would try anything. I was on it many years ago before the introduction of human insulin. I will try anything at this stage because, despite reassurances that I am doing everything correctly, I am feeling a bit of a failure just now.
Pumper_Sue
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- Type 1
You are not a failure, I think you have a major problem with the Levemir. (Which isn't your fault)
Why did you come off of the animal insulin?
I was diagnosed over 47 years ago and use animal insulin still. Works very well ty in my pump
trophywench
Well-Known Member
- Relationship to Diabetes
- Type 1
I wonder ..... Josco, have you put weight on, making you insulin resistant hence the Metformin or were you taking euually large amounts of insulin before the addition of the Met - or a simpler question - why did they add Metformin?
Just wondering if the large amounts of insulin have caused a weight gain, which has caused IR, is all !
Sue, I don't recall being given a choice at all. I did NEED to come off the pig insulin as I'd developed antibodies to it. I expect in the old days they'd have changed me to a bovine derived one? Dunno. But anyway I was given Humulin at that time. Had a terrible time with it. There was never any suggestion there was any other thing I could try but I stuck my neck out when I moved here and asked. Took me a year or two but eventually they changed me to analogue etc one day when I'd given up asking. Imagine my surprise when I got online and found out all the things I supposedly could have asked for! - and was presumed to know already. And in any case nobody was listening whenever I asked.
Never held back since .... if I fancy trying summat, I ask. And keep on till I get ....
Lastly Josco- since you are an IDEAL candidate for a pump - QOL and all that - middle of the night, every night? OMG. WHY next year? Have they given a reason? I'd be asking for one .....
Just wondering if the large amounts of insulin have caused a weight gain, which has caused IR, is all !
Sue, I don't recall being given a choice at all. I did NEED to come off the pig insulin as I'd developed antibodies to it. I expect in the old days they'd have changed me to a bovine derived one? Dunno. But anyway I was given Humulin at that time. Had a terrible time with it. There was never any suggestion there was any other thing I could try but I stuck my neck out when I moved here and asked. Took me a year or two but eventually they changed me to analogue etc one day when I'd given up asking. Imagine my surprise when I got online and found out all the things I supposedly could have asked for! - and was presumed to know already. And in any case nobody was listening whenever I asked.
Never held back since .... if I fancy trying summat, I ask. And keep on till I get ....
Lastly Josco- since you are an IDEAL candidate for a pump - QOL and all that - middle of the night, every night? OMG. WHY next year? Have they given a reason? I'd be asking for one .....
Hi trophywench - I am very overweight but have been for a long time and needless to say that every time my insulin increases so does my weight. I have been insulin resistant for many years and the Metformin was an attempt to see if they could reduce this. I can only tolerate 750mgs daily and it made no difference. I was introduced to carbohydrate counting (which I love!) and they were excited because I would see my insulin requirements dropping and the weight falling off. Neither happened much to everyone's disappointment. Especially mine! My excess weight is not just about eating too much and too little exercise although that is certainly part of it (I have depression and have been seeing a psychologist weekly for more than two and a half years). I am in something of a vicious circle. I live in Scotland and a year's wait is considered a great improvement over recent waiting times. I am not considered urgent so just have to be patient. There is some query as to whether or not I have Cushing's disease which would explain a lot of the symptoms such as the severe dawn phenomenon as well as the difficulties with weight but it takes an average of seven years to diagnose!! I am going to a nurse led diabetic pump clinic at the end of October and given what you guys have said I am going to ask about getting a pump sooner. Setting an alarm for the middle of the night every night and taking 96 units (I split the dose between two pens before I go to bed in case I make a mistake since I am still pretty much asleep when I take it!!) plus a correction dose is acceptable apparently! Having said that the consultant has never known anyone who has had to do that in order to avoid very high BGs in the morning. Oh well. Such is life !!
Sue - I just did as I was told at the time and did not consider animal insulin as an option!! I think I will do some research on this now that you have mentioned it.You are not a failure, I think you have a major problem with the Levemir. (Which isn't your fault)
Why did you come off of the animal insulin?
I was diagnosed over 47 years ago and use animal insulin still. Works very well ty in my pump
lauraw1983
Well-Known Member
- Relationship to Diabetes
- Type 1
Josco - what health board in scotland are you under?
I have to agree with Sue. I have been on insulin a similar time. Two attempts to change me over to more modern insulins were total failures. The first hid all hypo symptoms and the second resulted in me taking massive doses with little effect on my blood sugar. When I reverted back to pork insulin after the second experiment my dose had increased by over 30% suggesting I had built up a fair degree of insulin resistance in a relatively short time.
novorapidboi26
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- Type 1
You are using Levemir yeah?
Is this split over a morning and evening dose...........?
Have you done a through the night test [every hour or two] with no carbs to see when your DP is starting......?
I am overweight also, nearly 18 stone and I am 6 foot tall, in total I take 60 units of Levemir this has came down recently just from lifting some free weights 3 times a week.....
Is this split over a morning and evening dose...........?
Have you done a through the night test [every hour or two] with no carbs to see when your DP is starting......?
I am overweight also, nearly 18 stone and I am 6 foot tall, in total I take 60 units of Levemir this has came down recently just from lifting some free weights 3 times a week.....
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I am sure you probalby did, but if lev isn't working out, and porcine/bovine proves problematic... did you ever try taking Lantus at breakfast? After a number of years I started waking low and tested a few alternatives/splits etc before settling on breakfast lantus as the better option for me pre-pump.
laura - it is Lanarkshire Health Board
Everydayupsanddowns - I did not try Lantus in the morning. I was taken off it because of the hypos (as I live alone there were concerns about my safety during them) and it was thought Levemir would give me better control because I could change it more readily. Because Lantus has such a long action I do not think it would suit the severe dawn phenomenon that I get. I must admit though it was not something that was suggested or that I considered. This forum is fascinating because it is suggesting lots of different ways to look at issues when I would have assumed that my consultant would have considered all options but that is clearly not the case.
Novorapidboi - It is a single dose of 96u of Levemir taken in the middle of the night! I have done repeated profiles overnight. I am slightly unusual in that I am unable to fall asleep until 3am (despite a sleeping tablet) so I take my Levemir at 6.30am and this seems to stop the extreme rise in BGs to 25 - 27mmols that I was having previously ( sleep about 6/7 hours per night). But my previous dose of 82u was not holding me steady through the day hence the recent increase, yet again Well done on being able to decrease your dosage.
Everydayupsanddowns - I did not try Lantus in the morning. I was taken off it because of the hypos (as I live alone there were concerns about my safety during them) and it was thought Levemir would give me better control because I could change it more readily. Because Lantus has such a long action I do not think it would suit the severe dawn phenomenon that I get. I must admit though it was not something that was suggested or that I considered. This forum is fascinating because it is suggesting lots of different ways to look at issues when I would have assumed that my consultant would have considered all options but that is clearly not the case.
Novorapidboi - It is a single dose of 96u of Levemir taken in the middle of the night! I have done repeated profiles overnight. I am slightly unusual in that I am unable to fall asleep until 3am (despite a sleeping tablet) so I take my Levemir at 6.30am and this seems to stop the extreme rise in BGs to 25 - 27mmols that I was having previously ( sleep about 6/7 hours per night). But my previous dose of 82u was not holding me steady through the day hence the recent increase, yet again
Well done on being able to decrease your dosage.
ukjohn
Much Missed Member
- Relationship to Diabetes
- Type 2
I changed from Levimer to Insulatard at my own request.
I take 130 units a day, but that is split 60 units at 8 am and 70 units at 10 pm. I still struggle with fasting levels between 7 and 10, the rest of the day they are in the 4/5 range.
I take 130 units a day, but that is split 60 units at 8 am and 70 units at 10 pm. I still struggle with fasting levels between 7 and 10, the rest of the day they are in the 4/5 range.
Not great for you I know but it is good to know that there is someone on high doses too. I used to be on Insulatard years ago but for the life of me cannot remember why I was changed from it!
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