Jump to content
Diabetes forums
  • Welcome To Diabetes Forums!

    Registration is fast, simple and absolutely free so please, join our community today to contribute and support the site.

Archived

This topic is now archived and is closed to further replies.

foxl

Are you kidding me? Splitting Lev dose

Recommended Posts

foxl

:) I was using 6 or 7U per night, to lower my DP ... so I tried just subtracting a couple U out and injecting it 12 hr later.

 

HORRIBLE DP numbers ... so-so pre-dinner numbers.

 

I now seem ot have found my "formula" give or take:

 

6U at 8 pm, and 3U at 8 am. Pre-dinner in 90's - 100's but so far NOT going too low in afternoon. Perhaps a bit hungrier in the afternoon, however. But, who'd'a thunk 3U would make a difference?

 

Of course that all change, any day now, and one way or the other ... gotta keep an open mind! :)

Share this post


Link to post
Share on other sites
Subby

Glad to see you found a working split. I guess 3 units are something along the lines of 30% of your current tdd, which sounds a bit more substantial :)

 

Things can of course change, but I would suspect in working with the ebb and flow of the split insulin, you are determining basic basal fluctuations of your body over the 24 hours, and these trends may be persistent even if you start needing a higher dose etc. In other words, I think you've probably uncovered some of the shape of your persistent biological daily needs.

Share this post


Link to post
Share on other sites
foxl
Glad to see you found a working split. I guess 3 units are something along the lines of 30% of your current tdd, which sounds a bit more substantial :)

 

Or a bit more than 30%, but, yep! Just observing carefully now, to see if I am eating into it!

Share this post


Link to post
Share on other sites
fgummett

Nice result Linda.

 

Not sure it is relevant but noted you comment about afternoon hunger and it reminded me of an observation from when I was first finding my Levemir level... I started at around 6u and gradually over a couple of weeks increased to 12u (maybe 14?)... but after a couple of days at that level I found I could back it down to 10u and have stayed there since then.

 

Again I'm Type 2 not 1 or 1.5 and this may be totally off-topic :)

Share this post


Link to post
Share on other sites
foxl
Nice result Linda.

 

Not sure it is relevant but noted you comment about afternoon hunger and it reminded me of an observation from when I was first finding my Levemir level... I started at around 6u and gradually over a couple of weeks increased to 12u (maybe 14?)... but after a couple of days at that level I found I could back it down to 10u and have stayed there since then.

 

Again I'm Type 2 not 1 or 1.5 and this may be totally off-topic :)

 

Not at all OT. I experienced the same need to back it down when I started my once-a-day dosage. That is why I am being vigilant about the hunger!

Share this post


Link to post
Share on other sites
fgummett

OK then I will go further off topic :T and comment on how weird it feels to be talking in terms of 10u a day -- with 2u making significant difference -- when not so very long ago I was using upwards of 130u basal + bolus ;)

Share this post


Link to post
Share on other sites
foxl
OK then I will go further off topic :T and comment on how weird it feels to be talking in terms of 10u a day -- with 2u making significant difference -- when not so very long ago I was using upwards of 130u basal + bolus ;)

 

YEAH!!!! :) Weird, indeed!

Share this post


Link to post
Share on other sites
Subby

That's a pretty funny turn of the conversation, because I was thinking how in comparison I take about 160u in basal alone, and 3 units would only be about, what, 2% of my tdd. (yeah, I've never been good at maths). It reminds me too that I see my GP on Friday, and intend to ask about a script for NPH which I have not used in years. Maybe that will return me to the 50u mark that I got with Lantus and Novorapid as basals, and it might be quite similar to how the lev works for me. Worth a go. Rather tired of these huge injections and variable action.

 

Insulin use can be just so arbitrary. No wonder the most common reaction I get out of endos when trying to determine things beyond the basics is "shrug". (Mind you I prefer shrug to some BS answer, which some docs always try to have at hand...)

Share this post


Link to post
Share on other sites
foxl
(Mind you I prefer shrug to some BS answer, which some docs always try to have at hand...)

 

Absolutely!!!

 

Good luck with your appt. You should be able to compare insulins, don't you think?

Share this post


Link to post
Share on other sites
Subby
Absolutely!!!

 

Good luck with your appt. You should be able to compare insulins, don't you think?

 

Thanks, and I sure hope so. We don't have any OTC insulin, so I need to get scripted. It's a matter of how many hoops to jump through. When I first requested the levemir last year, he deferred it to my endo. I considered this fair enough as it was comparatively new and he had no experience with it. I'm hoping since the NPH is old news and I used it for years my GP will just give me a script on the spot... I don't want to go through my endo, he is 40 min away, I suspect it would take appointments, etc, a few weeks of stuffing around one way or the other. Or, maybe my GP can just call and ask him on the spot. Wonders might happen, I must remember to strongly suggest that!

Share this post


Link to post
Share on other sites
foxl
Thanks, and I sure hope so. We don't have any OTC insulin, so I need to get scripted. It's a matter of how many hoops to jump through. When I first requested the levemir last year, he deferred it to my endo. I considered this fair enough as it was comparatively new and he had no experience with it. I'm hoping since the NPH is old news and I used it for years my GP will just give me a script on the spot... I don't want to go through my endo, he is 40 min away, I suspect it would take appointments, etc, a few weeks of stuffing around one way or the other. Or, maybe my GP can just call and ask him on the spot. Wonders might happen, I must remember to strongly suggest that!

 

Uuuurgh -- hope he is receptive then!

Share this post


Link to post
Share on other sites
HeartMan

Thanks for this post. I'll be seeing my CDE next week and I'll ask about splitting my Levimir. I use it before I go to bed, which varies between 11:30 and 1:30. My morning numbers do creep up and over the years I've gone from 19 units to 24 units.

I have occasional bouts of DP. When I do I wonder if I've forgotten my evening dose or if I've just had some DP.

Share this post


Link to post
Share on other sites
foxl
Thanks for this post. I'll be seeing my CDE next week and I'll ask about splitting my Levimir. I use it before I go to bed, which varies between 11:30 and 1:30. My morning numbers do creep up and over the years I've gone from 19 units to 24 units.

I have occasional bouts of DP. When I do I wonder if I've forgotten my evening dose or if I've just had some DP.

 

I try to always record my dose so I know ... I was given Lev specifically for that little peak, to offset DP. Seems to be working the same way for dinner.

Share this post


Link to post
Share on other sites
Subby
Thanks for this post. I'll be seeing my CDE next week and I'll ask about splitting my Levimir. I use it before I go to bed, which varies between 11:30 and 1:30. My morning numbers do creep up and over the years I've gone from 19 units to 24 units.

I have occasional bouts of DP. When I do I wonder if I've forgotten my evening dose or if I've just had some DP.

 

This isn't advice to solve your issues (and I think splitting is well worth experimenting with in finding solutions) - but have you tried taking your evening shot at the same time each night, regardless of when you go to bed? It might be better than varying the shot, as while sleep may affect your BGs and issues like DP, your trends are likely locked into a 24 hour rhythm in general. It might also help to not forget too, if you associate, say, 11pm with taking your shot.

Share this post


Link to post
Share on other sites
Delphinus
:) I was using 6 or 7U per night, to lower my DP ... so I tried just subtracting a couple U out and injecting it 12 hr later.

 

HORRIBLE DP numbers ... so-so pre-dinner numbers.

 

I now seem ot have found my "formula" give or take:

 

6U at 8 pm, and 3U at 8 am. Pre-dinner in 90's - 100's but so far NOT going too low in afternoon. Perhaps a bit hungrier in the afternoon, however. But, who'd'a thunk 3U would make a difference?

 

Of course that all change, any day now, and one way or the other ... gotta keep an open mind! :)

 

Isnt experimenting fun, Linda? :D

Share this post


Link to post
Share on other sites
HeartMan

I try to always record my dose so I know

 

I have records going back to 2004 when I was first diagnosed and put on Novolog and NPH. As my prednisone dose was decreased from 50 units bid to zero, my NPH requirements declined. I was weaned off all insulin when I was off prednisone. But alas the docs said one patient a year couldn't stay off prednisone because of adrenal insufficiency. I was their patient for 2004.

When I was put back on prednisone I went back to my records to find out what dosage of NPH I needed.

When I switched from NPH to Levemir, I consulted with my CDE who converted my twice a day NPH to a single dose of Levimir.

Now my insulin needs are stabilized and I don't record them. I suppose if I had to record them, I couldn't just plug my meter into the computer once every couple of weeks. I'd have to find some way to record (manually or electronically) what they were.

Share this post


Link to post
Share on other sites
foxl
Isnt experimenting fun, Linda? :D

 

I am totally a biologist! :D

 

Heartman, you notice I said I "TRY TO" record all my doses ... ;)

Share this post


Link to post
Share on other sites
anneliza
That's a pretty funny turn of the conversation, because I was thinking how in comparison I take about 160u in basal alone, and 3 units would only be about, what, 2% of my tdd. (yeah, I've never been good at maths). It reminds me too that I see my GP on Friday, and intend to ask about a script for NPH which I have not used in years. Maybe that will return me to the 50u mark that I got with Lantus and Novorapid as basals, and it might be quite similar to how the lev works for me. Worth a go. Rather tired of these huge injections and variable action.

 

I did that, I went off Lantus, which I was up to taking 80 units a day, and went back on NPH. I'm fine on 50 per day. Even though back when I was first diagnosed I was on 32 NPH in the morning and 16 NPH in the evening, I now do very well with 25 am and 25 pm. The equal amounts work as a good basal for me. I do take my second shot at bedtime, and let my dinner Regular cover any gap between the daytime and nighttime NPH. Oh, yes, I ditched my Novolog and went back to Regular. I eat somewhat low carb and high fat, and Regular covers my meals much better.

 

So much for progress. Hope they don't discontinue the Regular and NPH the way they discontinued beef and pork insulin.

 

Ann

Share this post


Link to post
Share on other sites
Rekarb
:) I was using 6 or 7U per night, to lower my DP ... so I tried just subtracting a couple U out and injecting it 12 hr later.

 

HORRIBLE DP numbers ... so-so pre-dinner numbers.

 

I now seem ot have found my "formula" give or take:

 

6U at 8 pm, and 3U at 8 am. Pre-dinner in 90's - 100's but so far NOT going too low in afternoon. Perhaps a bit hungrier in the afternoon, however. But, who'd'a thunk 3U would make a difference?

 

Of course that all change, any day now, and one way or the other ... gotta keep an open mind! :)

 

Linda

 

If I'm following correctly. You didn't actually split your Lev dose. You kept your same dose then augmented it after 12 hours.

 

How did you decide to take it at 8 pm? If you don't mind me asking.

 

Mike

Share this post


Link to post
Share on other sites
foxl
Linda

 

If I'm following correctly. You didn't actually split your Lev dose. You kept your same dose then augmented it after 12 hours.

 

How did you decide to take it at 8 pm? If you don't mind me asking.

 

Mike

 

Well for starters, I WAS WRONG -- at 3 pm was 125 ... and at 5 pm. So needing to add MORE ... silly me -- what was I thinking?

 

BUT, I split off part of the dose first, then later re-upped the PM dose.

 

8 pm ... well I go to bed at 9, get up at 5:30 ... that time was always the same. It gave me a little flexibility to make it 8. And it worked, for my DP.

Share this post


Link to post
Share on other sites
Rekarb
Well for starters, I WAS WRONG -- at 3 pm was 125 ... and at 5 pm. So needing to add MORE ... silly me -- what was I thinking?

 

BUT, I split off part of the dose first, then later re-upped the PM dose.

 

8 pm ... well I go to bed at 9, get up at 5:30 ... that time was always the same. It gave me a little flexibility to make it 8. And it worked, for my DP.

 

So exactly what's your dosages now? I'm doing 10u of Lev. I'm taking it around 10 pm believing that I want it to last through most of the morning when I tend to get high readings. I'm figuring that if it slacks off after that I'll be okay because I'm pretty active then.

 

Mike

Share this post


Link to post
Share on other sites
Subby
Linda

 

If I'm following correctly. You didn't actually split your Lev dose. You kept your same dose then augmented it after 12 hours.

 

These terms are up for interpretation, but Linda did move to a "split" dose, though, as in basal split up over more than one shot a day, which is why I would consider splitting as an adequate term. It's pretty common to find that on moving to a split dose, more is needed overall...

 

Often the problem with one dose a day is that you can't cover or reach areas of need given nature of the single dose action. On being about to work with two or more peaks of action, you can cover areas of need that you simply couldn't cover before.

Share this post


Link to post
Share on other sites
Subby
Well for starters, I WAS WRONG -- at 3 pm was 125 ... and at 5 pm. So needing to add MORE ... silly me -- what was I thinking?

 

You formulated a theory with common sense and tried it... then you adapted it to be better next time. Perfect insulin practise. It's easy to be critical with hindsight, but as far as you knew you didn't need additional insulin... only experience tells you that.

Share this post


Link to post
Share on other sites
dbaratta
:)

 

 

 

But, who'd'a thunk 3U would make a difference?

 

:)

 

1 unit can make a difference for me. :) When I told doc that he said 1 unit was a joke, when I used his line in this forum last year I got attacked LOLOLOL Heck, I didn't know. :eek:

But I do know thanks to the experience in this forum.:)

Share this post


Link to post
Share on other sites
ant hill

Hello Linda :D, I would think that with those low doses is a big jump compared to say 4 to 6 than 20 to 24 as percentages go. Have you looked at half doses Lin? I know that Novo have half unit doses in their pens.

Share this post


Link to post
Share on other sites

×

Important Information

By using this site, you agree to our Terms of Use.