Levenmir Question

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Dizzydi

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Relationship to Diabetes
Type 1
I have recently switched from Insultard to Levenmir.

Do any of you guys change your insulin requirments depending on your BS results ?

With the insultard if my morning BS was rising I would increase a unit or two and then reduce again when they settled down.

I'm really struggling to control my bs at the moment this moring it was 9.6!! not been under 8 all week. Evenings have all been 13+

Getting desparate now
 
Good Morning

Yes, I changed my insulin on the third day of any increase or decrease of bg.

there is a great site i use as reference to dose adjusting.

www.medweb.bham.ac.uk under insulin dose instruction and this explains when to change and by how much.
 
Hi

I only know this from a type 1 point of view (dont know if type2 is different), like hotchop I was told to wait until there is a pattern - the same thing happening for 2 days running and then to just change 1 insulin amount at a time.
 
As you are type 2 I wouldnt qoute myself, if you are on a single dose of levemir at night, then it might not be enough to get your morning readings down, and it might also be running out by the time the evening results are in...... so increasing the dose may tackle the morning and also, more insulin lasts longer, so it may deal with the evening too.........

If the evening is still high despite the continual increase in dose, you may have to split the dose.......
 
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I used to be one 1 dose, in the mornings but my waking levels were rising.

I split my dose now at 50/50 and waking levels are between 5 and 6 which is great and proves to me that my levemir wasnt lasting the full 24 hours for me.

I hadnt told my doc initially i was splitting as my dsn completely dismissed the idea a while back but i saw him last week and he was good about it and said that the main reason they dont initilly recommend splitting is 1, the increased possibility of weight gain.... and 2, doing that 2nd injection.... neither of which concern me.
 
Hi DizzyDi

Did your team not give you any help moving from Insulatard to Levemir?!? That's terrible! They are very different insulins, and you should have been given quite a bit of help and support in making the transition.

Do you have access to a specialist DSN who you could ask for advice?

I'm only going on what I hear from Levemir users as I'm on Lantus (though I am considering talking to my team about switching)...

From what I know (it's a long time since I was on it) Insulatard is a medium-long acting human insulin with a fairly short onset, something like half an hour, followed by a peak activity until about 12 hours after injection, then a gradual tail off up to 24 hours-ish. I took mine in one dose, late at night and ate a little supper to counteract the overnight peak.

Levemir on the other hand is a long-acting analogue insulin. Slightly longer onset and a fairly peakless profile of between 5 and 23 hours duration depending on the dose taken (bigger doses of most insulins tend to last longer). Levemir seems to be usually taken in two doses, roughly 12 hours apart. People who have differing overnight and daytime basal requirements can adust the two doses to match.

I've always been advised to keep doses the same when switching insulins, but to test more often to see how things are going. From your results it might be that you need an extra unit or two, and/or if you are injecting one dose in the evening it may be that the Levemir is not quite lasting 24 hours with a corresponding rise before the following injection.

If you have only recently changed, your body may still be 'settling in' to the new insulin. I changed my rapid-acting earlier this year and doses initially went down, before settling pretty much back up to the old levels.

If you do not usually adjust your own doses, and are not confident in doing so I'd suggest you get on to your care team as soon as possible and discuss it with them.
 
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Hi Guys thanks for your reponses.

I do get a lot of support from my care team, I'm back seeing my consultant on 3rd Sept (back to 4 weekly visits for the time being).

I've been having a bit of a complicated time at the moment with drugs for IVF and this has not helped with the BS I think. We knew they would rise slightly but not to the extent they have. I wanted to see how other people sort out there highs in the meantime before I see the consultant.

With the insultard I changed it accordingly - but was finding if I injected more then I had night time hypo's. This is why they have switched me to levemir. When I go back they are going to assess if I need to do split doses and or / if i need another insulin after meals (sigh) - and if it is safe to do so, I will change the levemir (1 unit at a time) until I see the consultant - no point asking my DR as he thinks my consultant should have all the say in my meds.

Will not be using any more drugs after today for the IVF and hopefully these will be out of my system in a couple of days.

Fingers crossed it will all settle back down again and stop being so god darn complicated (sigh again)
 
Hope it settles down quickly for you and massively good luck with the IVF.
 
I am sure it will settle down in time........

You have the right idea adjusting one unit a time............🙂
 
I've just been switched from Lantus to Levemir and am having the same problem. My morning results seem too high and I'm also high (12ish) before meals. I've had no help from anyone and am inclined to just sort it myself! I've increased my morning Levemir this morn and was 10 before lunch so a slight improvement. Some of my problems are probably caused by inactivity and stress at the moment as Im not able to do much until I've got my MRI done and know my results. It's a right pain.
 
If you feel confident adjusting your insulin and your team are happy for you to do so then I would leave it 2-3 days between each dose change to see the effect.

Are you taking more or less levemir than you were of the insultard?
 
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