[June91]

I've switched from pumping to MDI with Levemir and Novorapid recently. I have somewhat confusing results and would appreciate your suggestions, since I'm still in the experimental stage. Please excuse my preference for mmol/l and cm/kg

My pump numbers which got me a hba1c of 6.9 were:
- total bolus: 24u (variable due to pronounced DP)
- insulin/carb ratios: 1/8 - 1/12
- insulin sensitivity: 2.9 mmol/l
- total daily dose: 34-40

I am now taking:
-30u Levemir at 11pm + 16u at 2pm*
- insulin/carb ratio: 1/5
- insulin sensitivity: 2.0 mmol/l
- total daily dose: 66-68

* Levemir lasts about 15 hours, so the best time for me for overlapping of insulins would be sometime in the early morning, and that's where this unorthodox time comes in.

My mornings are fine, but my afternoons are not good (8-13), so I am about to increase the afternoon Levemir even more. Total daily dose increase is 70% overall, which is way too much.

Also, since I have lost very little weight in spite of being on 1200 calories a day since August last year, my doctor put me on 2 x 500mg Metformin just prior to my break from the pump as she feels that my liver is overproducing glycogen. I am not seriously overweight - 65kg, 164cm tall.

Should I split the Levemir differently, try smaller doses, or what? My i:c ratio also baffles me. Going back to the pump is not currently an option. Thanks for your input, everyone.

[BriOnH]

I would split the levemir 12 hours apart. The first few hours after injection have a very slow metabolic rate.

For those on pumps so long they haven't tried Levemir or Lantus ever, they really are great basal insulins. All my friends on the pump who have tried it call lantus and levemir the "poor mans pump', I call it something different.

[June91]

Thank you very much, BriOnH. I took Levemir at 11pm and 11am as per your advice, and so far it's been great:

7.00 - 4.7
8.00 - 5.3
9.00 - 6.4
10.00 - 6.3
11.20 - 8.8 Levemir 14u, Lunch 12.00 - 10 Novorapid
13.30 - 11.5
14.00 - 9.8
15.00 - 8.2
16.00 - 7.9
17.00 - 7.1
18.00 - 7.2 Dinner 18.00 - 10 Novorapid
19.30 - 9.2

And this is with no breakfast I'm keeping my fingers crossed that his trend continues tonight (it's now 7.30pm).