Author Topic: Levemir  (Read 1695 times)

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Offline Victoria

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Levemir
« on: 06 January 2016, 07:44:33 PM »
Consultant is restarting Levemir for me .In the past this just seemed not to work and sort of remember Sedge saying how much Levemir per body weight is usual would be interested in case it was just not sufficient .My weight is now (gulp) 159 lb thanks to mixed insulin so hoping for good things this time :-\
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Levemir

Dec hba1c 63 April 53

Offline Pattidevans

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Re: Levemir
« Reply #1 on: 06 January 2016, 11:07:31 PM »
I could be wrong, but the Levemir to body weight graph tells you how long Levemir lasts i.e. it's dependent on how much per kilo of body weight you take,  I think that might be what Sedge was referring to.  How much anyone needs is another matter.  For example I might need more per kilo of body weight than Sedge for example, because I am more insulin resistant than she is. 

A T2 may well need significantly more per kilo of body-weight than a T1 with no IR.

There are about 4 pages about it in "Think like a Pancreas" but it's too late tonight for me to try to precis it.  If no one else has given the possible answer by tomorrow afternoon I'll try to sum it up or scan the pages.  Am out tomorrow until about 2.30pm
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


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Offline sedge

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Re: Levemir
« Reply #2 on: 06 January 2016, 11:27:41 PM »
Well from the graph it looks to me that you need at least about 0.2u per kg - for it to last 12 hours and still be as active as it should be in the first place. 72kg @ 0.2u/kg is only 3.6u - then add however much more you need to actually do its job for you.  (Anybody's guess until after you start using it)

Doesn't sound a huge lot - I was a bit concerned it might work out at gallons!  Let's see if Patti agrees with my maths Victoria.
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Pattidevans

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Re: Levemir
« Reply #3 on: 06 January 2016, 11:57:02 PM »
Sedge

72 x 0.2 works out at 14.4 according to my calculator x twice per day i.e. 29u split dose.  Sounds realistic - about what I was on on MDI, but it would have to be adjusted to personal needs i.e. the amount of IR you have, so anything upward of that per day.  As you know Victoria, T2s usually do have more IR than T1s.  Mind you I know at least one T1 who was on 70u per day until he got a pump and we had someone recently who was on 30u + 55u.

I'd start on 2 doses of 14.5 and test my basal - instructions on how to do that as per the 2nd half of this page http://www.diabetes-support.org.uk/info/?page_id=120
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


© 2015 Patti Evans

Offline Pattidevans

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Re: Levemir
« Reply #4 on: 06 January 2016, 11:58:03 PM »
PS  what dose has the Consultant put you on?
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


© 2015 Patti Evans

Offline Victoria

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Re: Levemir
« Reply #5 on: 07 January 2016, 08:52:07 AM »
He havered loads changed his mind twice then decided on 12 @ am 8@ pm split doses .He was trying to sort out what 38 units of mixed would equate to in basal bolus  :)
novorapid
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Levemir

Dec hba1c 63 April 53

Offline sedge

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Re: Levemir
« Reply #6 on: 07 January 2016, 12:49:11 PM »
I knew my answer didn't sound right!  Sorry!
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Pattidevans

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Re: Levemir
« Reply #7 on: 07 January 2016, 03:46:44 PM »
He havered loads changed his mind twice then decided on 12 @ am 8@ pm split doses .He was trying to sort out what 38 units of mixed would equate to in basal bolus  :)

It's not guaranteed to be right straight away.  I imagine you'll have to change it a few times before it's right.  Can you remember what you were on when you were on Levemir before?  I know you said that it didn't work for you and was like injecting water, but wonder if it was just that you weren't on enough then?
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


© 2015 Patti Evans

Offline Victoria

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Re: Levemir
« Reply #8 on: 07 January 2016, 03:55:56 PM »
Patti I wondered much the same and recall I was on 16 units once a day. So far its way out but am bearing in mind once basal is okay will probably need to change ratios for carbs but I have got three months to sort it and if its still not good and hba1c same or higher then tresiba will be prescribed but dont care which insulin it is as long as I get off the teens readings in the evening
novorapid
indapamide
Levemir

Dec hba1c 63 April 53

Offline Pattidevans

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Re: Levemir
« Reply #9 on: 07 January 2016, 08:07:53 PM »
Quote
Patti I wondered much the same and recall I was on 16 units once a day.
Hm, I am not surprised it didn't work for you.  It's supposed to be a twice a day injection, it rarely lasts 24 hours for anyone - even the manufacturers say that!  I don't know what you weighed then, but 16u is a very conservative amount which, even if split, would only really do a very small T1 person.  I think that your current doses are much nearer what you might need and also I do not know what ratio you are on for meals, since you haven't told us what rapid acting you are on OR what ratio you are working to.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


© 2015 Patti Evans

Offline nytquill17

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Re: Levemir
« Reply #10 on: 07 January 2016, 08:32:48 PM »
If it helps give a little perspective, I weigh 150 lbs and take about twice that much Levemir currently (30u per day)! Dunno how much you weigh, Victoria, but 16u per day wouldn't do for most people of adult size unless they were training for the Olympics or something - and once per day Levemir hardly does for anyone at all! Not at all surprised you felt you weren't getting good results off it, but frankly your consultant should have walked you through adjusting your dose and number of injections before anyone up and decided that it didn't work for you, period!
T1 DX 1995
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"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
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Offline sedge

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Re: Levemir
« Reply #11 on: 07 January 2016, 09:17:15 PM »
When I weighed about 53- 56 kg I was on 14u am and 4u pm.
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Pattidevans

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Re: Levemir
« Reply #12 on: 07 January 2016, 10:52:13 PM »
If it helps give a little perspective, I weigh 150 lbs and take about twice that much Levemir currently (30u per day)! Dunno how much you weigh, Victoria, but 16u per day wouldn't do for most people of adult size unless they were training for the Olympics or something - and once per day Levemir hardly does for anyone at all! Not at all surprised you felt you weren't getting good results off it, but frankly your consultant should have walked you through adjusting your dose and number of injections before anyone up and decided that it didn't work for you, period!
In Victoria's first post in this thread she told us she was 159lbs - so 9lbs more than you Nyt and if you go by kilos about 4 kilos and therefore even if no IR she would need more than you.  I totally agree, someone e.g. her nurse or the consultant (assuming she was seeing one at the time) should have seen the light regarding her dose being too low.  Not just accepted "it's not working for her"

Sedge
Quote
When I weighed about 53- 56 kg I was on 14u am and 4u pm.
Yes Sedge, but you are T1 with little IR. 

Unless someone has tested Victoria and proved unequivocally that she is T1, then she will naturally have more IR.  So far as I know, and you can correct me Victoria, you are T2 aren't you? 
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


© 2015 Patti Evans

Offline sedge

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Re: Levemir
« Reply #13 on: 08 January 2016, 02:05:31 AM »
All I meant was, just by weight alone - I would think from that, that Victoria is bound to need at least half as much again - 18u would go up to about 27u, even with no insulin resistance.

Good thing about adjusting Levemir is that it's far easier and quicker to spot the changes taking effect on your BG, usually.
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Pattidevans

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Re: Levemir
« Reply #14 on: 08 January 2016, 09:59:58 AM »
All I meant was, just by weight alone - I would think from that, that Victoria is bound to need at least half as much again - 18u would go up to about 27u, even with no insulin resistance.

Good thing about adjusting Levemir is that it's far easier and quicker to spot the changes taking effect on your BG, usually.


Yes, sorry Sedge, I didn't quite get the context of your message.  I see what you were saying now you explain.  Totally agree with that point and about Levemir being easier to adjust.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


© 2015 Patti Evans