Levemir Doses

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Laura22

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Type 1
I am getting pretty sick of this now. Nearly EVERY single night I am waking up with a hypo. It's irritating and scary especially after falling unconscious the other day.

I woke up at 5:10am at 1.7mmol!!

I am taking 28u of Levemir in the evenings which I just started the other day after reducing it from 29u about two days ago.

I try and go to bed with my BG abover 5/6mmol but I still drop so low

Advice please?
 
I used to have that happen to me (on lantus) and would need to go to bed on 8/9 or above. If I was lower, I'd have a slice of bread and peanut butter, and this seemed to tide me over. What does your doctor/DSN say? I must admit, I just used my own judgement in reducing the lantus, going from 20 initially to 8 eventually. I'm not suggesting that you do as I did though, as we are very different people! I found that a 10% reduction every 3 days or so was the best approach until I started waking in the 5s. To wake at 1.7 is awful!

Hope you can get it sorted, it is a real worry, especially when it happens overnight. Have you thought about changing your levemir to a morning injection?
 
A point that my DSN made to me

I was the same (on lantus though). I was told to change my eavening meal ratio from 1:10g to .5:10g.

I eventually changed my lantus to middmorning but thats another story.

What have your Docs/DSN's said for you to do?
 
I think you need to discuss this with your DSN, it might be worth either changing the timing of your injection, or splitting the doses, so you have more in the morning than at night.

Personally I dont go to bed lower than 8 as I am prone to nightime hypos.
 
What are your levels like the rest of the day? If it were me (this is NOT advice) I would look to initially reduce the levemir by a unit at a time.

I've also been told to go to bed on around 8.

I've recently split my lantus to try and stop the night time hypos, and I think - touch wood - it might be working.
 
I do the Levemir twice a day- at 8am and 8pm. The morning dose is 30u and evening is now 28u.

Might have to give DSN a ring and see if she can help
 
Have u tried basal testing Laura? There are some good posts about it around. I've not tried it, but my DSN talked about it. Also we have always been told to see what the morning fasting numbers are for 3 days, work out the average, and then adjust the basal accordingly, by 1 or 2 units. Slowly, slowly is always the advice. I would say tho you should talk to your Dr or nurse about it before experimenting with anything suggested here! I woke up on 1.8 the other night, less than 3 hrs after going to bed on 12.7!! I think I took Apidra doses too close together and it caught up - but who knows! I'm on 8 units of Lantus once a day.(Just a bit of useless background!!😉)
Gloria
 
Vicsetter said:
This site has a table of how to adjust your dosage (supposed to be for Lantus, but they reckon it's similar). I know it's aimed at Type 2 but it's a good read and covers pumps as well.:
http://medweb.bham.ac.uk/easdec/prevention/lantusnotes.htm
Click to expand...

There's some really useful information on that site but I would just add (and I know there's a disclaimer on the page) to be cautious about changing the doses based on the table alone. For example the suggestion of dose changing by a specific number of units is unusual, most sources I've used (dafne for example) suggest looking at reductions/increases by a % of the existing dose rather than an exact nmber as that number will have varying degrees of impact based on what you usually take. Always a good idea to chat to your dsn anyway if you're considering altering your regieme anyway.
 
Just the one shot of Levemir? Lev doesn't last 24 hours so surely it should always be split?
 
DOH! Sorry. Missed that post.

In that case 58 units of basal for a T1 is unusually high isn't it?
 
Hi Laura,

Perhaps discussing other basal insulins with your DSN may be useful…

I switched from levemir (although for various reasons) to Lantus, as Levemir has much bigger peaks in activity then Lantus, which has a much steadier release rate. If it’s the hypos occurring during the peak release times, that could be why, especially if it is through the night and you aint eating…

Just a thought, maybe worth mentioning.

(I seem to have found that certain hospitals seem to have a preference for one type of basal over the other, not really considering the differences in how they act and how that relates to the individual’s patterns).
 
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