Recent Posts - DAFNE Online

Apr 29, 2013

Anthony Murray 9 posts

Topic: Questions for HCPs / "Bed time" testing time & BG hit and miss

Just a little update on how my sugars have been the past week. I've only had 1 high that I had to do an adjustment for. I know my BED results are mostly in the red but I like to be between 6 and 8.5 at night. I don't know what caused those hypos on Friday morning but it seems to have been a one off.

I was able to get my "bed time" BG lower by changing how I counted cps that weren't full numbers i.e.
Before last week if I had two items for dinner and both were say 5.7 cps each I would usually count it as 11.5 and would only take 11 units as my pen only gives single units and then make any necessary adjustments for high/low BG. Now I would count it as 12 cps and then make adjustments.

Apr 28, 2013

Vickyp 137 posts

Topic: General Discussion / Rapid-acting Insulin - Overstacking

I would inject qa for what I am eating but wouldnt do a correction

Apr 28, 2013

mum2westiesGill 502 posts

Topic: General Discussion / Rapid-acting Insulin - Overstacking

Wondering what others would do if you had eaten a meal but wanted to eat your next meal before the insulin duration (3 - 5 hrs) is over?

Apr 28, 2013

mum2westiesGill 502 posts

Topic: General Discussion / 7-day waking average

no test - bedtime
21.8 - this morning

BG 5.1 - teatime

Apr 27, 2013

GLS 12 posts

Topic: Questions for HCPs / Lantus to Levimer

Hey everyone.

Thanks for the info on insulin Warwick. That makes sense to me and explains why I am needing more Levimer compared to lantus. Although I am struggling slightly with the fasting BIs over night, I have found the Levimer really useful after exercise. Reducing it by 1u really helps stop those post exercise lows. So definitely work considering if you are quite active.

Regarding the lantus effects, Apollo, to be Honest I didn't adjust my lantus dose at all, as just took hospital advice, that the changes take a few days to take effect. So didnt really give it a go as took their word for it!

As for my troubles- I got one good week of morning blood sugars but back to being a bit Stuck now. Fasting tests for me through tonight!

Apr 27, 2013

Apollo 45 posts

Topic: General Discussion / 7-day waking average

Hi Becky,

Is have started a new topic of I were you as this is a question in its own right.

When you took the 12.9 reading how long had it been since you last took any quick acting (QA) insulin? If it was less than 4 hours prior then you will likely still have had some QA in your system and it may be that which caused your sugar levels to drop.

If it was over 4 hours since your last dose of QA then it would be worth dropping your back ground a few units and keeping an eye on it for the next few days.

Apr 27, 2013

beckyshaw 1 post

Topic: General Discussion / 7-day waking average

Hiya

I was 8.4 waking up this morning which had dropped from 12.9... I didmt do a correction as this happened the night before so I am seeing if my bi needs changing... what do people think? Smile

Apr 27, 2013

SA2010 69 posts

Topic: Carbohydrate Counting / Carbohydrates on Packaging

novorapidboi26 said:
You would be suited to a pump due to your sensitivity...................there are many DAFNE grads that use the half unit pen, its very useful for most, in fact all pens should have it........

Thanks James - may be. But I worry about all the things that might go wrong with the pump and leaving this decision until I really have to have one, I remember my hospital days with canulars and how they leak sometimes and need to be checked all the time and moved and replaced and repositioned. My conerns about pumps are :
* risk of infection at the site
* risk of knocking it of its place - I am sometimes clumsy with hardware ! Seat Belts when driving? seat belt on airplane. Knocking and bumping into things that might dislodge the positioning of the pump and when dressing/undressing or when cycling or moving my arms or whatever.......
* need to reposition it every few days
* impact on pump when taking shower or bath.
* always worrying if it is making good contact and primed or has moved

There may be answers to all these and I may be wrong worrying about these ! There is also probably a psychological element - getting wired to a pump permanently - a realisation that i have a serious problem. It is, but at least i think of it as just a few injections a day. Anyway - probably this is more suitable for a thread on pumps.

Apr 27, 2013

mum2westiesGill 502 posts

Topic: General Discussion / 7-day waking average

Sun 21/04
10.9 - bedtime
18.8 - this morning

Mon 22/04
6.8 - bedtime
6.5 - this morning

Tue 23/04
9.4 - bedtime
15.3 - this morning

Wed 24/04
5.9 - bedtime
10.7 - this morning

Thu 25/04
10.8 - bedtime
5.4 - this morning

Fri 26/04
4.7 - bedtime
8.4 - this morning

Sat 27/04
5.8 - bedtime
7.2 - this morning

Apr 27, 2013

Vickyp 137 posts

Topic: Carbohydrate Counting / Carbohydrates on Packaging

I use a half unit pen and am awaiting funding for the pump! As am very sensitive with ratios of 0.5:1 at lunch and dinner and 0.5:1-0.5 at breakfast! Lots of reading labels and weighing food!

Apr 27, 2013

novorapidboi26 1,819 posts

Topic: Carbohydrate Counting / Carbohydrates on Packaging

You would be suited to a pump due to your sensitivity...................there are many DAFNE grads that use the half unit pen, its very useful for most, in fact all pens should have it........ Very Happy

Apr 26, 2013

Apollo 45 posts

Topic: General Discussion / DAFNE Returner

I haven't had a bad reaction myself but I was told when going from Levimir to Lantus that some people did experience a burning sensation at the injection point.

May I ask what sort of reactions you had & to which insulin?

Apr 26, 2013

Apollo 45 posts

Topic: Questions for HCPs / Lantus to Levimer

I have to say I've never heard of anyone using both Levimir and Lantus so I don't know if there are any potential complications that could arise from it but I'd have thought they would work together in much the same way that BI & QA do. Obviously it's going to make it more of an arse to get your background set right as you effectively have to 2 modes you need to define so certainly worth trying a total switch to Levimir first and seeing how you get on with it, but if you need to take 2 shots of BI anyway then I'd have thought you would get on with it fine. If you look at those graphs I posted back on page 1 of this it will give you a better idea of the difference of how aggressively each works from the time you take it so you have a better idea of what to expect.

Certainly if you take a shot before you go to sleep make sure you are over 8 before hand as it was normal with Levimir (atleast for me) to drop a little in the night.

A question just to clear some things up for me, people say that Lantus is not quick to change, so if they lower the dose it takes a few days to see the result of that. I can't say I have really had cause to play with mine to much in the last year since I changed but I have had the odd day where I've forgot to take the shot due to exhaustion and the next day I've been stupid high because there was no background in my system.

To me that says that the Lantus had all left my system so if I'd taken say a half dose the night before because I was going to do something the next day that was going to be seriously physically exerting then that change would have taken for the next day. I accept that once you put the stuff in it's there for 24 hours and if you put in to much then you're going to have to manage that with extra carbs but it almost seems like Wariwick and a few others are saying that if they change what they take Sunday bedtime then they won't really see that change in their readings till Wednesday. Have I got the wrong end of the stick here or is that most peoples experience?

Apr 26, 2013

ladybirdov6 6 posts

Topic: Questions for HCPs / Lantus to Levimer

Just come bact to DAFNE. Had 6 month break due to problems with Levemir. Am now back on Lantus, which I have had before, just injected a quick acting at meal-time years before DAFNE was even thought of.

Apr 26, 2013

ladybirdov6 6 posts

Topic: General Discussion / DAFNE Returner

Just come back after 6 month break. Has anyone elses had bad reaction to background insulin? Were they told begining symptoms 'were due to age' ? Looking forward to hearing from anyone. Ladybird.

Apr 25, 2013

SA2010 69 posts

Topic: Carbohydrate Counting / Carbohydrates on Packaging

Just a comment on Alan's note re what DAFNE says. It is my belief that DAFNE says what it says because they want it to be simple for the masses. So everything rounded in whole numbers and all ratios in half unit ratios. I decided not to accept this advice because I can and because I believe I am very sensitive to Insulin. I add numbers with decimal points for the Carbs and I go overboard perhaps and instead of rounding the total, I work out from my QA:CP ratio for that meal what would the CP number have to be so that no rounding occurs and I top up meal by a few grams of a biscuit or a wafer or half a mini flapjack, Over the top you would say but there are so many factors that affect BG that I want to eliminate as much as I can.

I actually go a step further and have QA:CP ratios with decimal point fractions - so I am on 1.3:1 for QA:CP for breakfast, 0.7:1 for lunch and 0.8:1 for dinner. And I switched to a QA pen with half units !

Goes against DAFNE but that was the system I had in place before I was put on DAFNE and after 9 months of adhering to the DAFNE advice I went back to my system.

I only approximate and round when I eat out and probably over 50% of the time my BGs are wrong afterwards

What does it mean ? I use a calculator all the time when I eat at home. I weight food. I read all labels and complain to tyhe store when they do not have the nutrition data, Well in a few years time they will be forced to have it on all packaged food.

Apr 25, 2013

SA2010 69 posts

Topic: General Discussion / My Blood Glucose Diary - all comments welcomed!

Hi

Just noticed that you are still having lows. I have not been online for a while. I recall saying that you had to be more aggressive in reducing your BI.

I am on split BI as well similar to you in timing. mine is 11am and 11pm. First I got the overnight level right and then started to look at the morning one. Basically I found that the BI at 11am and the QA with lunch at about 1:00pm-2:00pm start to work together and about 5-7 hours after 11am there are risks of low BGs. Despite what people say, I think lantus peaks at about 7 hours. and what that coincides with 3 hours after QA then there would be risk of low BG/Hypo if the doses are high. My 11am BI dose is now 3 units and 11pm at 6 units. I started in 2010 on about 18 units a day of BI.

Because of interaction of fresh BI coming in the morning and QA for lunch, my lunch QA:CP ratio is lowest and I see that 0.5 u/1 CP has been suggested to you.

Points to note: bedtime: you had a time when you did not do anything with BG below 6 at bedtime. I try to get mine close 8 at bedtime. Need to have half a toast probably if BG between 5 and 6 at bedtime.

As advised, do reduce your morning BI dose - wait 3 days before making another change - if you can. Lantus takes a while to settle down. I think you are on lantus.

Remember the meters are not very accurate - in fact repeating a test may give a different reading. I find different hands give different results - 1-2 mmols ! So for that reason I treat 4.0 and 3.8 and 3.5 all the same - as hypos.

Hope this is not confusing.

For driving it has to be 5.0 or above. There is some news coming about driving and BG testing rules. I passed the info to the admin team.

Apr 25, 2013

Warwick 423 posts

Topic: Questions for HCPs / Lantus to Levimer

Thanks NuMo and Apollo. It ain't that sunny in Melbourne right now :-( I am actually finding that I am having to up my BI to cope with the season change right now.

Interesting idea Apollo. Insulin prescriptions give about a 6-month supply here in Australia, but I could ask my GP about a 2-month supply of Levemir and go back to Lantus if it doesn't work for me. The idea of mixing BI insulins is one that I hadn't considered. I have my 12-month DAFNE review on Thursday. I'll mention it to my DAFNE diabetes educator and get her opinion on that.

Thanks,
Warwick.

Apr 25, 2013

Apollo 45 posts

Topic: Questions for HCPs / Lantus to Levimer

I switched the other way from Levimir to Lantus but only because I didn't want to be taking two shots of background each day. I never really found it to be unstable, the results were quite predictable just didn't last long enough on a single shot.

I don't know how prescriptions etc work in Aus, over here before I switched the diabetic unit gave me a single cartridge of Lantus (which was enough to last me almost 2 weeks) and said have a play and see how it works for you, could you do the same?

or could use your Lantus only for mid week and then on the weekends still take your lantus but top it up a bit with some levimir? That way you get the boost to your BI that you need on the weekends and everything is back to normal again come Monday.

Apr 25, 2013

Vickyp 137 posts

Topic: Carbohydrate Counting / Carbohydrates on Packaging

It also depends on the individual. I am insulin sensitive and if I always round up it could cause me to gave too much insulin!
Agree with Apollo about BGs at time of having the CPs, as this plays a massive role for me too!

Apr 25, 2013

Alan 49 284 posts

Topic: Carbohydrate Counting / Carbohydrates on Packaging

We were told on our DAFNE course always to round partial CPs up to the next whole CP.

Apr 25, 2013

NuMo 28 posts

Topic: Questions for HCPs / Lantus to Levimer

Hi Warwick

I haven't switched to Levemir as I was put on it from the start, but I do find it quite versatile. I am on 2 doses of BI daily. This means that I can reduce the dose prior to exercise in the morning, or if I have been exercising in the evening I can reduce the overnight dose. Also, not that this will affect you in sunny Melbourne, but on cold inactive days in the winter I increased the BI to cover. I have found the quicker reacting effect of Levemir over Lantus suits me well.

Apr 25, 2013

Warwick 423 posts

Topic: Questions for HCPs / Lantus to Levimer

To answer the original question, from the book "Think Like a Pancreas" by Gary Scheiner page 40:

"Insulin is measured in units. A unit of insulin should lower the blood sugar by the same amount no matter what kind of insulin you use. A unit of short-acting insulin will lower your blood sugar the same as a unit of long-acting insulin ; it just does so in a shorter period of time. One exception is a long-acting basal insulin called detemir (brand name Levemir) which is approximately 25 percent less potent than other insulins.

In summary, if switching from Lantus to Levemir, then you would expect to need to increase your dose to get the same results.

I'm interested in hearing others' experiences in switching from Lantus to Levemir. I'm on a split dose of Lantus right now (because it wasn't lasting 24 hours for me), but the lag between changing the dose and its effect is annoying.

I cycle to work every day, and my BGs are excellent throughout the week as I have a desk job so activity levels are predictable, but reducing BI before the weekends which are much more active aren't giving me the reduction in hypos that I want, and instead, Monday and Tuesday tend to run a little high as a carry-over from the BI reduction at the weekend.

Looking through some of the threads on Levemir, there seem to be more users of it experiencing unpredictable results than stable ones. Lantus is very stable for me; it is only the lag between changing doses that I don't like and I won't make a switch if it is likely to cause more unpredictable results.

I'd love to hear from anyone who has switched as to whether they would recommend switching, especially from anyone who is reasonably active and exercises frequently.

Thanks,
Warwick.

Apr 29, 2013 Anthony Murray 9 posts	Topic: Questions for HCPs / "Bed time" testing time & BG hit and miss Just a little update on how my sugars have been the past week. I've only had 1 high that I had to do an adjustment for. I know my BED results are mostly in the red but I like to be between 6 and 8.5 at night. I don't know what caused those hypos on Friday morning but it seems to have been a one off. I was able to get my "bed time" BG lower by changing how I counted cps that weren't full numbers i.e. Before last week if I had two items for dinner and both were say 5.7 cps each I would usually count it as 11.5 and would only take 11 units as my pen only gives single units and then make any necessary adjustments for high/low BG. Now I would count it as 12 cps and then make adjustments.

Apr 28, 2013 Vickyp 137 posts	Topic: General Discussion / Rapid-acting Insulin - Overstacking I would inject qa for what I am eating but wouldnt do a correction

Apr 28, 2013 mum2westiesGill 502 posts	Topic: General Discussion / Rapid-acting Insulin - Overstacking Wondering what others would do if you had eaten a meal but wanted to eat your next meal before the insulin duration (3 - 5 hrs) is over?

Apr 28, 2013 mum2westiesGill 502 posts	Topic: General Discussion / 7-day waking average no test - bedtime 21.8 - this morning BG 5.1 - teatime

Apr 27, 2013 GLS 12 posts	Topic: Questions for HCPs / Lantus to Levimer Hey everyone. Thanks for the info on insulin Warwick. That makes sense to me and explains why I am needing more Levimer compared to lantus. Although I am struggling slightly with the fasting BIs over night, I have found the Levimer really useful after exercise. Reducing it by 1u really helps stop those post exercise lows. So definitely work considering if you are quite active. Regarding the lantus effects, Apollo, to be Honest I didn't adjust my lantus dose at all, as just took hospital advice, that the changes take a few days to take effect. So didnt really give it a go as took their word for it! As for my troubles- I got one good week of morning blood sugars but back to being a bit Stuck now. Fasting tests for me through tonight!

Apr 27, 2013 Apollo 45 posts	Topic: General Discussion / 7-day waking average Hi Becky, Is have started a new topic of I were you as this is a question in its own right. When you took the 12.9 reading how long had it been since you last took any quick acting (QA) insulin? If it was less than 4 hours prior then you will likely still have had some QA in your system and it may be that which caused your sugar levels to drop. If it was over 4 hours since your last dose of QA then it would be worth dropping your back ground a few units and keeping an eye on it for the next few days.

Apr 27, 2013 beckyshaw 1 post	Topic: General Discussion / 7-day waking average Hiya I was 8.4 waking up this morning which had dropped from 12.9... I didmt do a correction as this happened the night before so I am seeing if my bi needs changing... what do people think?

Apr 27, 2013 SA2010 69 posts	Topic: Carbohydrate Counting / Carbohydrates on Packaging novorapidboi26 said: You would be suited to a pump due to your sensitivity...................there are many DAFNE grads that use the half unit pen, its very useful for most, in fact all pens should have it........ Thanks James - may be. But I worry about all the things that might go wrong with the pump and leaving this decision until I really have to have one, I remember my hospital days with canulars and how they leak sometimes and need to be checked all the time and moved and replaced and repositioned. My conerns about pumps are : * risk of infection at the site * risk of knocking it of its place - I am sometimes clumsy with hardware ! Seat Belts when driving? seat belt on airplane. Knocking and bumping into things that might dislodge the positioning of the pump and when dressing/undressing or when cycling or moving my arms or whatever....... * need to reposition it every few days * impact on pump when taking shower or bath. * always worrying if it is making good contact and primed or has moved There may be answers to all these and I may be wrong worrying about these ! There is also probably a psychological element - getting wired to a pump permanently - a realisation that i have a serious problem. It is, but at least i think of it as just a few injections a day. Anyway - probably this is more suitable for a thread on pumps.

Apr 27, 2013 mum2westiesGill 502 posts	Topic: General Discussion / 7-day waking average Sun 21/04 10.9 - bedtime 18.8 - this morning Mon 22/04 6.8 - bedtime 6.5 - this morning Tue 23/04 9.4 - bedtime 15.3 - this morning Wed 24/04 5.9 - bedtime 10.7 - this morning Thu 25/04 10.8 - bedtime 5.4 - this morning Fri 26/04 4.7 - bedtime 8.4 - this morning Sat 27/04 5.8 - bedtime 7.2 - this morning

Apr 27, 2013 Vickyp 137 posts	Topic: Carbohydrate Counting / Carbohydrates on Packaging I use a half unit pen and am awaiting funding for the pump! As am very sensitive with ratios of 0.5:1 at lunch and dinner and 0.5:1-0.5 at breakfast! Lots of reading labels and weighing food!

Apr 27, 2013 novorapidboi26 1,819 posts	Topic: Carbohydrate Counting / Carbohydrates on Packaging You would be suited to a pump due to your sensitivity...................there are many DAFNE grads that use the half unit pen, its very useful for most, in fact all pens should have it........

Apr 26, 2013 Apollo 45 posts	Topic: General Discussion / DAFNE Returner I haven't had a bad reaction myself but I was told when going from Levimir to Lantus that some people did experience a burning sensation at the injection point. May I ask what sort of reactions you had & to which insulin?

Apr 26, 2013 Apollo 45 posts	Topic: Questions for HCPs / Lantus to Levimer I have to say I've never heard of anyone using both Levimir and Lantus so I don't know if there are any potential complications that could arise from it but I'd have thought they would work together in much the same way that BI & QA do. Obviously it's going to make it more of an arse to get your background set right as you effectively have to 2 modes you need to define so certainly worth trying a total switch to Levimir first and seeing how you get on with it, but if you need to take 2 shots of BI anyway then I'd have thought you would get on with it fine. If you look at those graphs I posted back on page 1 of this it will give you a better idea of the difference of how aggressively each works from the time you take it so you have a better idea of what to expect. Certainly if you take a shot before you go to sleep make sure you are over 8 before hand as it was normal with Levimir (atleast for me) to drop a little in the night. A question just to clear some things up for me, people say that Lantus is not quick to change, so if they lower the dose it takes a few days to see the result of that. I can't say I have really had cause to play with mine to much in the last year since I changed but I have had the odd day where I've forgot to take the shot due to exhaustion and the next day I've been stupid high because there was no background in my system. To me that says that the Lantus had all left my system so if I'd taken say a half dose the night before because I was going to do something the next day that was going to be seriously physically exerting then that change would have taken for the next day. I accept that once you put the stuff in it's there for 24 hours and if you put in to much then you're going to have to manage that with extra carbs but it almost seems like Wariwick and a few others are saying that if they change what they take Sunday bedtime then they won't really see that change in their readings till Wednesday. Have I got the wrong end of the stick here or is that most peoples experience?

Apr 26, 2013 ladybirdov6 6 posts	Topic: Questions for HCPs / Lantus to Levimer Just come bact to DAFNE. Had 6 month break due to problems with Levemir. Am now back on Lantus, which I have had before, just injected a quick acting at meal-time years before DAFNE was even thought of.

Apr 26, 2013 ladybirdov6 6 posts	Topic: General Discussion / DAFNE Returner Just come back after 6 month break. Has anyone elses had bad reaction to background insulin? Were they told begining symptoms 'were due to age' ? Looking forward to hearing from anyone. Ladybird.

Apr 25, 2013 SA2010 69 posts	Topic: Carbohydrate Counting / Carbohydrates on Packaging Just a comment on Alan's note re what DAFNE says. It is my belief that DAFNE says what it says because they want it to be simple for the masses. So everything rounded in whole numbers and all ratios in half unit ratios. I decided not to accept this advice because I can and because I believe I am very sensitive to Insulin. I add numbers with decimal points for the Carbs and I go overboard perhaps and instead of rounding the total, I work out from my QA:CP ratio for that meal what would the CP number have to be so that no rounding occurs and I top up meal by a few grams of a biscuit or a wafer or half a mini flapjack, Over the top you would say but there are so many factors that affect BG that I want to eliminate as much as I can. I actually go a step further and have QA:CP ratios with decimal point fractions - so I am on 1.3:1 for QA:CP for breakfast, 0.7:1 for lunch and 0.8:1 for dinner. And I switched to a QA pen with half units ! Goes against DAFNE but that was the system I had in place before I was put on DAFNE and after 9 months of adhering to the DAFNE advice I went back to my system. I only approximate and round when I eat out and probably over 50% of the time my BGs are wrong afterwards What does it mean ? I use a calculator all the time when I eat at home. I weight food. I read all labels and complain to tyhe store when they do not have the nutrition data, Well in a few years time they will be forced to have it on all packaged food.

Apr 25, 2013 SA2010 69 posts	Topic: General Discussion / My Blood Glucose Diary - all comments welcomed! Hi Just noticed that you are still having lows. I have not been online for a while. I recall saying that you had to be more aggressive in reducing your BI. I am on split BI as well similar to you in timing. mine is 11am and 11pm. First I got the overnight level right and then started to look at the morning one. Basically I found that the BI at 11am and the QA with lunch at about 1:00pm-2:00pm start to work together and about 5-7 hours after 11am there are risks of low BGs. Despite what people say, I think lantus peaks at about 7 hours. and what that coincides with 3 hours after QA then there would be risk of low BG/Hypo if the doses are high. My 11am BI dose is now 3 units and 11pm at 6 units. I started in 2010 on about 18 units a day of BI. Because of interaction of fresh BI coming in the morning and QA for lunch, my lunch QA:CP ratio is lowest and I see that 0.5 u/1 CP has been suggested to you. Points to note: bedtime: you had a time when you did not do anything with BG below 6 at bedtime. I try to get mine close 8 at bedtime. Need to have half a toast probably if BG between 5 and 6 at bedtime. As advised, do reduce your morning BI dose - wait 3 days before making another change - if you can. Lantus takes a while to settle down. I think you are on lantus. Remember the meters are not very accurate - in fact repeating a test may give a different reading. I find different hands give different results - 1-2 mmols ! So for that reason I treat 4.0 and 3.8 and 3.5 all the same - as hypos. Hope this is not confusing. For driving it has to be 5.0 or above. There is some news coming about driving and BG testing rules. I passed the info to the admin team.

Apr 25, 2013 Warwick 423 posts	Topic: Questions for HCPs / Lantus to Levimer Thanks NuMo and Apollo. It ain't that sunny in Melbourne right now :-( I am actually finding that I am having to up my BI to cope with the season change right now. Interesting idea Apollo. Insulin prescriptions give about a 6-month supply here in Australia, but I could ask my GP about a 2-month supply of Levemir and go back to Lantus if it doesn't work for me. The idea of mixing BI insulins is one that I hadn't considered. I have my 12-month DAFNE review on Thursday. I'll mention it to my DAFNE diabetes educator and get her opinion on that. Thanks, Warwick.

Apr 25, 2013 Apollo 45 posts	Topic: Questions for HCPs / Lantus to Levimer I switched the other way from Levimir to Lantus but only because I didn't want to be taking two shots of background each day. I never really found it to be unstable, the results were quite predictable just didn't last long enough on a single shot. I don't know how prescriptions etc work in Aus, over here before I switched the diabetic unit gave me a single cartridge of Lantus (which was enough to last me almost 2 weeks) and said have a play and see how it works for you, could you do the same? or could use your Lantus only for mid week and then on the weekends still take your lantus but top it up a bit with some levimir? That way you get the boost to your BI that you need on the weekends and everything is back to normal again come Monday.

Apr 25, 2013 Vickyp 137 posts	Topic: Carbohydrate Counting / Carbohydrates on Packaging It also depends on the individual. I am insulin sensitive and if I always round up it could cause me to gave too much insulin! Agree with Apollo about BGs at time of having the CPs, as this plays a massive role for me too!

Apr 25, 2013 Alan 49 284 posts	Topic: Carbohydrate Counting / Carbohydrates on Packaging We were told on our DAFNE course always to round partial CPs up to the next whole CP.

Apr 25, 2013 NuMo 28 posts	Topic: Questions for HCPs / Lantus to Levimer Hi Warwick I haven't switched to Levemir as I was put on it from the start, but I do find it quite versatile. I am on 2 doses of BI daily. This means that I can reduce the dose prior to exercise in the morning, or if I have been exercising in the evening I can reduce the overnight dose. Also, not that this will affect you in sunny Melbourne, but on cold inactive days in the winter I increased the BI to cover. I have found the quicker reacting effect of Levemir over Lantus suits me well.

Apr 25, 2013 Warwick 423 posts	Topic: Questions for HCPs / Lantus to Levimer To answer the original question, from the book "Think Like a Pancreas" by Gary Scheiner page 40: "Insulin is measured in units. A unit of insulin should lower the blood sugar by the same amount no matter what kind of insulin you use. A unit of short-acting insulin will lower your blood sugar the same as a unit of long-acting insulin ; it just does so in a shorter period of time. One exception is a long-acting basal insulin called detemir (brand name Levemir) which is approximately 25 percent less potent than other insulins. In summary, if switching from Lantus to Levemir, then you would expect to need to increase your dose to get the same results. I'm interested in hearing others' experiences in switching from Lantus to Levemir. I'm on a split dose of Lantus right now (because it wasn't lasting 24 hours for me), but the lag between changing the dose and its effect is annoying. I cycle to work every day, and my BGs are excellent throughout the week as I have a desk job so activity levels are predictable, but reducing BI before the weekends which are much more active aren't giving me the reduction in hypos that I want, and instead, Monday and Tuesday tend to run a little high as a carry-over from the BI reduction at the weekend. Looking through some of the threads on Levemir, there seem to be more users of it experiencing unpredictable results than stable ones. Lantus is very stable for me; it is only the lag between changing doses that I don't like and I won't make a switch if it is likely to cause more unpredictable results. I'd love to hear from anyone who has switched as to whether they would recommend switching, especially from anyone who is reasonably active and exercises frequently. Thanks, Warwick.