Levemir- how does it work

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hotchop

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Type 2
Morning all...

as above, how does it work?

my understanding is that its background insulin which should keep my levels steady over 24 hours.

if this is the case, shouldnt my bg levels be fairly consistant through the day?

my waking level are somewhere between 8.0 and 8.7 which is fantastic compared to what it was! ( doses are changing to bring down further by increasing by 2 units every 3 days or so) I speak to DSN every 3 days and she seems concerned that i am NOT having any hypos? is that because the insulin levels are too low? im confused!

my levels 2 hours after food sre still higher than i want them to be, averaging around 13 but testing before food is usually around the 9 mark and doc looking to start Novorapid when my base insulin is covered.

Thanks all!:D
 
Yed it is a long acting - but it doesn't last 24 hours! It can last up to 18-20 hours. As with any basal insulin, it's pretty important to get the doses right.

These are good levels to start with - ask your DSN if you should UP your levemir by 2 units or so. But remember with levemir, it takes about a week for any noticable difference to come into play.
 
blimey, that was quick, thank you

ah right, so if I took it later in the day, my waking levels would probably be lower, given that it is not 24 hour coverage? I currently inject about 730am

am i right in thinking that before food should be pretty much the same levels as waking?
 
Levemir is a backgorund, or basal insulin that in theory lasts 24 hours, but more likely 18-22 hours so a lot of people find they have to split it to get better coverage. In an ideal world, it would cover you at the same level throughout the day and night, but there are many factors that will affect this. Absorption rate from the injection site is one, also you may have different levels of insulin resistance throughout the day - I am much more resistant in the morning, for example.

Here's how it actually works, and the difference between it and the other popular basal insulin, Lantus:

http://www.diabeteshealth.com/read/...nd-levemir--whats-the-difference/?section=200
 
Hi hotchop, welcome to the wonderful world of levemir. I find that if you run out of Levemir your levels will remain at a higher level. At this point an injection will have an effect but will take a couple of hours. NovoNordisk recommend you inject in the evening, this way you can adjust for your morning fasting level. I inject 12 hours apart roughly 7:30 am and 7:30pm. I try and go to bed with a reading of 8 and end up with <6.5 in the morning (80 units morning and night). It's never quite that simple as it depends what you have eaten and what you have done (I find fast driving drops my levels) and yesterday the dentist extracting a tooth did a wonderful job. So it looks like adrenelin has an effect and I am beginning to suspect that the time it takes to digest your food is another factor.
 
Northerner, that was an interesting article, thank you.. I have since spoken to my dsn this morning who had increased dosage by another 2 units.

I mentioned maybe splitting the dosage and to say she was horrified was an understatement hahahahah

I have also thought about what Vicsetter mentioned and injecting maybe at night.. my concern here would be that if the Levemir is not lasting 24 hours, I potentially would be higher in the morning but i guess is easier to adjust for?

my bedtime numbers are not too off from waking... 8.7 this morning and 8.9 going to bed last night ( food was spag bol, not a lot of spag tho with 2 hour figures 10.1) im finding my food peak tends to be 3.5 hours rather than the normal 2.

i tend to hit a brick wqall of tiredness about 3pm>>> realllly debillatating, fall asleep on a pin, cant keep eyes open jobby... is this related to the insulin? its only been so bad since i started. I tended to be tired all the time before lol
 
Just looking at my bg record books from when I started on levemir (16/5/08) by 1st june I was injecting 22 units at night and waking up to 10.6 reading. By 16/6 I was up to 38 units and getting 7.2 in morning. on 28/6 I split the dose to 20 in morning and 18 at night and by August was up t o 40 am and 28 in evening. Daily readings of about 5.5 to 6.4 . all the time I was trying to get rid of my bad habits (peanut butter and apple sandwiches, chips, bread, rice etc etc) and trying to follow a relaxed Bernstein diet (see books). Still fighting the temptations and trying hard not to have a 1 to 1.5hr sleep in the afternoon (at 62 the doc is not too surprised). Like you I don't seem to fit the 2hr cycle on food. Don't want to panic you but I am on 80/80 units now but reducing them slowly as I've had a few readings below 5 which is a bit rough when you are 35miles from home and have to drive.
 
Vicsetter, that's interesting! 80 units is blooming crazy!

I looked back at my levels before diagnosis and my waking figures were circa 10.

Down to 8 ish now but not budging from there, I'm on 16 units a day now.

Am thinking that my units will be increased until I get below 7 and don't speak to my dsn until monday morning, when we review the weekend levels.
 
I take 66u of levemir in the morning and 70u at night, if I remember correctly I started at about 18 or 20u when i was changed from Insulatard to Levemir. Even with my night one at 70u my morning levels still don't come in that much under 8, I see my DSN on Tuesday so no doubt she will increase it again.
 
Squidge

I saw ur figures on a post and it certainly made me squirm! I'm guessing that as the diabetes progresses, you will hjave to inject more to counteract what your own body may, or may not be producing!

Scary!
 
I don't wait to be told, I just increased or decreased by smallish amounts. Is was on 85 and 85 until I stopped taking Rosuvastatin and then by readings dropped and I went down to 60 and 60. Been a bit naughty and eating too many KitKats so had to go up again. Only had half a dozen hypos and they have all been at 3am, wake up to cold sweat. Jelly babies and toast and peanut butter and back to sleep.
 
I only adjust my fast acting insulin Vic, I don't adjust the Levemir unless my Consultant or one of his docs or my DSn tell me to. I am on Rosuvastatin as well but if I come off it my cholesterol shoots up.

Hotchop, I have no idea what my body is up to lol it does it's own thing, as for producing insulin I have no idea if I am still producing some or whether it has given up the ghost...!!!
 
Have you ever asked why shouldn't you adjust your Levemir? My doc is more than happy that I control the dosage, she calls me her star diabetic. I wont know what my cholesterol is going to be but I'm not having rosuvastatin again, the leg aches have gone, my knee is nearly better, i'm sleeping better and the visits to the loo are less frequent and of course the insulin requirement is down.
 
No I haven't asked, don't know why, I suppose I have got used to my DSN upping it, and I see her roughly every 6 weeks.. although I think sometime ago she did say don't adjust the Levemir, but I am not sure on that memory lol I haven't had any problems on any of the statins I have been on. I was on simvastatin for about 8 years, then I went on to atorvastatin but didn't last on that long as it didn't lower my cholesterol and I have been on rosuvastatin for a couple of years now.
 
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