I need some help...or advice....

[grace girl]

I'm really having a hard time getting my fasting numbers right. I don't know if I'm just over thinking the whole process, but I feel totally lost.
I'm currently taking 12 units of Lantus in the am and 8 at night. With the 8 units if I do an overnight test I'll drop around 60 points. Too much, I know, but at 8 units the rise I'm getting (DP) in the morning has increased to around 50 to 60.....way more than I like.
I've been tossing this around in my mind and what I've been thinking is that if I were to increase the pm lantus to 9 units (which gave me about a 30 point rise, not great, but more managable) and simply commit to eating some sort of a snack at night to stop me for dropping to low over night, would that make sense?
When I first split the lantus I planned to adjust the pm dose until I had it within 30 point spread as suggested, but now that I see how far down with the dose I'm going to have to go to get there, I'm really concerned about what it's going to do in the morning with the dp thing. I'd like to avoid humalog upon rising to deal with the dp, if possible.
Another thought...could it be possible that if I increased the am lantus dose it might help out with all of this?
I've thought about all of this so much I'm really totally frustrated, which is really helping, let me tell you.
Perhaps I just need some perspective on the thing from someone outside of my own head. Thanks in advance for wrestling with my issues!

[SueM]

Eating a small snack before bed would prob solve your problem.

[BlueSky]

I assume from your comments that you are getting the DP rise after you get up. It takes several hours for Lantus to get up to speed. Which is why you need to control your DP rise with the previous evening's Lantus shot. So, yes, increasing your PM dose and having a snack to keep your night-time BG up should work. Alternatively, you can I try what I do. Which is to use Regular (which is much longer acting) for your breakfast bolus, and inject it as soon as you get up. :)

[lilituc]

I've heard of people in that case also adding one shot of NPH. I don't know how they do it, though.

[Cinnabon]

When I was on MDI I seriouly tried it all and could never get my fasting under 200. This is a very frustrating issue. It never damaged my A1C. Only thing that really got it for me was a pump.

[grace girl]

When I was on MDI I seriouly tried it all and could never get my fasting under 200. This is a very frustrating issue. It never damaged my A1C. Only thing that really got it for me was a pump.

PLEASE don't tell me that! Aside from just personal thoughts, there really is NO way I can afford a pump. This is going to have to work out somehow.

[BlueSky]

I've heard of people in that case also adding one shot of NPH. I don't know how they do it, though.

I do that too! :) My DP starts at about 3am, and I used to get very high waking BGs. 5 units of NPH (Protophane) before bed put a stop to that. But it seems that my DP continues until about 11am. Novolog before breakfast didn't stop the late morning highs. So I replaced it with Regular (Actrapid). It works reasonably well. But minimising insulin requirements through reducing carbs definitely helps.

If your BG is dropping overnight, you don't need NPH before bed. But Regular when you get up could work for you. It's all a bit messy. But without a pump, what else can you do? :rolleyes:

[Tsukia]

another thing you can try is depending when you are taking your lantus shots
I was advised to take mine when i got up and then about 8 hours later so around supper time.
Since then my schedual has been changed around at work and what not so i now do a shot at about 12pm (when i get up) and about 12( when i normally get home) and my fasting is a little low but in range 4ish(that is canadian bg)

but that is another idea :)
good luck