Hello my frds!
Was diagnosed with type 1 diabetes 3years ago, the 1st two years was on Lantus/humalog treatment and then been on a pump for more then a year but due to my lifestyle i stopped the pump and im back to the traditional treatment, but using Levimir/Novorapid now.
Im 25 & my weight is 73kg.
I started Levemir 3days ago with 2 shots per day.
One at 10am (14units) and the 2nd at 10pm (16units).
And also i switched from Humalog to NovoRapid 3days ago.
I am on a strict diet with reduced amount of carbohydrates…mostly i am not in need to take NovoRapid before my meals bcoz of the low amount of carbohydrates (salad, fish, chicken).
During the 1st two days, my readings were a little bit out of range (at night & during the day)
Ill start with yesterday (august 15th), my daily shot of Levemir at 10am was 14units.
Had my lunch without carbs (fish + salad) & without the need of a short acting insulin (novorapid)
and then i checked my BG at:
2:00pm: 185 >> Took 3 units of novorapid as a correction
6:00pm: 187 >> Took 3 units of novorapid as a correction
9:40pm: 193 >> Took 3 units of novorapid as a correction
my usual night shot of levemir were 16 at 10pm, i added 2 units so i took 18units.
(NB: usually i sleep a little bit late, around 4am)
After 5 hours, at 3am (was still awake) my BG was 150, then i fixed my alarm at 7am to check my BG & it was 136 and at 10am it was 122.
So today at 10am (BG 122), i took my daily shot (increased from 14 to 16units).
Slept around 4 hours, then at 2pm i checked my BG and it was 110.
Had my lunch without carbs & without the need of a short acting insulin (novorapid).
Then at 6pm i checked my BG and it was 189.
Should i adjust the amount of my daily shot? and the night one too?
I am thinking about adding 2 units to my night shot and around 4 units to my daily shot.
Or should i change the timing of both shots?
NB: i had a strict diet with reduced amount of carbs due to some weight gain & now i prefer to find my daily basal rate before i get back to eat carbs, I dont wanna get confused.
Your help would be appreciated
Thanks
Shad
all i can really suggest is just trial and error… fast and see if it stays relatively the same… and if it does then its good
I wonder whether you would be better doing your NovoRapid before meals rather than after as a correction. Even if you are having a really low carb meal, it seems you are getting a bit of a spike after eating (above 180, which is higher than you probably want to be.) We do convert some protein to glucose, so that might account for the spike. I would continue doing what your doing with the Levemir, which is adjusting it slowly until you get to your target fasting level.
Shad - I went back to MDI after being on the pump for a few years - just for the heck of it - and I went on Levemir - twice a day injections like yourself. Like others are saying here - it’s trial and error. Also, have you done basal tests just like you did with your pump? That can show you more of how to tweak your amount of insulin (I’m not going to say you should be injecting this amount for your weight, etc. - I’m not a doctor - just someone whose been diabetic 43 years - and continually playing guinea pig).
Also, I am the same Libby that you should be using the Novorapid (fast acting insulin) for your meals - e.g. carbs. Just like you did with your pump - you knew your I:C ratio - and the same should be applied to your new regime with MDI.
Good luck - and keep us posted. BTW, I am back to Lantus - due to allergic reaction to Levemir - that NovoNordisk says they have never heard of - except I’ve heard from a few other diabetics who experienced the same as me - but obviously they never called up NovoNordisk to tell them about problem! I had to fill out all the medical reports for my endo - he signed them - so at least my record is logged with them.
FatCatAnna from Diabetes1.org
Sorry to state the obvious, but you need to bolus for meals no matter how low carb they are. About 58% of protein converts to glucose, though far slower than digesting carbs. Salad, though certainly very low carb depending what’s in & on it, isn’t zero carbs:)
Doing Novorapid corrections isn’t helping you arrive at daytime Levemir doses. You need to test basal as you did on your pump for day & evening doses. It does sound like you may need a bit more Levemir before bed, but you can’t tell your day Levemir needs with meals & no bolus.
I take two doses of Levemir. Because of pretty severe dawn phenomenon, I take Levemir right before bed & another as soon as I wake up. Mine aren’t 12 hours apart.
Protein raises my bg. I get the grams of protein and divide by 2. Everyone has different factors for protein. They seem to range between 40% and 60%. I am type 1. Protein raises my bg about 3 to 6 hours after I eat. I don’t notice anything before the 3 because I probably assume any other raise is caused by carbs I am eating. If you bolus for the protein, I would consider doing some an hour after you eat and another bolus w hours later, rather than the 4 hours later and the four hours after that. We are all different, so you have to learn through trial and error.
Best advice I can give is to get “Think Like a Pancreas” by Gary Scheiner and “Using Insulin” by John Walsh. I prefer the first one, but others here prefer the second. If you can afford it, I would get both, if not, pick one and get it. They tell you how to balance your insulin with food, exercize, and other factors. They also teach you how to fine tune your insulin doses. You will learn a lot. They tell you how to figure your i:c (insulin to carb ratio) for carbs and protein.
Can you describe the allergic reactions you had? It might be helful for other users to identify the cause.
I will just try to look more into proteins although they never affect my BG much during the last 3years…
can you pls explain abt allergic reaction to levemir? im just ok with it…wondering what kind of allergic reaction you had?
mmmm yea i think i should read more about proteins converted to carbs… specially i dont know what 58% of proteins converts to glucose…and how much should it take as an insulin …
thx Gerri
Hi Shad,
Your bolus should be about the same as it was on the pump, depending on what bolus features you were using. You’ve got the info you need based on your readings before your meals & the corrections you’ve been doing. If you’re going to continue eating so few carbs for a bit longer, you may also need to take the bolus injection later since protein hits later than carbs.
Thank you Emmy for this detailed explanation.
Concerning my basal rate I am now on 20 units of Levemir at 10pm & another 20 units at 10am.
This is my 3rd day and my readings are pretty well, bad time is gone for now.
Adjustment now ( if necessary) is only - or + 1 units for my night or daily shot.
Now about having some insulin resistance, you are totally right. Although my basal rate shot isn’t much different on Levemir now compared to the old Lantus (40 with Levemir & 36 with Lantus) but you were right about my high insulin to carb ratio, because during the past 3 years and when i was on Humalog for short act insulin, my insulin to carb ration was 1:5
And as i said in my 1st post, i just started Levemir 6days ago and NovoRapid 5days ago.
I am doing lots of BG tests during the day and now i am focusing on meals carbs/insulin and i started with my old insulin to carb ratio which as 1:5, i am saving detailed day to day data and will analyze them later …
will keep you posted
thanks again for your gr8 help
Thanks Tanya.
Well yea i am interested in getting “Think like a pancreas” by Gary Scheiner, Ill order it soon.
and yea i am very interested in knowing more about proteins, i never cared about this before!
Thx again 
Probably i am on the right track concerning my basal rate. It is somehow well controlled during the whole day.
( with 20 units of levemir at 10am and 20 units at 10pm) and im getting reading between 85 and 125, Which i think is great.
Now i am facing some difficulties regarding my bolus shots. I am on NovoRapid now, after being on Humalog since i was diagnosed type 1 diabetes 3years ago.
I am using the same carb/insulin ratio i used when i was using the pump. my ratio is a little bit high 1:5
today i had my lunch at 3pm, my BG was 88, had only 3 hard toasts without added sugar (18.6g of carbs) with light cheese only. my shot was 4 units of Novorapid 10min before lunch.
1hour after lunch my BG was 193
2hours after lunch my BG was 213
3hours after lunch my BG was 170
I am just wondering why i had this high BG? cant be related to PROTEINS! coz even if i count proteins which are 2.6g only so this dont explain this high BG!
i have 2 questions:
1- Could this be because of the time of my shot? i mean, i should have took my shot after the lunch or during, or should i have to split my shots in 2?
2- Or Should i update my carb/insulin ratio?
Thanks