Butters Has Switched to Levemir

Mac88

Member Since 2020
Previous thread here: http://www.felinediabetes.com/FDMB/...rom-novolin-n-to-levemir.226858/#post-2541868

I gave Butters his first dose of Levemir this morning, 1.0 units as suggested. He was previously on Novolin N for a week, 3 units twice daily which I was told was too high of a starting dose by the fine folks here. I'm grateful, as his BG dipped to 142 last night, 12 full hours after his last dose of insulin! I shudder to think what would have happened had I not checked his BG and given his usual insulin dose.

After that, his previous low BG episode/seizure in 2014, and reading on here I've decided to try him on Levemir as I am terrified of Novolin bringing his BG too low again. I took his BG this morning (after no insulin last night) and it was 493. 6 hours after the first dose of Levemir, it was 356.

Am I right in assuming that the Levemir takes time to take full effect?
 
Yes, like lantus, Levemir has an insulin "depot".

Somewhere I remember reading a suggestion to test at +3, +6, +9 for the first 3 days when starting Levemir. I think that is for TR (Tight Regulation) protocol.

Probably a good idea to do the same testing levels with SLGS (Start Low, Go Slow) protocol.
 
You will need to hold the initial dose of levemir for 5 to 7 days for the depot to fill and the dose to stabilise, unless the numbers tell you otherwise. After that if/when you increase the dose, you hold that dose for 6 cycles (3 days) each time you adjust the dose, unless the number drops low (50) for TR and (90) for SLGS, in which case you would reduce the dose by 0.25 units
So don't be disappointed if the numbers are not great for the first few days....the depot is filling!
I'm sure you will love Lev!
 
You will need to hold the initial dose of levemir for 5 to 7 days for the depot to fill and the dose to stabilise, unless the numbers tell you otherwise. After that if/when you increase the dose, you hold that dose for 6 cycles (3 days) each time you adjust the dose, unless the number drops low (50) for TR and (90) for SLGS, in which case you would reduce the dose by 0.25 units
So don't be disappointed if the numbers are not great for the first few days....the depot is filling!
I'm sure you will love Lev!

To be honest, the numbers haven't been good on Novolin so far, so literally anything is better than that. :) Just gave him his night dose and at the time his BG was 312. It is good to know about the cycles and dose stabilization, I am hoping Levemir keeps my guy in check.
 
Somewhere I remember reading a suggestion to test at +3, +6, +9 for the first 3 days when starting Levemir. I think that is for TR (Tight Regulation) protocol.
It is part of the dosing methods sticky note, along with the comment that you should monitor closely the first three days. With Levemir, since typical onset is +4 and typical nadir +8, you might want to move the +3 test to a +4.
 
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