Help with Levemir basal insulin and Dexcom G5. Please! (Newbie)


I need the help of all you experts out there. I am currently in my honeymoon phase. My last A1C was 5.6. I thought it would of been lower cause all my finger sticks were 95% of the time below 100. I couldn’t understand why I would wake up in the middle of the night having to go to the bathroom. I would go to sleep with a BG of less than 100 and wake up to a BG of a little above 100. I knew that the going to the bathroom after 3 hrs of sleep was night right if my BG was good. So finally I was able to get my Dexcom G5 last night. I believe I know what my problem is now. I set my Dexcom alarms to 60 to 150 BG. I went to sleep at around 9pm. My BG at 9pm was 84 and steady. I woke up to a alarm of 150 BG with a diagonal arrow up. Went to the bathroom then went back to sleep. The highest my BG was 164, and by the time I woke up at 3am it was 129. Now I only take Levermir 5 units in the morning. Through out the day my BG is usually around the 90s. I though my A1C would of been in the 4s, but the increase in BG during sleep time is screwing me up. Now that I got my Dexcom I want to try to resolve this. I know Levermir tends to last only 18-20hrs. That should explain why my BG goes up at that time.I take my once a day Levermir shot at 3am. Should I split the dose and take 4 units in the morning and 1 unit at night? Or 3 units in the morning and 2 units at night.

You could certainly try taking your Levemir at night before bed. Dr. Bernstein believes that Levemir doesn’t last through the night as overnight our bodies clear insulin at a higher rate. There is a good chance you are running “dry” overnight.

Despite that, you should also understand that many if not most people with diabetes have their blood sugar rise overnight in the wee hours of the morning due to something called Dawn Phenomenon (DP) (I call it Darn Phenomenon). For some of us keeping our blood sugars below 160 mg/dl even with a finely tuned insulin regime is considered a “win.”


Brian is right, Levemir doesn’t last 24 hours for the majority of people. If that is what is happening to you, then it makes sense that it would be fading out during the time you are sleeping. You should discuss this with your doctor.

Another thing that produces superior results—again, for some people—is to split the Levemir dose in two (some at night and some in the morning). Since two cases of diabetes seldom behave in precisely the same way, trial and error is a big part of determining the optimal strategy for you. But based on what your CGM is telling you, Brian’s suggestion is probably the one to try first.

When I was on levimer I split my dose am and pm. Nancy

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You might want to research switching to Tresiba for your basal insulin (once the dust settles)…

I also split my dose and I actually make my nighttime dose larger to counteract that wicked Darn Phenomenon.

Tresiba is new which means it isn’t on many insurance formularies. Under my insurance (Aetna) Tresiba costs ten times as much as Levemir.

Costs exactly the same on mine… Probably worth looking into in each individual case…

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As do I (larger in the evening).

I guess every day is different. Yesterday pretty much spent the entire day around the mid 60s. Last night woke up to a constant 85bg. Did not change my dose yet. Just trying to figure out the trend. Thanks for all the great advice guys.

I am really interested in tresiba, but have 8 pens of levemir left. Dont want to waste insulin just so i can switch. I have read all the positives of tresiba. I will change to that once i have used up all my levemir pens. Its great you are able to take 1 shot every two days with Tresiba.

Most people are still using tresiba 1x daily… I haven’t heard of anyone taking it every other day actually (even though it does claim to last 42 hours)

But because it’s not constantly wearing off and being recharged it just reaches a stable level in your body, which seems to be quite beneficial

i second that on splitting the levemir. i did that too when i was on it. however, running low on levemir at night doesnt explain to me the great morning BG of around 100. if you really had too little insulin at night, i would expect a raised morning number. but anyway. what also doesnt make sense to me is the peeing at a BG of 160. i don’t notice my kidney producing more urine unless i go over 200.
5.6 is an excellent A1c result, many of us would kill for that :wink:
good luck!

I walk-around all day with a blood sugar of 70 to 100. So when ibam sleeping and my body sees double that. I would think it says this is not normal for him. Hense the peeing. I could be wrong just guessing.

Ok if i want to start giving myself the levemir at night instead of the morning. How would I go about doing this without overlapping the IOB and pushing myself too low?

You said you take 5 units. Why don’t you take 2-3 units the first night and then just start on 5 units the next night. You Dexcom should tell you if there is anything going awry.

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