Levemir

[destype]

Hi,

First time poster. Type 1 diabetic.

I have been having to gradually reduce my overnight basal and I am currently on 1.5 units. To me this seems a very small amount but I had to reduce it from 2 units recently as I had 2 hypos during the night.

Background is that I am perimenopausal and I am having light therapy for Vitiligo. I also have some sinus issues that I will be having a procedure for at the end of the year.

Any clues as to what may be going on or has anyone had the same thing happen to them? I've contacted my diabetes nurse and I'm waiting for an answer and asked my Light Therapy nurse but she doesn't think they are linked.

Thanks in advance.

 

[Inka]

Welcome @destype 🙂 I’m perimenopausal (the fun!) and I’ve found my insulin needs have dropped quite a lot. They’re also quite erratic, although HRT has improved that. So, perhaps it is hormones.

I have no experience of light therapy but I suppose in theory if it made the areas hot it might affect absorption too, but my money’s on the peri. Reading round, I’ve found people needed to make quite significant reductions. One women said her basal more than halved. So, be safe - you only need what you need, however little that is.

 

[destype]

Welcome @destype 🙂 I’m perimenopausal (the fun!) and I’ve found my insulin needs have dropped quite a lot. They’re also quite erratic, although HRT has improved that. So, perhaps it is hormones.

I have no experience of light therapy but I suppose in theory if it made the areas hot it might affect absorption too, but my money’s on the peri. Reading round, I’ve found people needed to make quite significant reductions. One women said her basal more than halved. So, be safe - you only need what you need, however little that is.

Thanks Inka! I had forgotten that hormones effect blood sugars. But I wonder why only my night time basal has reduced? Or maybe in time that will reduce as well. But that does sound like what it could be. Thanks. I’ll do some reading around that now I know.

 

[Inka]

Who knows @destype ? I stopped trying to make sense of it because it was driving me mad trying to work out a pattern. I find I just have to adjust things as needed. I had to reduce my basal a bit but the biggest effect I’ve noticed is with my mealtime ratios. I imagine it can vary a lot.

I wish there was more official advice. I think I read they were doing a study on it now or soon.

 

[rebrascora]

I have to reduce my evening basal after exercise/increased activity during the day.
I need a lot of Levemir during the day (22units) which is pretty stable although can need reducing down to 20 sometimes and occasionally 24u) but generally 22 keeps me nice and steady during the day, but my night time dose varies anywhere from 0 and 7. A zero dose will be after 3 consecutive days of increased exercise/activity and sometimes I will still mildly hypo overnight with no evening basal. I will need 7 if I have been laid up or far too sedentary. I rarely have a week of needing the same Levemir dose....usually no more than a few days before it needs adjusting as I seem to be very sensitive to it during my sleep.... or probably more sensitive to the effects of exercise to reduce my BG levels (muscles sucking glucose out of my blood to replenish their stores) at night whilst I sleep. With the help of Libre I am getting better at assessing how much Levemir on an evening I will need but it is very intuitive and I consider it a bit of a dark art. There is certainly no empirical way to calculate it.

Something else to consider is that alcohol lowers BG during the night for some people, so if you have been having a glass of wine with your evening meal recently, that can impact it too.

But yes certainly hormones as well. I use HRT and the patches are supposed to be applied twice a week after 3 days and 4 days but sometimes I forget with it not being a clear routine and sometimes I can manage with just 1 a week instead of 2 from a symptoms point of view but I am sure there is also an element of this impacting my evening BG levels as well as exercise, although for me it is to a lesser more subtle effect than exercise which is quite significant.

 

[everydayupsanddowns]

Welcome to the forum @destype

Our parent of children with diabetes, and our insulin users who have been through pregnancies seem to experience significant changes in insulin sensitivity as the hormones ebb and flow - so I am certain that the menopause will be merrily lobbing spanners in the works for you right left and centre.

We have had a few members over the years who have all but stopped taking their basal insulin - one of whom was our ex-Admin @Northerner for who, menopause will not have been an issue!

 

[destype]

Thank you all. So my takeaway from your answers is that it’s normal for basal to fluctuate and it’s not as we are told that it’s a fixed amount.

I have to reduce my evening basal after exercise/increased activity during the day.
I need a lot of Levemir during the day (22units) which is pretty stable although can need reducing down to 20 sometimes and occasionally 24u) but generally 22 keeps me nice and steady during the day, but my night time dose varies anywhere from 0 and 7. A zero dose will be after 3 consecutive days of increased exercise/activity and sometimes I will still mildly hypo overnight with no evening basal. I will need 7 if I have been laid up or far too sedentary. I rarely have a week of needing the same Levemir dose....usually no more than a few days before it needs adjusting as I seem to be very sensitive to it during my sleep.... or probably more sensitive to the effects of exercise to reduce my BG levels (muscles sucking glucose out of my blood to replenish their stores) at night whilst I sleep. With the help of Libre I am getting better at assessing how much Levemir on an evening I will need but it is very intuitive and I consider it a bit of a dark art. There is certainly no empirical way to calculate it.

Something else to consider is that alcohol lowers BG during the night for some people, so if you have been having a glass of wine with your evening meal recently, that can impact it too.

But yes certainly hormones as well. I use HRT and the patches are supposed to be applied twice a week after 3 days and 4 days but sometimes I forget with it not being a clear routine and sometimes I can manage with just 1 a week instead of 2 from a symptoms point of view but I am sure there is also an element of this impacting my evening BG levels as well as exercise, although for me it is to a lesser more subtle effect than exercise which is quite significant.

Hi Barbara, strangely I’m actually more sedentary currently because I’ve injured my knee so I should need more but instead my night time basal requirements are going down. I’ve always taken very small amounts 15 units in 24 hours. It’s baffling.

I have to reduce my evening basal after exercise/increased activity during the day.
I need a lot of Levemir during the day (22units) which is pretty stable although can need reducing down to 20 sometimes and occasionally 24u) but generally 22 keeps me nice and steady during the day, but my night time dose varies anywhere from 0 and 7. A zero dose will be after 3 consecutive days of increased exercise/activity and sometimes I will still mildly hypo overnight with no evening basal. I will need 7 if I have been laid up or far too sedentary. I rarely have a week of needing the same Levemir dose....usually no more than a few days before it needs adjusting as I seem to be very sensitive to it during my sleep.... or probably more sensitive to the effects of exercise to reduce my BG levels (muscles sucking glucose out of my blood to replenish their stores) at night whilst I sleep. With the help of Libre I am getting better at assessing how much Levemir on an evening I will need but it is very intuitive and I consider it a bit of a dark art. There is certainly no empirical way to calculate it.

Something else to consider is that alcohol lowers BG during the night for some people, so if you have been having a glass of wine with your evening meal recently, that can impact it too.

But yes certainly hormones as well. I use HRT and the patches are supposed to be applied twice a week after 3 days and 4 days but sometimes I forget with it not being a clear routine and sometimes I can manage with just 1 a week instead of 2 from a symptoms point of view but I am sure there is also an element of this impacting my evening BG levels as well as exercise, although for me it is to a lesser more subtle effect than exercise which is quite significant.