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From New York, USA:

I use an insulin pump, but my diabetes team encourages all of their pumpers to have a back-up plan in case of pump failures. I was given Levemir to use next time, with instructions to replace my pump basal on a unit-for-unit basis. However, I know some people use Levemir twice a day and others once a day. I would like to see if once a day would work for me, but I don't know how to try this safely. I get six units of basal between 10 p.m. and 10 a.m., and eight units between 10 a.m. and 10 p.m. So, if my pump failed, I figured I would simply add up the basal I would get over the next 12 hours and give that amount. However, if I wanted to try and see if it worked once a day for me, I would have to inject 14 units all at once, I imagine. If I didn't, then I would go high anyway from too little basal and if I did inject all 14 units at once, and it only worked 12 hours, then it would essentially be like having double the amount of basal I needed during those 12 hours. So, how do I determine if once or twice daily dosing is more appropriate for me? Lantus is not an option for me.


When the drug was released, most of the studies were done on twice a day dosing. It is more conservative. Since this plan is only short term, you would probably want to use the most conservative regimen, which would be twice a day basal insulin. There is no other way but to try. Since you are on a pump, you would not necessarily be able to do this.


[Editor's comment: Since it is your diabetes team that has given you the Levemir, you should ask them about your dosing. And, of course, if your pump fails at 2 a.m., you might wish to use short-acting insulin for several hours until you can give yourself Levemir. A lot depends on what time the pump fails and how long it takes your pump manufacturer to provide you with a replacement. I recently heard of someone whose pump failed at midnight and got the replacement at 2:30 a.m.! BH]

Original posting 22 Jan 2007
Posted to Insulin Analogs and Daily Care


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