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Extreme insulin sensitivity..basal a nightmare!

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A

Amjay

Member
Relationship to Diabetes
Type 1.5 LADA
Hi all!
Does anyone have any experience with extreme insulin sensitivity?For 3 months now...it's been somewhat difficult.Basal insulin given once a day just doesn't do it anymore.Low during the day at work (physical).Too high through sleeping hours and upon waking.Any advice much appreciated.
 
What basal insulin are you using? Levemir is designed to be split into 2 doses in 24 hours and you don't have to do the split 50/50, you can do whatever works for you. Alternatively have you asked about a pump? The basal on those can be adjusted by the hour (they don't use long acting insulin, they give you teeny tiny doses of rapid acting every few minutes for your background). Not everyone who wants a pump is able to get one unfortunately, but worth asking if you haven't already tried, and your chances improve if you can show a good reason why your control might be better with one.
 
Hi. I'm on Levemir and was taking one dose a day at night which worked well but as my Beta cells have continued to degrade I have had to split the dose which has helped a lot.
 
Sally71 said:
What basal insulin are you using? Levemir is designed to be split into 2 doses in 24 hours and you don't have to do the split 50/50, you can do whatever works for you. Alternatively have you asked about a pump? The basal on those can be adjusted by the hour (they don't use long acting insulin, they give you teeny tiny doses of rapid acting every few minutes for your background). Not everyone who wants a pump is able to get one unfortunately, but worth asking if you haven't already tried, and your chances improve if you can show a good reason why your control might be better with one.
Click to expand...
Hi there Sally,thanks for the reply!!I was on Lantas but they are currently trying me on Toujeo...Not good at all.So I'm going to go back on Lantas..until I see the nurse in a couple of weeks and then..as you say..suggest Levemir...sounds the best option for me.I life in Mallorca..so a pump indeed would be best...but not possible here for free...bit too exspensive unfortunately.Many thanks Sally.Much appreciated!!
 
If I remember correctly not all the Insulins that are available here in the UK are available in all parts of Spain. I am going by what members have posted in the past.
 
DaveB said:
Hi. I'm on Levemir and was taking one dose a day at night which worked well but as my Beta cells have continued to degrade I have had to split the dose which has helped a lot.
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Hi Dave, splitting the dose is sounding like my best option.Many thanks for your reply!
 
grovesy said:
If I remember correctly not all the Insulins that are available here in the UK are available in all parts of Spain. I am going by what members have posted in the past.
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Ah... wonder if that's why I have never heard anyone mention it.Will be asking pronto!!Thanks.
 
I believe from what I remember when it has been mentioned in the past it is the way the Health Systems/ Boards are set up there.
 
Amjay said:
Hi all!
Does anyone have any experience with extreme insulin sensitivity?For 3 months now...it's been somewhat difficult.Basal insulin given once a day just doesn't do it anymore.Low during the day at work (physical).Too high through sleeping hours and upon waking.Any advice much appreciated.
Click to expand...

Yes, I am so unbelievably sensitive to HUMALOG I have given it the nick name 'rocket fuel'. I used to have very similar issues which you are having and this is what worked for me:-

I was sleeping through hypos and contacted a DSN who told me that nocturnal hypos are not good so she advised that I have a milky hot chocolate drink right before bed and omit the 10 pm inj of Levemir. So that was exactly what I did. BG ran high 16 mmol all night so corrected at breakfast time, had ALL injections at my usual breakfast and whoooosh. Blood sugars went beserk, 23 to 25 mmol at about11:00am that morning! I was nearly needing to contact NASA to bring them down and omg never again am I stopping a night time Levemir!! I realised that Levemir was only lasting for about 18 hours a day and I need 2 injections not 1. DSNs were going ballistic with me on the DAFNE course last July for refusing to stop my night time Levemir, due to hypos which they had asked me to do for the same reason, but I stood my ground and I am so glad I did.

So I decided to go back into 2 inj of Levemir ( without speaking to DSNs ) and also because I eat during the day and not at night, I decided that I will have a higher dose of Levemir in the morning and a lower dose at night. I was scanning and testing blood through out the day and recording my bg on the mysugr app. Careful notes are important because diabetes type 1 requires us to juggle many balls in the air without them falling on us and I find making notes about my doses on a whiteboard helped me a lot during this time. Anyway, night time hypos were caused by Levemir and not my tea time humalog because HUMALOG has a duration of 4 hours and I only had Levemir on board at the time of the hypos which was between 03:00 and 07:00 am

So within 24 hours of these changes, all my blood sugars became stable and night time bg was in range with no hypos at night and less hypos during the day. It's pretty tight controlled now in the past six weeks or so that have elapsed since the changes but I get the occasional wobbler I feel good now, have more energy and glad I made these changes.

Hope this helps!
 
Well Levemir was always intended to be delivered in 2 goes anyway. I was on (after lots of testing and experimentation over months and months I'm bound to say) 14u as soon as I got up about 7 to 7.30 am and another 4u at approx. 9.30 pm at night.
 
Haemagoblin said:
Yes, I am so unbelievably sensitive to HUMALOG I have given it the nick name 'rocket fuel'. I used to have very similar issues which you are having and this is what worked for me:-

I was sleeping through hypos and contacted a DSN who told me that nocturnal hypos are not good so she advised that I have a milky hot chocolate drink right before bed and omit the 10 pm inj of Levemir. So that was exactly what I did. BG ran high 16 mmol all night so corrected at breakfast time, had ALL injections at my usual breakfast and whoooosh. Blood sugars went beserk, 23 to 25 mmol at about11:00am that morning! I was nearly needing to contact NASA to bring them down and omg never again am I stopping a night time Levemir!! I realised that Levemir was only lasting for about 18 hours a day and I need 2 injections not 1. DSNs were going ballistic with me on the DAFNE course last July for refusing to stop my night time Levemir, due to hypos which they had asked me to do for the same reason, but I stood my ground and I am so glad I did.

So I decided to go back into 2 inj of Levemir ( without speaking to DSNs ) and also because I eat during the day and not at night, I decided that I will have a higher dose of Levemir in the morning and a lower dose at night. I was scanning and testing blood through out the day and recording my bg on the mysugr app. Careful notes are important because diabetes type 1 requires us to juggle many balls in the air without them falling on us and I find making notes about my doses on a whiteboard helped me a lot during this time. Anyway, night time hypos were caused by Levemir and not my tea time humalog because HUMALOG has a duration of 4 hours and I only had Levemir on board at the time of the hypos which was between 03:00 and 07:00 am

So within 24 hours of these changes, all my blood sugars became stable and night time bg was in range with no hypos at night and less hypos during the day. It's pretty tight controlled now in the past six weeks or so that have elapsed since the changes but I get the occasional wobbler I feel good now, have more energy and glad I made these changes.

Hope this helps!
Click to expand...
Hi there...Yes indeed, has helped very much.Thankyou! Yeah... Humalog I'm on around the 2 units mark..and basal which is my biggest problem (Lantas)on 1 and slowly working my way up.But do believe it has to be Levemir split dose for better control.Just came off Toujeo.....not a good one for me!!See the Dsn in a week or so.....fingers crossed it gets better!!Many thanks for your reply!!
 
trophywench said:
Well Levemir was always intended to be delivered in 2 goes anyway. I was on (after lots of testing and experimentation over months and months I'm bound to say) 14u as soon as I got up about 7 to 7.30 am and another 4u at approx. 9.30 pm at night.
Click to expand...
Hi,yep...think that's the way forward!!Also not an exact 12 hour split that you do..great to know!!
 
Hope you find a way to get on Levemir. Lantus and Toujeo both are intended to have long flat profiles, and it seems you need more flexibility.

As you say, a pump would be best, but if that’s not an option then a basal insulin that works well split is a decent alternative. Some split Lantus, but I never found that worked too well for me. Some go back to using older insulins (protaphane/insulatard), but these are a little more ‘peaky’ than Lev on average, so may not suit you.

At the end of the day, it’s finding a system that works well for you - at the moment - and then changing it when diabetes shifts the goalposts in the future 🙂
 
Amjay said:
Hi there...Yes indeed, has helped very much.Thankyou! Yeah... Humalog I'm on around the 2 units mark..and basal which is my biggest problem (Lantas)on 1 and slowly working my way up.But do believe it has to be Levemir split dose for better control.Just came off Toujeo.....not a good one for me!!See the Dsn in a week or so.....fingers crossed it gets better!!Many thanks for your reply!!
Click to expand...
You are more than welcome Amjay hope you feel better soon.
 
Amjay,

Be aware of peak times of your insulins and the timing of your insulins can help prevent hypos I have experienced extra hypos when I had 2 insulins peaking at the same time so my consultant told me to have Levemir at 10:00 pm at and this works very well for me. Your DSN can help you with this too.
 
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