Levimir and Novalog


I have been put on 5 shots a day starting out with 7 ml of Levimir in the morning and before bed and 5 units of Novalog before each meal. I did the boluses one week and crashed 3 times, wont be doing that no more. I decided to take the 5 units prescribed only before each meal. I have to then eat something every hour 1/5 or so because by two hours I am falling out again. I eat right and crash, < low sugar drops,I dont eat right and never crash. I'm to see about classes for diabetes and eating in the coming week here. So thats the new prescription for now. I have been to the endo over 6 times this year alone,its tiring. I dont see alot of change with my numbers as of yet and the meds are both flex pens. The day the endo put me on insulin was my A1C check. I was in a rush, BIG RUSH. I had a banana and thats it for breakfast and almost 3 hours later my sugar was 400. I'm thinking, its not looking good.

I use Lantos and humalog I get Lantus 2 times a day and humalog for my carbs . Works well for me. My only carb choices are oatmeal yogurt or bread. I try and stay away from high fat because raises my sugar levels. I use fruit like a apple only I need some sugar slowly while I’m doing something like shopping and levels are on the low end no shot. Bandanas are a fast actingcarb

A set dose of the same number of units of bolus before each meal doesn't work very well, as you can see because you are having to eat more to keep your blood sugar from crashing. You need to figure out your Insulin to carb ratio and then take the right amount of insulin for what you are actually eating. You need a very different dose of insulin for a salad then you would for a hamburger with bun, and french fries! Your endo doesn't seem to be helping you very much or teaching you the state of the art ways to take insulin. I encourage you to either find an endo who will, and/or get the book Using Insulin by John Walsh to learn how to dose your insulin. Many of us learned by reading that or another book and coming on here, rather than being given instructions by a doctor. I would be careful about classes as they vary in quality of knowledge as well.


Thank you for the heads up. I eat a carb between meals ( fruit mainly) so I wont drop out. Its either too much or not enough. I'm presently a mess with this stuff. By the time I eat correctly all day long, I end up coming home and pigging out because I am so weak from these stupid drops. I'm going to give it another week to see whats going to happen again.

Hey Zoe..

Boy you hit it right on the eight ball with the salad deal. I was at Apple Bee's and took 7 ml of Novalog before eating a chicken fried salad. Its 5 ml each time unless I use the bolus on account of the range in which my sugar may be at, so it was 216 meaning for me to take 2 more units of the Novalog >7<. I then ate my salad and at the end of eating this salad had a horrible spell. Ya, I was eating right and crashed anyway. My follow up sheet from my endo informs me of just how much bolus to take. However, like you said, carb to ratio, maybe I should have stuck with the 5 ml and when I eat a can of sardines for lunch, maybe I should just use 3 ml of Novalog, is this what you mean? I will have to learn a new way. Today, I had another attack, used 5 ml, ate sardines, then in an hour, another attack. I have a book I'm reading now but its not John Walsh although I think I have been recommended this book before in here by the good people who have helped me. Wake up time again, I have been sleeping. Thanks again for the help, funny thing is, I trust the diabetics in here more than the doctors.

Hi -

It gets better. I actually did ok on a fixed dose for the first 6 months or so until I was taught how to use an insulin to carb ratio. But if you use a fixed dose, you have to eat approximately the same number of carbs each meal. If you've had any meals that "worked", try to figure out the number of carbs you ate and see if eating that same number of carbs with your dose works a second (and third time). If it does you have at least one solution to the insulin equation.

Are you waking up with ok numbers?


Putting you on a fixed dose like that is dangerous. You need to talk to your endo about learning to carb count and giving insulin for the carbs you eat. You are putting yourself in danger just blindly giving yourself 5 units at each meal. I personally think it was extremely irresponsible of your doctor to tell you to do so.

If your doctor really wants you to use a fixed dose regimen, then you should be meeting with a dietician to determine how many carbs/what kinds of food you will need to eat at each meal in order to use that insulin.

We don't want anything to happen to you! It's just so astounding to me how uninformed some doctors are....


Thanks on this, ya so far my morning numbers arent that good. Ranging in the 200's and over but thats my fault. I tend to eat a bowl of cherios throughout the night somewhere and or before bed. No sugar of course. I'm trying to re-arrange my sleeping schedule but its difficult, I'm up late. So I tend to eat again before bed as I go to bed late "many" nights. I don't sleep that well. I figured my morning numbers may get better when I eat better or learn the carb to ratio thing. I knew it would be about counting carbs and lining them up to the amount of insulin I am to use but had no idea the onset of change with all of this and the affect physically it would have on me with drop-outs. I'm up early to check into this book with John Walsh. I am really guessing with everything right now, not looking forward to all of this but no choice. My husband places articles for cures with diabetes on my desk for me to read and I think, well, I wont see that in my lifetime, and if it starts, well it will be for the young first. They dont want a cure, the medical industry would begin to fold and hoards of money would be lost due to not paying for insulin + +. So we hold fast to hope, but if the hope leads to companies losing money, that hope wont come quickly. A young virginia girl of 17 I believe discovered a cure to one of the bacteria cells in cancer within the cancer cell itself. It has to be activated with a lazer and then the cancer cell begins to die. However, they already stated it will be years and years before it can be actually used as it must be tested thoroughly, and well, they just dont want to get on it either because of the loss over money. Ya. the root of all evil. Money is not bad, the abuse of it there-of can be.

Hi Kari

Thanks for your reply. I think because I have been a diabetic so long that my doctor thinks I am on top of my eating habits, I am not. I just made this transition from pills to insulin and he has given me a sheet of paper to follow with the bolus counts. He asked about sending me to a dietician, I told him I already saw one but she only confused me even more. I am going to call the hospital and check into some classes in hopes to get on a proper eating schedule in at least learn about the carb to ratio use with eating and insulin. I believe he gave me the fixed dose along with the bolus and he probably just figured I would eventually start to understand, which I am now waking up too. He said to call if any issues arise at all, but its up to me at this point, I have to figure it out, my eating habits and how much insulin to actually use. Thank you for caring, I am thinking today about breakfast and lunch, and I clean houses so my sugar tends to drop quickly before I realize what the heck is going on. I find myself indulging in a carb between meals when working so I wont have a spell. They are unbarable as you probably know. Just hoping this book will help right now. I will look at Walmart to find it but probably Barns and Nobles would be my best bet. Thank you again Kari.

Wow. That is a weird regime. Fixed doses are one thing, but taking 7 units of basal and 4 x 5 units of bolus? That is like a 25/75 basal/bolus ratio. I found the books "Using Insulin" by Walsh and "Think Like a Pancreas" by Schiener really helpful.

As others have pointed out, your bolus insulin should be matched to what you eat and how high or low your blood sugars is. Just taking a bolus of insulin and not eating the appropriate number of carbs can lead to a bad hypo. Sometimes, doctors will give you an "easy" routine for using insulin without taking the time to explain the "proper" method.

I think everyone who uses insulin should learn the basics. You need to count the carbs in what you eat. Then you need to choose the right dose of insulin based on those carbs. The books I gave you can explain everything, but a good set of diabetes classes also can really help. Get into a class as soon as possible and get those books, they should be on everyone's shelf.

ps. What your doctor did to you is like giving a 16 year old the keys to the car, not bothering with teaching them to drive and wishing them good luck with that driving thing. This is not your fault, it is your endo's (and medical teams) fault for not helping you properly.

You are on a sliding scale but need to be counting carbs and calculating how much insulin to bolus when you eat. Sounds like you're crashing because of too much insulin in your system. I'm sure the chicken salad had very few carbs in it hence the 7 units of insulin was probably way too much. Has the Endo given you your ratios in order to figure how much to take? You should have a I:C or insulin to carb ratio and you insulin sensitivity ratio to calculate corrections. That is how I was taught to administer MDI shots. I know you are new at it but you need to see a CDE if your doctor isn't up to the task.

why would a supposed cure, in your opinion, be for 'the young first'...type 1 diabetes is the same if you're young or old. if they find a cure, which is doubtful, IMO, it would be a cure for anyone who has type 1 diabetes, which is an autoimmune disease. there's no age limit to onset type 1. The person(s) who indeed does find a cure for type 1 would be rich beyond rich, there is an incentive there for researchers. Are you a type 1, did you test postive for the antibodies, have a low or 'no' cpeptide test?

agreed, this is a very strange insulin regime. you don't have to figure out your eating habits, if you're a type 1 on insulin, both basal and bolus, you count the number of carbs you're eating (we can eat anything) and take insulin, in terms of units to match the carbs..it's not that difficult but does take adjustments and focus. if you eat a bowl of cherrios, you need to count the carbs in that 'meal' and then take insulin to match that food, including milk...anything WITH CARBS! It's not about your 'eating habits', it s about your insulin regime and protocol. you take your basal insulin to keep your fasting, inbetween blood sugars stable, they interact with each other, the basal should just keep you steady, without peaks or drops. this is very dangerous what you're doing. you need to get a class on I:CR.

Hi -

I don't know what your financial and health insurance situation is but if you can swing it the Joslin Cliniic in Boston has a very good 3-4 day out patient program called "DOIT". You meet with an endo, nurses, nutritionists and exercise physiologists who all help you develop your skills. I took the program and besides straightening out my insulin program, I learned an enormous amount.


Hey bsc..

Thank you for your help and reply. My daughter was over last night, I realized I am still type 2 and yet need to take insulin. We did some research online about both. She said I am to eat out of the basic 5 food pyramind with my diabetes as I am still secreting from pancreas what is need to keep sugars down. Although my sugar is high as of yet unless I'm starving so it seems. I decided to wait till tomorrow, eat right by starting out with the pyramid before I can actually trust my numbers to be in a safe range. She beleives thats why I am falling out and to eat a true balanced meal with the 5 food group and I would more than likely not fall out. Including half of a peice of fruit per meal, between that and the starch it should hold me over in between times, if not then pop a glucose tablet. I tend to lean towards meat and veggies and stear away from starch. I do the carbs though and well, not right I am sure. I love fruit. You know, I a bit overwhelmed here, the needles have my thighs sore and it bruises my stomach terribley. I am using the Victoza needles on my insulin shot, they dont fit right but they work. The other needles are longer and they terrify me. I'm going to get this thing right, its going to happen. Its just one thing after another these days in my life and then this. Oh well, I will make it happen. I like your analogies bsc, they are very interesting.

I am thinking your right on the doctor number, I may hit him up on Monday to see whats up.

Hey Shawnmarie,

Boy your right on this, its nuts, all of it. I am very physical but at this age in my life its not the best thing to be, I feel my bones to be brittle and if I went to the doctors everytime my heart stirred I would be living in the hospital period. I have a long ways to go to get this right but I'm going to do it. So glad of these forums, my goodness they make all the difference in the world. I'm thankful.

Hey type 1Gal..

Well thats where I am going wrong, see I am type 2 diabetes insulin dependent. Even so, my sugars remain high, I cant figure it out. So this is why I am needing that balanced meal as I wrote bsc. Too much insulin and or not enough on account of still producing insulin from the pancreas. If you ask me its not much..but from my doctors angle its still happening. I dont understand that entire part of it or how they know that to be precise but I guess they do. So by eating out of the pyramid group I am actually helping the insulin from my pancreas to work properly instead of treating it as though no insulin is being used by totally counting the carb to ratio. Only because...I am diagnosed as type 2, but I am going to call him Monday and I am going to test this theory this weekend with my eating. I will eat half of a banana along with cereal to see what my numbers will be by lunch. By eating cereal only, I will fall out by noon easy. My daughter said to do that or eat a peice of toast with my cereal, she was really helping me to see whats going on. I am overwhelmed here but I'm going to get this down. And, I'm going to try my legs instead of thighs now, I get those bumps and little bruises all over and a pump I could never do. I sure admire the people in here who can pull this off without issues, they are my heroes and I can learn alot.

bananas and cereal w/milk are some of the toughest things to eat for a diabetic. i don't understand this at all, sorry. try low carbing...just count your carbs and match that with insulin. it doesn't matter if you're a type 1 or type 2 if you're using a fast acting (bolus) insulin, you still match the carbs. a doctor can indeed measure your insulin, it's called a cpeptide test (fasting, typically). have they done that? have you seen an endocrinologist? if you low carbed, maybe you wouldn't need to be on insulin. did anyone show you how and where to inject and to rotate? you're eating all carbs!

what do you mean "you realized you're a type 2"...what did the doctors tell you? if you're a type 2 and lowered your carbs, maybe lost weight (if that's an issue) exercised, etc...maybe you could get your numbers down. type 1's don't have this option. the pyramid...that's all carbs and old school, think they recommend like tons of carbs per serving. a diabetic cannot process CARBS without a medication (either oral or insulin). fruit is A CARB, milk is a CARB, vegetables have CARBS....do you look at any of the labels you're eating? use insulin needles, and have someone get you the right size!