# A newbie with Levemir problem...



## cat305 (Jan 11, 2011)

Hi there! I'm a type 1 diabetic diagnosed 12 years ago. I've recently started having problems with hypos overnight which I think are caused by Levemir. I've been on Levemir and Novorapid a few years now and never had a problem til now - I'm fine during the day, but my sugar can easily drop from 11-12 down to 2 or below overnight. I don't like having it that high but I've had to for the last few weeks as I've had a few mornings where I just haven't woken up.

 I take Novorapid 3 times a day and Levemir at night. I was told to start on once a day and it has been fine so far but I'll probably have to change to twice a day soon. The problem with changing being that I came home for Christmas and had a hypo which resulted in me falling and breaking my leg, so I'm stuck at home now away from my doctors. I'm just looking for other peoples experiences with Levemir - is it mostly twice a day dosage? Anyone else have a problem with lows? Thanks!


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## Northerner (Jan 11, 2011)

Hi Cat, welcome to the forum  Very sorry to hear about the broken leg  I know how that feels! It certainly sounds as though your levemir is too high for your overnight requirements - you shouldn't have to go to bed on such a high level and then dropping right down. I used to be the same with my lantus, but ended up reducing the dose considerably and now I'm pretty stable overnight. I can go to bed at 6.0 and wake at the same number.

From what I have gleaned (I am on lantus so no direct experience of levemir) it is very common to split the levemir, partly because it only lasts around 18 hours in some people, but also because it gives more flexibility when basal needs are different at night to during the day. Can you phone your DSN for advice?


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## rachelha (Jan 11, 2011)

Hello. Welcome to the forum.  I am on twice daily levemir as I have problems with hypos overnight.  I take 7 units at 7am and 4 units at 7pm.  My night time hypos are not as frequent since I started on this regime, but they do still happen.  

I hope your leg is healing well.


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## cat305 (Jan 11, 2011)

Northerner said:


> Hi Cat, welcome to the forum  Very sorry to hear about the broken leg  I know how that feels! It certainly sounds as though your levemir is too high for your overnight requirements - you shouldn't have to go to bed on such a high level and then dropping right down. I used to be the same with my lantus, but ended up reducing the dose considerably and now I'm pretty stable overnight. I can go to bed at 6.0 and wake at the same number.
> 
> From what I have gleaned (I am on lantus so no direct experience of levemir) it is very common to split the levemir, partly because it only lasts around 18 hours in some people, but also because it gives more flexibility when basal needs are different at night to during the day. Can you phone your DSN for advice?



I used to go to bed fine and drop maybe 2-3 units overnight, I don't know why it's changed the last few months (OK, that's a lie, I've been pretty stressed but still!). I would normally never let it go high. I got it better last night, I was 9.3 last night and I had something to eat anyway as I've fallen by up to 11 overnight since mid December. I gave 6 units of Levemir, dropped from 7 the previous night and I gave it in the upper arm instead of the leg (I was hoping it would absorb slower) and I woke up this morning at 12.2  I'm just hoping it'll work the same again... 

 I phoned my DSN when it started and they were advising me to drop the Levemir. Once they suggested giving it with dinner at 6pm instead of just before bed but I changed back to giving it before bed after 2 days. I asked about changing to twice a day but they said they'd have to see me to do that. Fair enough. I'm in Ireland for the next month though and I can't walk.... god if I don't laugh, I'll cry! I don't want to change to giving it in the morning without help being available.

 Does anyone know how long Levemir is supposed to work for and how long after injecting does its action peak?


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## cat305 (Jan 11, 2011)

rachelha said:


> Hello. Welcome to the forum.  I am on twice daily levemir as I have problems with hypos overnight.  I take 7 units at 7am and 4 units at 7pm.  My night time hypos are not as frequent since I started on this regime, but they do still happen.
> 
> I hope your leg is healing well.




Were you long on Levemir before changing? I was reluctant to change to giving yet another job a day but I think this has scared me into it!

Off topic, but I'm from Edinburgh too  I miss it!


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## Robster65 (Jan 11, 2011)

Hi Cat. Welcome 

I'm another Lantus abuser I'm afraid but I'm on a split dose and it does give better flexibility.

I think Levemir is supposed to have a very flat response but I guess it depends on where you inject, etc. as with anything.

Hope the leg heals soon.

Rob


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## Steff (Jan 11, 2011)

Hi Kat and a warm welcome to the forum from me , sorry i cant help with your particular qiestion as im a type 2 not on insulin, just wanted to welcome you to the mad house


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## Northerner (Jan 11, 2011)

cat305 said:


> I phoned my DSN when it started and they were advising me to drop the Levemir. Once they suggested giving it with dinner at 6pm instead of just before bed but I changed back to giving it before bed after 2 days. I asked about changing to twice a day but they said they'd have to see me to do that. Fair enough. I'm in Ireland for the next month though and I can't walk.... god if I don't laugh, I'll cry! I don't want to change to giving it in the morning without help being available.
> 
> Does anyone know how long Levemir is supposed to work for and how long after injecting does its action peak?



In theory it will last 24 hours, but many people report a much shorter action, hence the splitting. It's also supposed to have little or no peak. I'm just wondering if you have done any education courses about diabetes, like DAFNE for example? If not, then it's certainly worth asking for - just because you've been diagnosed 12 years doesn't mean that you should be expected to know everything (as many of the long-term diagnosed here will freely admit! ). 

The reason why I ask is because you don't seem very confident about making the changes yourself. I was lucky enough to go on a course shortly after diagnosis and have always been pretty confident about making any changes - the key is to do it gradually and test to confirm the effects. I personally wouldn't want to wait a month to see someone in order to make a change as I have to make them quite frequently depending on whether I am training for a run or not. For example, when diagnosed I was put on 20 units of lantus, but I realised this was too high and gradually moved this down to 8 units. In training it can go as low as 3 units and I'm currently on 7 units having just picked up running again after Christmas.

I'm not criticising you, by the way, just trying to understand your situation better


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## cat305 (Jan 11, 2011)

Northerner said:


> In theory it will last 24 hours, but many people report a much shorter action, hence the splitting. It's also supposed to have little or no peak. I'm just wondering if you have done any education courses about diabetes, like DAFNE for example? If not, then it's certainly worth asking for - just because you've been diagnosed 12 years doesn't mean that you should be expected to know everything (as many of the long-term diagnosed here will freely admit! ).
> 
> The reason why I ask is because you don't seem very confident about making the changes yourself. I was lucky enough to go on a course shortly after diagnosis and have always been pretty confident about making any changes - the key is to do it gradually and test to confirm the effects. I personally wouldn't want to wait a month to see someone in order to make a change as I have to make them quite frequently depending on whether I am training for a run or not. For example, when diagnosed I was put on 20 units of lantus, but I realised this was too high and gradually moved this down to 8 units. In training it can go as low as 3 units and I'm currently on 7 units having just picked up running again after Christmas.
> 
> I'm not criticising you, by the way, just trying to understand your situation better




To be honest, I am usually very confident about making changes, I have studied Dietetics and Biomedical - but I am at home with my parents right now and they are so worried about me and don't trust anyone but doctors to make changes! I totally understand them being worried, they are the ones who had to pick me up after I fell, inject me with glucagon, etc  If I was on my own, I would change it to morning right now or else split it. I usually tell my doctors what to do. I don't mean that in an "I know it all" way, just that I know more about the effect diabetes has on me than they do.


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## Northerner (Jan 12, 2011)

cat305 said:


> To be honest, I am usually very confident about making changes, I have studied Dietetics and Biomedical - but I am at home with my parents right now and they are so worried about me and don't trust anyone but doctors to make changes! I totally understand them being worried, they are the ones who had to pick me up after I fell, inject me with glucagon, etc  If I was on my own, I would change it to morning right now or else split it. I usually tell my doctors what to do. I don't mean that in an "I know it all" way, just that I know more about the effect diabetes has on me than they do.



I quite understand. The problem is that, if your levemir remains too high during the night then you are more prone to hypos which your parents would have you avoid.  Which part of your leg did you break? I broke my femur once.


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## cat305 (Jan 12, 2011)

Northerner said:


> I quite understand. The problem is that, if your levemir remains too high during the night then you are more prone to hypos which your parents would have you avoid.  Which part of your leg did you break? I broke my femur once.



I have lowered the Levemir and it seems to be improving.. slowly! Improving as in it was high this morning so it needs some fine tuning. I'm just paranoid about getting rid of the highs for a while yet!

 My leg isn't too bad. Well, as in it's not the worst part to break. 3 toes, sprained my ankle and it's really bruised all over but I'm starting to walk without crutches now (with a boot instead of a cast) so I'm getting there! The parts that are broken aren't sore, it's only the ankle really. Yeah, the femur would be much worse!


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## Northerner (Jan 12, 2011)

Gald to hear the break wasn't too bad (if such a thing can be said!). Good to hear that you are seeing changes for the good with the levemir reductions - let us know how things go


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