Should I split my Levemir?

November 27, 2009 11:28

Alan 49 DAFNE Graduate
Maidstone & Tunbridge Wells NHS Trust 284 posts

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I currently take one injection of 17 units of Levemir before bed. My BG before bed last night was 10.9. I didn't take any Humalog to correct this. My BG this morning was 3.8. A similar thing happened the night before: 9.7 before bed and 4.1 first thing. I have noticed this happening more and more recently. Would splitting my Levemir injection sort this out?

November 27, 2009 20:21

marke Site Administrator
South East Kent PCT 675 posts

Alan,
You don't really supply enough BG readings to draw conclusions. However splitting your Levimir dose is usually done because it doesn't last 24 hours NOT because of hypos in the morning. This is more likely caused by your BI being too high, however as I say without more evidence its dangerous to jump to conclusions. I would suggest you speak to your DAFNE Educators or a DAFNE aware Diabetes consultant before making any changes. I had my Levimir dose split before I went on a DAFNE Course and had DAFNE people around to advise me. Although you could split it on your own, I'm not sure its a good idea.

December 09, 2009 11:22

Carolin DAFNE HCP
Sheffield Teaching Hospitals 83 posts

Hi Alan,
In most cases we would recommend Levemir is taken twice a day as it doesn't really last for 24hours.
As Marke rightly points out, there is too little data from these 2 days to draw firm conclusions (thinking about the DAFNE step-wise approach), however if your BG is dropping significantly overnight the most likely reasons are:
Bed-time BI is too high
Tea-time QA may still be affecting bed-time BG (a large dose of QA could still be active up to 5hrs later)
Exercise during the day.
I note you had been swimming, so that's a possibility.
Remember to follow the step-wise approach and rule out all other possible causes first.
Be aware that if you do go for splitting your BI, you may well need to review your QA:CP ratios too.
Hope this helps.

November 27, 2009 11:28 Alan 49 DAFNE Graduate Maidstone & Tunbridge Wells NHS Trust 284 posts	[Shared diary only visible when logged in] I currently take one injection of 17 units of Levemir before bed. My BG before bed last night was 10.9. I didn't take any Humalog to correct this. My BG this morning was 3.8. A similar thing happened the night before: 9.7 before bed and 4.1 first thing. I have noticed this happening more and more recently. Would splitting my Levemir injection sort this out?
November 27, 2009 20:21 marke Site Administrator South East Kent PCT 675 posts	Alan, You don't really supply enough BG readings to draw conclusions. However splitting your Levimir dose is usually done because it doesn't last 24 hours NOT because of hypos in the morning. This is more likely caused by your BI being too high, however as I say without more evidence its dangerous to jump to conclusions. I would suggest you speak to your DAFNE Educators or a DAFNE aware Diabetes consultant before making any changes. I had my Levimir dose split before I went on a DAFNE Course and had DAFNE people around to advise me. Although you could split it on your own, I'm not sure its a good idea.
December 09, 2009 11:22 Carolin DAFNE HCP Sheffield Teaching Hospitals 83 posts	Hi Alan, In most cases we would recommend Levemir is taken twice a day as it doesn't really last for 24hours. As Marke rightly points out, there is too little data from these 2 days to draw firm conclusions (thinking about the DAFNE step-wise approach), however if your BG is dropping significantly overnight the most likely reasons are: Bed-time BI is too high Tea-time QA may still be affecting bed-time BG (a large dose of QA could still be active up to 5hrs later) Exercise during the day. I note you had been swimming, so that's a possibility. Remember to follow the step-wise approach and rule out all other possible causes first. Be aware that if you do go for splitting your BI, you may well need to review your QA:CP ratios too. Hope this helps.