Split Levemir dose - DAFNE Online

April 19, 2018 09:30

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

ruthhutchinson said:
No. My evening numbers aren't too bad. Low if anything. Just the peak mid morning which is puzzling me.

That's good, you seem to have it sorted overnight.....

Is the peak mid morning after your breakfast......first thoughts of a mid morning peak is an issue with the bolus dose.....

April 19, 2018 10:56

ruthhutchinson 39 posts

Have considered that but as I said I do revert to normal numbers by lunch so an I crease in bolus.might be risky. Will go e it a try some day I am not at work and keep a close eye on it. Thanks.

April 19, 2018 11:33

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

Going back to normal by lunch, as you have pointed out, means your dosing is right......

getting the spike down as low as possible 1.5-2 hours after eating is achieved by timing.....so at a minimum, giving your insulin ten minutes before anything passes your lips.....this timing can be increased as well if the spike is still too high for your liking.....

October 09, 2018 11:05

planehazza DAFNE Graduate
Newcastle upon Tyne Hospitals NHS Foundation Trust 4 posts

Hi all, first message here. Some very good tips and looks similar to me. I've just adjusted my PM BI to 15u of levimir and am still confirming that that is correct. Before bed last night, BG was 8.4, 3AM it was 6.5, and 7AM it was 6.0. I had 2CPs for breakfast at 8:30 and now, at 11:30, it is 16.6. My gut feeling is that my breakfast QA ratio needs upping from 1:1 to 1.5:1 or higher, as I've always need a little more insulin in the mornings before DAFNE (when I was on lantus).

Assuming my PM BI is correct, what is the best way to adjust morning basal? Is it a case of seeing if all meals are causing high BIs and relying on QA ration adjustments if only one meal is out?

April 19, 2018 09:30 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	ruthhutchinson said: No. My evening numbers aren't too bad. Low if anything. Just the peak mid morning which is puzzling me. That's good, you seem to have it sorted overnight..... Is the peak mid morning after your breakfast......first thoughts of a mid morning peak is an issue with the bolus dose.....
April 19, 2018 10:56 ruthhutchinson 39 posts	Have considered that but as I said I do revert to normal numbers by lunch so an I crease in bolus.might be risky. Will go e it a try some day I am not at work and keep a close eye on it. Thanks.
April 19, 2018 11:33 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	Going back to normal by lunch, as you have pointed out, means your dosing is right...... getting the spike down as low as possible 1.5-2 hours after eating is achieved by timing.....so at a minimum, giving your insulin ten minutes before anything passes your lips.....this timing can be increased as well if the spike is still too high for your liking.....
October 09, 2018 11:05 planehazza DAFNE Graduate Newcastle upon Tyne Hospitals NHS Foundation Trust 4 posts	Hi all, first message here. Some very good tips and looks similar to me. I've just adjusted my PM BI to 15u of levimir and am still confirming that that is correct. Before bed last night, BG was 8.4, 3AM it was 6.5, and 7AM it was 6.0. I had 2CPs for breakfast at 8:30 and now, at 11:30, it is 16.6. My gut feeling is that my breakfast QA ratio needs upping from 1:1 to 1.5:1 or higher, as I've always need a little more insulin in the mornings before DAFNE (when I was on lantus). Assuming my PM BI is correct, what is the best way to adjust morning basal? Is it a case of seeing if all meals are causing high BIs and relying on QA ration adjustments if only one meal is out?