Hi all, just wanted to ask if anyone has had a similar experience to mine. I've noticed my blood sugar is spiking during the night always around 3/4am and so when i wake up in the morning it is sky High between 15 to 19. I've adjusted my background dose etc but to no avail. Has anyone had anything similar? I'm type 1 on novorapid and levermir. Thanks in advance.
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Hello and some advice please!
- Thread starter C_Star
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rebrascora
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Hi and welcome from me too.
Do you take a single dose of Levemir or take it twice daily, usually morning and evening? Levemir doesn't last 24 hours and was designed to be used as a split dose. I am guessing that you may be taking it once a day in the morning and it is running out in the early hours just as Dawn Phenomenon is kicking in.
Do you take a single dose of Levemir or take it twice daily, usually morning and evening? Levemir doesn't last 24 hours and was designed to be used as a split dose. I am guessing that you may be taking it once a day in the morning and it is running out in the early hours just as Dawn Phenomenon is kicking in.
Another welcome from me @C_Star
I too thought about Dawn Phenomenon and whether you were taking a single dose of Levemir.
Seeing as diabetes can be rather fickle and often has a mind of its own, I also wondered about a couple of other things.
For example, you may be a newbie to Diabetes World and in the honeymoon period where your body is erratically producing some insulin of its own until most of your beta cells are killed off. This can lead to a gradual rise in your insulin requirements.
Another thought was the annoyance of high Bg leading to insulin resistance. Once my BG gets above a certain level, I need more bolus insulin to correct it. It took my rather slow brain a little too long to also realise that I also have resistance to basal insulin. As a result, if my BG gets high overnight when I only have basal insulin, it will continue to rise further because the insulin resistance means the basal is no longer sufficient to keep it stable.
In other words, if you can keep your BG lower, you may need less Levemir than you have increased it to.
I too thought about Dawn Phenomenon and whether you were taking a single dose of Levemir.
Seeing as diabetes can be rather fickle and often has a mind of its own, I also wondered about a couple of other things.
For example, you may be a newbie to Diabetes World and in the honeymoon period where your body is erratically producing some insulin of its own until most of your beta cells are killed off. This can lead to a gradual rise in your insulin requirements.
Another thought was the annoyance of high Bg leading to insulin resistance. Once my BG gets above a certain level, I need more bolus insulin to correct it. It took my rather slow brain a little too long to also realise that I also have resistance to basal insulin. As a result, if my BG gets high overnight when I only have basal insulin, it will continue to rise further because the insulin resistance means the basal is no longer sufficient to keep it stable.
In other words, if you can keep your BG lower, you may need less Levemir than you have increased it to.
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Hope you can find a workaround @C_Star
We have a variety of strategies used by different forum members to try to combat their liver’s pesky shenanigans overnight!
Has your team spoken to you about a possible switch for Levemir? It is being phased out (much to the annoyance of many here who really value its particular strengths).
So perhaps whatever strategies you try will need to bear in mind that Levemir is on its way out?
We have a variety of strategies used by different forum members to try to combat their liver’s pesky shenanigans overnight!
Has your team spoken to you about a possible switch for Levemir? It is being phased out (much to the annoyance of many here who really value its particular strengths).
So perhaps whatever strategies you try will need to bear in mind that Levemir is on its way out?
Thank you all for your responses. Just to give you more information I've been diabetic since age 10 and I'm now in my mid thirtys. I use levermir twice a day roughly 12 hours apart. I feel like I've tried so many options it's just the worst way to start the morning!
rebrascora
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What sort of split of Levemir do you use? ie. It sounds like you need a bit more overnight at the moment. I constantly have to adjust my night time dose because my overnight levels are very sensitive to whatever exercise/activity I have or haven't done during the last 2 days.
Have you considered setting your high alarm at 10 or 12 and doing a correction during the night if it goes off? Not a long term solution but certainly something I have done before on numerous occasions if I haven't got my evening Levemir dose correct.
You say you have increased your Levemir.... was that just once and by how much? I would just keep increasing my dose every few days until it sorts it. Sometimes you have to be persistent and even heavy handed with it to deal with a problem.
Have you considered setting your high alarm at 10 or 12 and doing a correction during the night if it goes off? Not a long term solution but certainly something I have done before on numerous occasions if I haven't got my evening Levemir dose correct.
You say you have increased your Levemir.... was that just once and by how much? I would just keep increasing my dose every few days until it sorts it. Sometimes you have to be persistent and even heavy handed with it to deal with a problem.
How do you feel about having an insulin pump? This is exactly the kind of scenario that the ability to adjust basal dose every 30 minutes should solve.
It sounds like it would be worthwhile discussing a pump with your DSN. You may need to be persistent.
Inka
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A pump sorted my DP but you could try tweaking your Levemir. When I take a pump break, I use twice daily basal but I have them further than 12hrs apart so I can take my evening one closer to bedtime. Maybe you could try taking your evening Levemir later? I’d try that before deciding whether to increase the dose.
rebrascora
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Like @Inka I take my doses before I get out of bed in the morning and bedtime at night, so definitely not a 12 hour split. However I also don't take anywhere near an even split, with 20-24 units in the morning and between 0 and 6 units at night depending upon how active/inactive I have been during the last couple of days. Finding the dose split and timing that works for you is important.