Help please with Levemir/basal insulin

[heasandford]

Sorry Laura this isn't going to be of direct help for you but I have appreciated your post very much and am so impressed with the effort you are putting in. I decided to split my Lantus about 2 months ago and have 5u before bed (around midnight) and 5u on getting up (around 8am these days, how lazy!) It can vary an hour or so each side which doesn't seem to have any consistent affect. It does seem to have improved my evening cover, which always used to be high when I previously took my total Lantus before bed.
When I told my DSN what I'd done she said that Lantus is licensed to be split and Levemir isn't! Exactly the opposite of what everyone likes on here!

What is so interesting though is the attention to detail you have to apply to get it right, I am inspired by your trial. I am still too variable, but will keep at it

 

[lauraw1983]

YES.

There are some people out there for whom Levemir simply does not work. I'm one of them. I switched from 26u of Lantus to Levemir. 70u of Levemir every day later, and I was still having to do compensatory Novorapid jabs every two hours just to keep my BGs near 12. My total daily dose of insulin went from around 45u to 120 while my control got worse and worse.

After a week and half of this, I just gave up and went back to Lantus.

This is the conclusion I was coming to!

I am now on 10u Levemir at night and 16u morning. So 26u in total....I was on 13u Lantus so exactly double!!

I'll be giving it another week or two and will reassess it from there, I know I can go back to Lantus whenever I want but I really wanted the flexibility of Levemir

I wonder why they are so vastly different?!?!

 

[lauraw1983]

Sorry Laura this isn't going to be of direct help for you but I have appreciated your post very much and am so impressed with the effort you are putting in. I decided to split my Lantus about 2 months ago and have 5u before bed (around midnight) and 5u on getting up (around 8am these days, how lazy!) It can vary an hour or so each side which doesn't seem to have any consistent affect. It does seem to have improved my evening cover, which always used to be high when I previously took my total Lantus before bed.
When I told my DSN what I'd done she said that Lantus is licensed to be split and Levemir isn't! Exactly the opposite of what everyone likes on here!

What is so interesting though is the attention to detail you have to apply to get it right, I am inspired by your trial. I am still too variable, but will keep at it

Ahh thanks. It's the control freak in me....lol. I just really want Levemir to work for me I guess as it's much easier to adjust for exercise and stuff!

My DSN said I could split Lantus or Levemir, I wanted to switch to Levemir to try it but if it doesn't work for me and I go back to Lantus I will be splitting that dose too to see if it has better coverage. It definitely didn't last 24 hours for me.

I realise I am doing about a billion tests just now (my poor fingers!) but it's the only way to know what effect this new basal is having!

 

[Northerner]

...I wonder why they are so vastly different?!?!

They do work differently - I wonder if this is a factor and if any studies have been done?

http://www.diabetessupport.co.uk/boards/showthread.php?t=1719&

 

[everydayupsanddowns]

When I told my DSN what I'd done she said that Lantus is licensed to be split and Levemir isn't! Exactly the opposite of what everyone likes on here!

Perhaps your DSN should take the time to read the Patient Information Leaflet that comes with Levemir?

http://www.medicines.org.uk/emc/medicine/18503

How often to inject
When Levemir is used in combination with tablets for diabetes or as add-on therapy to liraglutide, Levemir should be administered once a day. When Levemir is used as part of a basal-bolus insulin regimen Levemir should be administered once or twice daily depending on patients’ needs. Dose of Levemir should be adjusted individually. The injection can be given at any time during the day, but at the same time each day. For patients who require twice daily dosing to optimise blood sugar control, the evening dose can be administered in the evening or at bedtime.

😉

 

[DeusXM]

I know I can go back to Lantus whenever I want but I really wanted the flexibility of Levemir

You might be able to play this to your advantage.

For me:

Levemir - doesn't work
Isophane - gives me wild blood sugars
Lantus - causes (in me) mild depression and increased perspiration

I'm one of this people for whom there simply isn't a basal insulin that's appropriate. As a result, I was actually offered a pump on the NHS but I turned it down on the basis that I'm not comfortable being tethered to something so I took my chances with the Lantus instead. Incidentally, the Lantus/depression issue is sporadically recognised within the NHS - some docs deny it completely, but I've also spoken to several who have told me I am by no means the only one who's had this issue going from isophane to Lantus.

You may be able to make a similar argument to your PCT in that Levemir doesn't work, Isophane will obviously ruin your life with hypos and hypers, and Lantus does not offer you the flexibility needed to meet your basal requirement. So you might even be able to score a pump out of this experience, if that's something you're interested in.

 

[lauraw1983]

You might be able to play this to your advantage.

For me:

Levemir - doesn't work
Isophane - gives me wild blood sugars
Lantus - causes (in me) mild depression and increased perspiration

I'm one of this people for whom there simply isn't a basal insulin that's appropriate. As a result, I was actually offered a pump on the NHS but I turned it down on the basis that I'm not comfortable being tethered to something so I took my chances with the Lantus instead. Incidentally, the Lantus/depression issue is sporadically recognised within the NHS - some docs deny it completely, but I've also spoken to several who have told me I am by no means the only one who's had this issue going from isophane to Lantus.

You may be able to make a similar argument to your PCT in that Levemir doesn't work, Isophane will obviously ruin your life with hypos and hypers, and Lantus does not offer you the flexibility needed to meet your basal requirement. So you might even be able to score a pump out of this experience, if that's something you're interested in.

Ha I WISH! I would snatch a pump from their hands in a millisecond.

Unfortunately I have been told 3-4 year waiting list here, end of story.

Levemir does seem to be working, albeit in awfully high doses I think, for me.

I'm just so unhappy about the DP I get, I NEVER stay stable overnight no matter what tactics I have tried. I am getting tired thinking about it. The only thing that works is injecting upon waking, this morning for example at 9.8 I took 3u Humalog and then by the time I ate it was 4.5. I also take my basal upon waking now too, up to 18u in the morning....It's really not ideal though and I feel it's really starting to affect my quality of life.