They seem to be largely immune to injection timing thanks to a newfangled black magic I have yet to get my head around.
Lantus and Levemir are basal insulins that last more-or-less 24 hours. If you take a shot late one day and take it on time the next day, the action of the two shots overlap. This is called stacking.
It can, for a time, create a double-dose of insulin in your blood. Of course, ask your doctor, blah, blah, yadda, yadda, but in general, the standard rule of thumb is that if you missed the basal boat by more than two hours, you should catch the next train instead. Oh, wait.
I think I changed hats in the middle of the stream again and mixed my metaphors. Anyway, the thought behind this is that the tail of extended insulin is weaker than the main run, and the onset of the next shot is not instantaneous; therefore some overlap is acceptable.
And the same thinking goes, that the longer the overlap is, the higher the risk of a low is, and that because one high day is less of a health hazard than one bad hypo, the lesser of evils is to skip any shot that has been missed by more than two hours.
Just be aware that you are at increased risk for a hypo following the next shot, and stay alert to your blood sugars during that time. In this scenario, I think you should shorten your late-shot window by half. Shifting shot times is doubly dangerous as this can place these areas of increased potency at times where you do not need them.
In my book, a missed NPH or U shot needs to stay missed. Screwing with the timing is dangerous. What do I personally do? Well, hell. One last word. Avoid driving or operating machinery until you know how this medicine will affect you.
Use Levemir Insulin Detemir exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. Insulin detemir is injected under the skin. A healthcare provider may teach you how to properly use the medication by yourself.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don't understand all instructions. Prepare an injection only when you are ready to give it.
Do not use if the medicine looks cloudy, has changed colors, or has particles in it. Call your pharmacist for new medicine. Your healthcare provider will show you where on your body to inject insulin detemir. Use a different place each time you give an injection. Do not inject into the same place two times in a row. Do not inject this medicine into skin that is damaged, tender, bruised, pitted, thickened, scaly, or has a scar or hard lump.
If you use this medicine once daily, use the injection at your evening meal or at bedtime. If you use the medicine twice daily, use your evening dose at least 12 hours after your morning dose. Your doctor may want you to also use a short-acting insulin. Always inject your insulins separately.
Insulin detemir must not be given with an insulin pump, or mixed with other insulins. Do not inject into a vein or a muscle. If you use an injection pen, use only the injection pen that comes with insulin detemir. Attach a new needle before each use. Do not transfer the insulin from the pen into a syringe. Never share an injection pen or syringe with another person, even if the needle has been changed. Sharing these devices can allow infections or disease to pass from one person to another.
If it has expired or is damaged, return it to your pharmacist for disposal. Tell your doctor if you have allergies to any other medicines, foods, preservatives or dyes. Tell your doctor if you are pregnant or plan to become pregnant. Pregnancy may make managing your diabetes more difficult. Insulin needs usually decrease during the first three months of pregnancy and increase during the last six months.
Your doctor can discuss with you the risks and benefits involved. Tell your doctor if you are breast-feeding or plan to breast-feed. Inform your doctor as soon as possible if you experience signs of heart failure such as unusual shortness of breath or rapid increase in weight or localised swelling oedema.
Some patients with long-standing type 2 diabetes mellitus and heart disease or previous stroke who are treated with thiazolidinediones in combination with insulin may develop heart failure. If you have not told your doctor about any of the above, tell them before you start using this medicine. Tell your doctor if you are taking any other medicines, including any that you get without a prescription from your pharmacy, supermarket or health food shop. If you take any of the medicines listed below, your blood sugar level may fall hypoglycaemia :.
Tell your doctor about any other med icines that you are taking. This is very important. Your doctor will advise you if it is alright to keep taking them or if you should stop taking them.
Your doctor and pharmacist have more information on medicines to be careful with or avoid while using this medicine. Your doctor, diabetes education nurse or pharmacist will have given you advice on how to use your medicine. Carefully follow all the directions. They may differ from the information contained in this leaflet. Any change in dose or type of insulin should be made cautiously and only under medical supervision. If you change the type of insulin that you use, you may have to use more or less than before.
This may happen with the first dose or over a period of time. If you do not understand the instructions, ask your doctor, diabetes education nurse or pharmacist for help. It is very important that you manage your diabetes carefully. Too much or too little insulin can cause serious effects. If you require twice daily dosing, the evening dose can be administered either with the evening meal, at bedtime, or 12 hours after the morning dose.
Your doctor will tell you when to inject your medicine. Check your medicine before each preparation and injection. Make sure you are using the correct type of insulin. Do not use this medicine if it is thickened, coloured, or has solid bits in it.
Always carry some sugary food or fruit juice with you. If you experience any of these symptoms of a hypo, immediately eat some sugary food or have a sugary drink, e. Tell your relatives, friends, close workmates or carers that you have diabetes. It is important that they recognise the signs and symptoms of a hypo. Make sure they know to give you some sugary food or fruit juice for mild to moderate symptoms of a hypo.
An injection of the hormone glucagon may speed up recovery from unconsciousness. This can be given by a relative, friend, workmate or carer who knows how to give it. If glucagon is used, eat some sugary food or have a sugary drink as soon as you are conscious again.
If you do not feel better after this, contact your doctor, diabetes education nurse, or the closest hospital. See your doctor if you keep having hypo reactions, or if you have ever become unconscious after using insulin.
The amount or timing of insulin, food or exercise may need to be adjusted. If you forget your insulin dose, check your blood sugar level and test your urine for ketones as soon as possible. If you are not sure what to do, talk to your doctor, diabetes education nurse or pharmacist. Do not use a double dose of your insulin. If it is almost time for your next dose, skip the dose you missed and use your next dose when you are meant to.
High blood sugar levels over a long period of time can lead to too much acid in the blood diabetic ketoacidosis. Contact your doctor immediately if your blood sugar level is high or you recognise any of the following symptoms. Discuss any worries you may have about this with your doctor, diabetes education nurse or pharmacist. Make sure all friends, relatives, workmates and carers know that you have diabetes and are using insulin. If your child has diabetes it is important to tell their carers.
Keep using your insulin even if you feel well. It helps to control your condition, but does not cure it. Tell your doctor if you often have hypos low blood sugar levels. Your doctor may need to adjust your insulin dose. If you experience any of the symptoms of a hypo, immediately eat some sugary food or have a drink, e.
Tell your doctor if you have trouble recognising the symptoms of hypos. Under certain conditions, the early warning signs of hypos can be different or less obvious. Make sure that you tell every doctor, dentist, pharmacist or other health care professional who is treating you that you have diabetes and are using insulin.
Tell your doctor, diabetes education nurse or pharmacist if you are travelling. Ask them for a letter explaining why you are taking injecting devices with you. Each country you visit will need to see this letter, so you should take several copies. You may need to inject your insulin and eat your m eals at different times because of time differences in and between countries.
Your doctor, diabetes education nurse or pharmacist can provide you with some helpful information. Do not use this medicine if you think it has been frozen or exposed to excessive heat. It will not work as well.
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