HELP! While giving my Levemir AM injection of 11u my pen jammed and I had to very forcefully press it to get it to go all the way down to zero and I am unsure as to whether or not I received the full dose or any at all. Has this ever happened to anyone else? I’ve never had this happen before! I’m assuming if I have high blood sugars later on today that I did not receive my full dose or maybe even any at all, in this case do you just take a lot of humalog to replace the Levemir?
I am sometimes rough, and have bent the needle shutting off flow a couple of times. This happens when I am particularly creative trying to inject at the far reaches of potential sites. Also, if you did not get the tip properly on, pressing the button may simply have increased the pressure in the cartridge and not delivered any insulin. I also broke a pen once from pressing it too hard (but I think that pen was broke anyway).
If you got it all the way down, then the best thing is to just assume it went ok. You have no evidence of getting too little, so when evidence is 50/50, always go for safety. Always better to correct a high than to treat a low.
I agree with BSC that correcting basal with 'log is risky. When my pump blew up last summer, I briefly considered “it’s a holiday and I already did my “long run”, I can just stay up for 36 hours taking a shade less than 1U/ hour…” but then I figured that it would be a lot more work and bought some NPH to keep me in action. The thing is you don’t want to take “a lot” of 'log, you want to take a little bit every hour or so, like a pump? Theoretically, you’d divide your TDD by 24 to get an hourly “rate” and then wait until your next Levimir shot but I don’t remember how many Levimir shots you are doing. There’s also issues of stacking since the you’d be taking shots with insulin “on board” and might hit a point where you’d take a shot and then 1/2 hour later you’d start to crash out. It’s workable but I would think that you can sit tight, see what happens and take CB as needed and the next Levimir shot will roll along?
I agree with BSC & AR. I would just monitor your BS closely and if you need to take a correction, you can do that. Like AR said, you would come up with an hourly rate. Don’t use TDD though, you just use your Levemir. Since you said AM dose, I am guessing that you take it twice a day. 11 units divided by 12 hours is .916 per hour. You don’t want to take that full amount because some of your Levemir went in.
Thanks for the wonderful feedback, as ALWAYS bsc&Acidrock. I agree with you both and will just ride it out and see how it goes today. Hopefully it all went in and all will be well considering I have the lil bundle in the oven to look out for. If not I’ll just correct with humalog until my next levemir dose tonight. Before pregnancy I took 2 UNITS A DAY!!lol I am now taking 21 units a day and it is climbing daily so it has been a wild ride. So I would assume that 21u/24 hours a day I need approx. 1unit per hour of basal.
Even there though 1/ hour is actually about 14% increase In my own “adventures”, even a 10% adjustment, or error, can lead to +/- 50 points of BG, which is nothing to sneeze at. I’m not sure about hypos but my Type G buddy gave me the impression that babies will sacrifice the mom for themselves endocrinologically speaking but I think we were mostly thinking in terms of elevated BG. I don’t know if that works for hypos. Since I presume you are still keeping up with Lil Guy #1 too, I think that playing it safe and taking CB with meals, if you do start to run high, is a better plan?
I’d just monitor closely and take correction if needed, like others have said above easier to treat a high than a low. As far as pregnancy goes. I was just the opposite I suffered severe hypoglycemia the whole time I was pregnant. Which was nice in some regards lol it was the first time in a REALLY long time I could really kinda eat what I wanted to eat. While I definately couldnt “stop” insulin being a Type 1 I was just super super sensitive to it. Wasn’t up until 36 or 37 weeks my bs finally started inching up…even then was only in 140s-150s.