a predicament.....

[D_G]

i know i dont post on here as often as i probably should but i need some help....

its been a problem for a while it has been bugging me and i havent bothered to do anything about it but i thought i can ask you guys what you think and maybe get some advice 🙂

I take my levemir at 7am and 7pm (as i split it)/Right so when i am working i have my dinner fine, and go to bed on reasonable levels and therefore wake up on reasonable levels and take my levemir at 7am before i go to work and that works perfectly!

However on the weekends and my days off it does not! the thing is when its my days off i obviously have a lie in....so i wake up at 7am do my levemir and go back to sleep but the problem is that i will then wake up a few hours later way down in the 2s! so when i go to bed on reasonable levels (like 6-7.5ish) i wake up do my levemir and that somehow makes me drop low as i have my lie in...

The only way around this is what i have been doing for a long time which is going to bed on levels of sometimes 12 or above! this seems to be the only method that works, and i get up at 7 do my levemir go back to sleep and wake up a few hours late with PERFECT levels!

But i know i am doing myself harm every night i run myself high but i cant find another way!! Do i reduce my morning levemir perhaps, or will that just mess me up for the rest of that day? i dont really know what to do, can anyone help......??

sorry for the essay!! 🙂

 

[Northerner]

Tricky! When you say a 'lie in' what time do you normally get up? What happens if you were to delay taking your morning levemir until you get up (after going to bed on reasonable levels) - are you high? I have found that with lantus I can be an hour or two late with my injection and it doesn't make much (if any) difference. Have you tried having less levemir on the weekend morning injections to see what happens? I presume that it's due to weekdays you are up and about and your liver is active, so the levemir covers this, but at the weekend your liver is less active (as are you!) so you need less. Just a thought! 🙂 Perhaps something to discuss with your DSN - as you say it's not good to have to deliberately run higher levels overnight to overcome the problem.

 

[D_G]

Tricky! When you say a 'lie in' what time do you normally get up? What happens if you were to delay taking your morning levemir until you get up (after going to bed on reasonable levels) - are you high? I have found that with lantus I can be an hour or two late with my injection and it doesn't make much (if any) difference. Have you tried having less levemir on the weekend morning injections to see what happens? I presume that it's due to weekdays you are up and about and your liver is active, so the levemir covers this, but at the weekend your liver is less active (as are you!) so you need less. Just a thought! 🙂 Perhaps something to discuss with your DSN - as you say it's not good to have to deliberately run higher levels overnight to overcome the problem.

Normally about midday! i do like my lie ins 🙂 i havent tried anything i wanted to ask you guys what you thought first but taking my morning levemir a little bit later sounds like something to experiment with, as does taking less of it in the morning as this is what i was going to experiment first with to see if it made a difference!

I presume that it's due to weekdays you are up and about and your liver is active, so the levemir covers this, but at the weekend your liver is less active (as are you!) so you need less. Just a thought! 🙂.

Yes this is what i thought too 🙂 i just wasnt sure what i should do to overcome the problem of it....but im glad you thought the same as me maybe proves i have learnt something in the year and half of being diabetic! lol

so what to experiment with first...
A: less of my morning levemir
B: Same amount of levemir just later .....

 

[Northerner]

...so what to experiment with first...
A: less of my morning levemir
B: Same amount of levemir just later .....

I think if it was me then I'd try having less levemir first as it would make things simpler - although it does mean continuing to wake up early to give it. 🙂

 

[D_G]

Ok good idea....i usualy have 18 units in the morning so shall i do maybe 13 or do you think i should knock more off?

Also if i give myself less do you think it will leave me running higher than than usual for the rest of the day??

Thanks for all ur help Alan, your a star

 

[Northerner]

Not sure I would go as low as 13, but then again your problem is you are hypoing. As you are up and about for about 5 hours less than on a working day, but will still need some levemir to cover the extra sleep time, I would be tempted to try 15 first 🙂 Sounds like you could do with a pump so you could set weekend patterns on it! 🙂 Let us know how you get on 🙂

 

[D_G]

Not sure I would go as low as 13, but then again your problem is you are hypoing. As you are up and about for about 5 hours less than on a working day, but will still need some levemir to cover the extra sleep time, I would be tempted to try 15 first 🙂 Sounds like you could do with a pump so you could set weekend patterns on it! Let us know how you get on 🙂

hmmm im going to go bang in the middle at 14 🙂

As you are up and about for about 5 hours less than on a working day,

God that sounds awfuly lazy lol 😛

And yes i intend to use this very reason as ammo towards maybe asking about a pump!

Thanks for your help Northey, i shall keep the thread updated over the weekend!

 

[Northerner]

Good luck Nikki, I hope it works out well for you 🙂

 

[D_G]

Right...nothing to report as the weekend was a bit of a flop lol

Ended up going out friday night and so had to eat before I went to sleep to compensate for all the dancing I did so it wudnt have been an accurate test really! And sunday morning I had to get up early anyway! So I shall have to make sure I do it in the week on my day off and keep the thread updated 🙂

 

[Northerner]

Looking forward to seeing how things go Nikki - don't forget! 🙂

 

[FM001]

Strange that your blood glucose plummets as opposed to shooting up which one might expect with no bolus insulin or food in a morning. Rather than reduce the levemir and confuse things why not take a small glass of fresh orange juice to bed with you, when you wake at 7am to inject follow this up with the juice which should prevent the mid morning low's.

 

[D_G]

results!

OK so managed to test this last night and here are the results!

I made sure there was no novorapid in my system when i went to bed and my levels were 8.5

I woke up at 7am and checked my levels before doing my levemir and they were 5.1! However i think this drop is because of the excercise DVD i did a few hours before i went to bed (had a small snack afterwards as i know i would have dropped low) So i was a little uneasy injecting my levemir and going back to bed on such a low level so i had 2 jelly babies just to stop my worrying! As suggested i dropped my levemir by couple units and only did 16 as opposed to my regular 18...

So then i woke randomy at 9am so did a random test which was 6.5

Got up properly around midday and the last test was 4.9! Sooo i think if i hadnt had those jelly babies i may have been in trouble, what do you think???

 

[everydayupsanddowns]

Sounds to me as if your basal is a bit too high D_G. If that overnight drop is a regular occurence it would suggest to me that your evening basal was out - though as you say it might be exercise related.

On the weekend mornings when you lie in you are effectively basal testing (no breakfast no bolus) and your levels *should* stay fairly steady.

On weekdays two thoughts strike me...

There's a phenomenon related to DP which I've seen written as FHTF (feet hit the floor) in that it't an extra boost of glucose from the liver that happens when you get up rather than the early hours. This seems to be what happens to me.

If this is affecting you then your weekend morning basal would need to be lower than your weekday (because youare not getting up so the glucose boost won't get released and don't need basal to cover it)

The other thought is that your morning bolus ratio might actually be out (too little) but on weekdays it balances out because your early morning basal is too high and is doing some of the bolus's work. On the weekend no breakfast (with underdosed basal) means you are abit of BG short.

Does that make any sense?

Have you ever skipped breakfast on a weekday and done some hourly tests to see what happens on basal only?

M

 

[D_G]

Sounds to me as if your basal is a bit too high D_G. If that overnight drop is a regular occurence it would suggest to me that your evening basal was out - though as you say it might be exercise related.

On the weekend mornings when you lie in you are effectively basal testing (no breakfast no bolus) and your levels *should* stay fairly steady.

On weekdays two thoughts strike me...

There's a phenomenon related to DP which I've seen written as FHTF (feet hit the floor) in that it't an extra boost of glucose from the liver that happens when you get up rather than the early hours. This seems to be what happens to me.

If this is affecting you then your weekend morning basal would need to be lower than your weekday (because youare not getting up so the glucose boost won't get released and don't need basal to cover it)

The other thought is that your morning bolus ratio might actually be out (too little) but on weekdays it balances out because your early morning basal is too high and is doing some of the bolus's work. On the weekend no breakfast (with underdosed basal) means you are abit of BG short.

Does that make any sense?

Have you ever skipped breakfast on a weekday and done some hourly tests to see what happens on basal only?

M

Yes i think the exercise may have been a factor in last nights drop i will have to test again on a night where i dont do my dvd 🙂

My basal on week days is fine its just the weekends that i was having issues with as i sleep in longer and the levemir i take in the mornings (18 units) made me drop considerably between when i inject it and when i get up, like you said i dont seem to have the boost of glucose on the weekends and this is what i wanted to try to change....i think it was successful as i gave myself 2 units less insulin this morning, however waking up on 4.9 was still a bit low considering i downed a couple of jelly babies as well!

Maybe try again and drop anothe unit? and you were saying about skipping brekfast on a weekday? i havent done this maybe its something to experiment with too when i am back at work, thankyou for the suggestion 🙂

 

[Northerner]

Sounds like a good result to me Nikki, just a little more tweaking 🙂 If your basal is OK through the week I'd leave it alone 🙂

 

[everydayupsanddowns]

One of the reasons I'm tempted with Levemir is that it is so much more 'biddable' and responds pretty much on the day you change the dose (rather than the 'Lantus lag'). At least that's what I've read from those who use it. Sounds like a different morning Levemir dose in the mornings when you are having a lie in could be just the ticket.

Good luck with your experiments/tweaks 🙂

 

[D_G]

Right so another test (with the exercise dvd)

Again no fast acting insulin in system when i went to bed and levels were 9 (again i knew they would drop due to the earlier exercise) Woke up at 7am and tested at 6.2 thought that was ok injected levemir ,which again i lowered to 16 units instead of 18.............woke up 2 hours later all sweaty and hot to a 2.6!!!

Urgh definatley need to test without doing exercise! thats what i get for trying to be healthy! lol

 

[Northerner]

Right so another test (with the exercise dvd)

Again no fast acting insulin in system when i went to bed and levels were 9 (again i knew they would drop due to the earlier exercise) Woke up at 7am and tested at 6.2 thought that was ok injected levemir ,which again i lowered to 16 units instead of 18.............woke up 2 hours later all sweaty and hot to a 2.6!!!

Urgh definatley need to test without doing exercise! thats what i get for trying to be healthy! lol

Blimey! Good job you lowered the levemir! What you need to do is exercise every day, then that will be normal and you'll know what dose to give 😉 When you reach a certain level of fitness, your requirements reach a plateau (or at least mine do!)

 

[D_G]

Blimey! Good job you lowered the levemir! What you need to do is exercise every day, then that will be normal and you'll know what dose to give 😉 When you reach a certain level of fitness, your requirements reach a plateau (or at least mine do!)

I know i cant belive how different it was to last time even though i gave myself the same amount of levemir!

Exercise every day!! 😱I barely manage to get up and do it every other day lol...its only a little half hour dvd i really didnt expect it to affect my levels this much 😱!

Well i wont be doing it tonight so we shall jus see what happens 🙂