When To Split Levemir Dose, Based on Current Dose, a Guide

Posted January 18, 2021 by Michael Chamberlain - See Editorial Guidelines

Wondering when to split your Levemir dose and under what circumstances it is appropriate? Here’s where we answer that question for you and offer some general guidance.

Here’s the quick summary answer, then we’ll dive into some further details based on your current dose and what to do.

When to split Levemir dose? Generally, longer-acting insulins are only split 12 hours apart. However, insulin is split mostly when:

  • You have higher doses
  • You don’t use two insulins along with Levemir (short or rapid-acting insulin) 
  • When blood sugar increases depending on your day 
  • If you experience high BG at night 
  • Less physically active

We need to take some things into account when assessing this, so let’s go into some of those factors next.

What to understand before knowing when to split Levemir dose

When To Split Levemir Dose

Levemir is a long-acting insulin. This means that the effect of insulin lasts longer than other types of insulin. Levemir specifically lasts up to 24 hours.

Many long-acting insulins only need to be administered once a day.

Your doctor may direct you to take the insulin either once in the morning, with an evening meal, or before bed-time. The time you should administer it may depend on when you experience high blood sugar levels the most.

If you’re once-daily does works well for you and your diabetic condition, then the general rule is that you do not need to split your Levemir dose.

Dose lengthening and fading effect

The primary reason why many split their Levemir dose is to lengthen the dose and avoid a fading out effect. This allows for peak effectiveness throughout each day.

This can bring about a more stabilized course of action than allowing the dose to fade out completely, as might be the case with a non-split dose. 

Although Levemir is long-acting insulin and is marketed as a once-daily injection, it rarely covers a full 24 hours with equal concentration.

When the dose is split, by the time the effects of the first dose begin to fade, you can then take the second dose. This can kickstart the action again, showing the same effect of the insulin with the same concentration as the first dose. 

This can help in the even distribution and concentration of insulin in the body, which, in turn, helps to regulate blood sugar levels regularly.

Related: When to take your diabetes tablets.

General recommendations on when to split Levemir dose 

The general recommendation on when to split Levemir dose comes from how the insulin works for you.

It’s only when your Levemir cannot show a full 24-hour effect as it should that you are then recommended to split your Levemir dose.  

It is important to note that splitting your Levemir dose should only be done under your doctor’s direction and guidance.

However, with the experience of many with diabetes that split their Levemir doses, it’s believed that a Levemir dose could, and perhaps should be split into 2 doses given every 12 hours.

The general recommendations regarding when to split Levemir dose falls in line with simply splitting equal units of your current full dose. The second dose should not be taken until it has been a full 12 hours since your first dose.

When to split your Levemir dose depends on certain factors

While the general recommendation calls for a split 12 hours apart, there are many other factors to consider for determining exactly when you should split your dose.

1. The size of your prescribed dose

In general, only higher doses are split because their effects don’t last for as long as expected for many patients.

Small doses of Levemir are usually prescribed for patients with type 1 diabetes. This is often accompanied by other types of insulin.

So, in general, if you’re taking small doses, it may not be advised to split your dose.

But if you observe that your smaller doses are not providing the expected results, then consider splitting them after consulting your doctor on this. 

2. Using two insulins when splitting the dose

Levemir should not be mixed with any other type of insulin. However, when using Levemir, your doctor may prescribe you another insulin to use alongside Levemir.

This happens mainly in patients with type 1 diabetes, where Levemir is prescribed to be used in a regimen with rapid-acting or short-acting insulin.

So, when you’re following an insulin therapy with two insulins, it’s often not recommended to split the dose, as the other insulin may make up for Levemir’s faded effects.

Splitting your Levemir dose when you are also using a rapid-acting insulin may put you at an increased risk of hypoglycemia. This can often occur when you are taking your insulin injections too close together.

Additionally, splitting Levemir when you do not necessarily have to means that you have to add another injection to your regimen. This takes time out of your day and can cause more pain than necessary.

3. Daily routines and hormonal changes impact Levemir dosage

Depending on your day and daily routine, you might want more doses than usual because your blood sugar levels can spike up more than normal. So, splitting up your dose, when you can predict a spike in blood sugar, can aid in better blood sugar control.

When To Split Levemir Dose

In general, stress, heat, sleep loss, eating foods high in saturated fat, skipping breakfast, hormonal changes during menstruation, physical inactivity, and infections can all spike up your blood sugar, causing unexpected imbalances in your blood sugar levels.

4. Insulin patterns overnight affect the Levemir dose 

If you experience fewer spikes in blood sugar during the day and more while sleeping, then split your dose with higher units at night.

This will keep your blood sugar stabilized as you wake up and provides a good healthy start with fewer symptoms of hyperglycemia for the day ahead.

If you don’t experience any spikes at night when sleeping, but have irregular spikes during the day, then just take the whole dose in the morning without splitting.

Also, if you’re a person that experiences low blood sugar while sleeping, don’t split your insulin, as the second or last split dose can result in hypoglycemia when you wake up. 

5. Physical activity can affect Levemir doses

If you’re physically active, which often benefits your condition, then you may not need to split your insulin because your blood sugar levels naturally reduce, and your body becomes more sensitive to insulin.

If this is the case for you, it may be best to stick to just one Levemir dose a day. Splitting your dose when you exercise regularly may cause abnormally low blood sugar levels for some individuals.

Summary of effects on splitting Levemir dose

Here’s a quick summary table that outlines some factors regarding splitting your Levemir dose and the recommendations.

Factor when splitting Levemir doseGeneral guidelines
Higher doses of LevemirThese are more eligible to be split
Lower doses of LevemirMostly for Type 1 Diabetes, less eligible to be split
Therapy involving two insulin typesNot recommended to split Levemir doses
Significant changes in daily routineConsult your doctor about potentially splitting your Levemir dose
Changes in hormonal balanceConsult your doctor about potentially splitting your Levemir dose
Greater blood sugar spikes at nightSplit Levemir dose during the day
Irregular daily spikes, fewer spikes at nightMaintain a single Levemir dose in the morning
Condition stabilized through activityMaintain a single Levemir dose in the morning

These are, of course, meant as general guidelines only. For recommendations based on your own specific needs, consult your doctor before taking any further action.

Closing

We hope this has provided some valuable information regarding when to split your Levemir dose. And while we can provide some basic information, it’s always in your best interests to consult your doctor before making any changes.

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