Woke up at 55....YUCK!-and a Lantus ???

[grace girl]

I hate it when this happens. Doing some over night basal testing...and I knew it was too much....I dropped 104 points over night. Thank-God I wasn't any lower when I went to sleep! (I was at 159)

The thing I don't totally understand about having split the lantus is that since I now know that I've got to reduce the pm dose, does that mean I should raise the am dose accordingly??? I'm pleased with the daytime results as it is, but I know that reducing the pm will affect the am, even if it's only slightly.

However, I've found something that works great for lows when you're half asleep and can't think. I bought some juice in individual cartons that are exactly 15 carbs each. Great to have a mindless choice! Within 20 minutes I was back to 93...I was impressed.
Now if I can just get rid of this headache.

[Funnygrl]

I'm lost...one of my problems with Lantus was that it is darn near impossible to fine tune when you need different basals at different times of day. I always dropped overnight on shots- I just couldn't make it work out to get my .4 overnight rate when I needed .8 during the day. My best suggestion is to get a pump, but I know you don't want one, so my other suggestion is maybe to try levemir. Lantus usually works for around 20 hours, so your doses may be overlapping. I would try reducing the pm and leaving the am untouched.

[BlueSky]

.....I dropped 104 points over night. ... I don't totally understand about having split the lantus is that since I now know that I've got to reduce the pm dose, does that mean I should raise the am dose accordingly??? ....
It all depends on how long Lantus lasts for you. If Lantus is acting over 24 hours for you, the relative size of the morning and evening shots doesn't make much difference to the level of insulin action over the 24 hour cycle (as long as the total stayed the same). In which case, having a low GI and/or high protein snack before bed is the best way to stop yourself from dropping. Alternatively, switch to Levimer, which has most of its action in the first 12 hours. And a big shot in the morning with a smaller shot before bed should produce the desired effect. :wink:

[grace girl]

The lantus lasts about 20 hours for me, and I'm currently taking 16 units in the am and 8 at night. I've had a few thoughts lately of looking into levimar simply because after 6 months of tweaking (and the high blood sugars that come with tweaking) I'm really getting fed up. I'm beyond ready to just get this thing figured out.
The overnight drop thing started when I was taking it at night only, so I switched to daytime, but the running out at 20 hours was still a problem, so I split it.
I'm beginning to wonder if I need to reconsider a pump. All of this is getting so old.

[BlueSky]

.... I'm beginning to wonder if I need to reconsider a pump. All of this is getting so old.
A pump would enable you to customise the basal action to your unique requirements. Get one on loan and see if you like it. Having said that, Levimer may give you all the flexibility you need. I will be discussing switching to it with my endo at the next annual visit. A pump isn't an option for me. And maybe I am old-fashined. But I would choose having a suitably timed snack every day over being attached to a machine 24x7 anyway. :smile:

[Funnygrl]

A pump would enable you to customise the basal action to your unique requirements. Get one on loan and see if you like it. Having said that, Levimer may give you all the flexibility you need. I will be discussing switching to it with my endo at the next annual visit. A pump isn't an option for me. And maybe I am old-fashined. But I would choose having a suitably timed snack every day over being attached to a machine 24x7 anyway. :smile:
Yep, you're old fashioned.

[duck]

I hate it when this happens. Doing some over night basal testing...and I knew it was too much....I dropped 104 points over night. Thank-God I wasn't any lower when I went to sleep! (I was at 159)

The thing I don't totally understand about having split the lantus is that since I now know that I've got to reduce the pm dose, does that mean I should raise the am dose accordingly??? I'm pleased with the daytime results as it is, but I know that reducing the pm will affect the am, even if it's only slightly.

However, I've found something that works great for lows when you're half asleep and can't think. I bought some juice in individual cartons that are exactly 15 carbs each. Great to have a mindless choice! Within 20 minutes I was back to 93...I was impressed.
Now if I can just get rid of this headache.

If you're lasting 20 hours, then let's figure this out:

Assuming AM dose is at 8AM, you run out of that at 4AM the next day.

Assuming your evening dose is 12 hours later, 8PM, you have an overlap of both doses from 8PM until 4AM...Then at 401AM until 8AM, you are only getting your evening dose of Lantus.

Ergh. I guess I could draw a chart...Can you post the times and doses you take Lantus?

[grace girl]

I take 16 units at 9am, 8 units at 9pm. I'm quite rigid about the times...so it's accurate. I appreciate the help...I feel lost sometimes trying to figure all this out.

[MJM]

With the pump you are in control and can key in your basal to change during the night if you wish. Even change a number of times if so required. My own requires the basal to drop from 9pm to 4am and then rise again from 5am to 8am. This will happen while you are asleep and without that particular worry hanging over you. I would seriously consider getting a pump.

[duck]

I take 16 units at 9am, 8 units at 9pm. I'm quite rigid about the times...so it's accurate. I appreciate the help...I feel lost sometimes trying to figure all this out.

Okay. If I did this right, this is what I get, assuming Lantus ends at 20 hours.

From 9AM to 4PM, you are getting a basal rate of 1.2 units an hour of Lantus.
From 5PM til 9PM, you are getting a basal rate of .8 units an hour of Lantus.
From 9PM til 4AM, you are getting a basal rate of 1.2 units an hour of Lantus.
From 5AM til 9AM, you are getting a basal rate of .4 units an hour of Lantus.

Assumptions: Your 9PM Shot wears off at 5PM the next day. Your 9AM shot wears off at 5AM the next morning. You get 8 hours a day of no overlap, 5AM to 9AM, and 5PM to 9PM.

So, looking at your original post, I would think you'd need to wake and test basal rates anywhere from midnight til at least 5AM and see if you drop or hold steady. Maybe get up real early and test from 5AM on as well, but for some of us, getting up earlier than normal triggers a DP-like reaction.

[grace girl]

Thanks, Duck, I don't have a head for math and it would take me days to figure all of that out. I've checked around 1 am, and I'm thinking my problem may be around 5...just a thought, but I'm going to check it out. I have found out that the DP doesn't kick in until after I'm up, so I at least know that much.