Levemir Dosing: Not Always Clear Cut

Levemir FlexPenI asked about trying Levemir back in December, 2007. My PCP gave me some sample pens and said to take it twice a day. Later I saw another doctor who tried to tell me that it was a once a day insulin. Although in the beginning I did better on Levemir than I had on Lantus, I found that it just didn’t last long enough and I would run high before my 12 hours was up.

The following spring, there was a discussion on a message board and several of us felt that Levemir was not lasting for 12 hours. I brought up trying it three times a day and I decided to give it a try. I actually found that worked a lot better for me. Right around when I tried that was when I also learned about doing basal testing. By doing basal testing, I know that my rates are set correctly and I can go 24 hours and have my blood sugar stay fairly stable.

Another person on that message started taking Levemir three times a day also after I started. There is a third person on TuDiabetes that also takes her Levemir that way. I know that there are at least three of us taking Levemir three times a day successfully.

A couple weeks ago, there was a discussion on TuDiabetes about Levemir. Someone has having trouble with it and I told her what I did. Every time I suggest that to someone, I also suggest doing basal testing and state that I know it works for me because of doing basal testing. Someone else immediately piped up and told her that she couldn’t do that. My response was why not. I have been doing it for 3 ½ years less the 8 months that I was on the pump. I get pretty good results from it.

If you read the prescribing information for Levemir, under Pharmacodynamics, it states “The mean duration of action of insulin detemir ranged from 5.7 hours at the lowest dose to 23.2 hours at the highest dose (sampling period 24 hours).” You can read the prescribing information on the Levemir website here, or I scanned the first page and have it below if you threw yours away. If you are someone getting the 5.7 hours out of Levemir, then taking it twice a day is not exactly going to work for you. If you are someone getting 23 hours out of it, you don’t want to be taking it three times a day – that won’t work either. The best way to know what works for you is to do basal testing.

If you read the line above, it says “5.7 hours at the lowest dose to 23.2 hours at the highest dose.” Note the lowest to highest. If you add more Levemir to your dose, then you will be able to extend the duration. However, if adding more Levemir causes you to go low, then that isn’t good either.

I take my Levemir at 7 AM, 3 PM and 11 PM. There are some drawbacks. If you stay up late and want to sleep in, you have to get up or your blood sugar will be high. If you are tired and want to go to bed early, that can be a pain. I have dual alarm clock so I have alarms set for 7 AM and 11 PM. If I want to go to bed early, my alarm wakes me up to take the Levemir.

My view on everything is that even if something works for 99.99% of people, if you are in that 0.01%, you need to find something that works for you. I grew up left handed in a right handed world, so I am used to doing everything differently – even telling time. Figure out what works for you and don’t worry about what everyone else is doing.

Levemir prescribing information

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2 thoughts on “Levemir Dosing: Not Always Clear Cut

  1. We are on the pump now, but when we were doing injections we were using Levemir. We started out with one shot per day. Then we cut the dosage in half and moved to two shots per day. We had better numbers that way. I think three shots would have been tougher to manage for us, but I can see how it could benefit your numbers.

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