Quote:
Originally Posted by walleyedave  I don't understand how people can say that your dose of lantus is high.
I have been told to keep upping my lantus untill my morning BG's(fasting) are normal. How do these people know your dose is high. I don't get it. I would love to hear there thoughts on this, as well as why they feel this dose should be split.
I don't know whats going on with your Bg. The more I read your other posts, the more you remind me of me. I have gone through some of the exact things you have. The weight loss and gain issues. The morning Bg issues. etc..
I can eat zero carbs for breakfast and still skyrocket in an hour..
I hope you get the answers your after bro, we'll both get some questions answered. I'll be subscribing to this 1 for sure.  |
The 'keep upping the lantus until your morning BG's are normal' is standard advice from docotors who fail to back it up with two other important questions
1. What is your BG before you go to bed?
2. Are you sure you aren't going hypo in the night?
The purpose of Lantus is to cover the output of your liver and to keep your BG stable in the absence of food or bolus insulin. Too often it is given in excess amounts and causes the BG to tick down slowly. If this happens in the night, you can have a nice night hypo. Your liver then has the decency to save you life by putting out everything it can. Some folks are high in the morning because of a liver dump and keep on upping the Lantus to keep the morning numbers down. It's a really good way to vanish up your own rear end. A place where I lived for quite some time and wondered where all the spikey numbers during the day came from.
The reason folks are thinking it's a lot of lantus is because it is a lot for a T1 acording to the general rules of thumb (such as they are). These rules of thumb obviously are there as a rough starting point from which to get to where you actually need to be. But looking as an average, a 50/50 split of bolus to basal is a reasonable starting point. So if Drummingfool fits this profile, his total daily dose is around 104u. Another little guideline I've seen as a starting point is that 0.5u of insulin is given per kilo of body weight. Again, only a guide but this would suggest that Drummingfool weighs 208 kilos which is almost 460lbs.
Again, everyone varies from this rule of thumb. But if there's even a tiny bit of truth in it then something else must be going on here, hence thoughts of either night hypos or absorbsion problems. If you put loads of insulin in one place at one time, you can get really bad absorbsion problems. For this reason, it's fairly common to split larger doses into smaller shots.
Splitting to dose between sites and also some overnight basal testing would be a good start on the road here IMO.
