Any suggestions?

[Philippa]

I'm currently using Protophane and Actrapid, but I don't have the best control. Over a daily basis my results range from a low 2mmol/L up to possibly 18 or more and back again. I'm type 1, reasonably good fitness, good diet.
The speed of the fluctuations leaves me really tired and worn out. So my old endocrinologist put me onto Lantus and Novorapid, which sent me into the worst hypo I've had in 15 years! I had such a bad siezure they thought I may have fractured my back.
Anyway, I got off Lantus pretty quickly, and back onto my old regemin. Does anyone know the answer to these two questions:
1. Has anyone else had a bad super-sensitive reaction (in blood-sugars) to Lantus? My doctors are stumped as to why I reacted the way I did.
2. Has anyone hurt their back really badly from a hypo? There is very little info online about it.
thanks heaps :fisheye:

[Ailsa]

I changed from actrapid / protophane 2 years ago. It's the best thing I ever did & sorted out a lot of the problems you mention.
You can only have a hypo like that if you have too much, so it could be worth giving it another go at a lower dose.
Just one thought - are you sure you didn't muddle up the insulins & give the doses for the 2 insulins the wrong way round. I did that once by mistake in the early days. I took 25 units of novorapid thinking it was Lantus & had a shocking hypo 1/2 hour later.

[BlueSky]

Pippa,

In answer to your second question, yes. Nearly 10 years ago, a hypo induced seizure caused a spinal fracture. The stomach muscles contracted so fiercely that the sudden curvature of the spine caused a wedge-compression fracture. I forget which vertebrae were invovled - it was quite high up. I had to wear a back-brace for 3 months. And I ended up being 1 inch shorter than I was before the fracture. :eek:

Back in the bad old NPH days, I used to have very volatile blood sugars. And they would occasionally precipitate seizures. It was very worrying. And switching to Lantus went a long way to sorting out the problem. In fact, using Lantus in conjunction with low carb (but not ketogenic) eating has enabled me to stop the anti-convulsant medication I had been on for many years.

So I am surprised to hear about Lantus having the opposite effect with you. If you are sure that you used it properly, maybe you should try Levimir. Or, if that doesn't work, get a pump. :wink:

[Funnygrl]

Pumping for the win!

[LancetChick]

So I am surprised to hear about Lantus having the opposite effect with you. If you are sure that you used it properly, maybe you should try Levimir. Or, if that doesn't work, get a pump. :wink:

I was hearing so many similar stories about Lantus, with the Lantus haters getting relief from Levemir, that I thought I was in the minority having such good success with it! Oddly enough, like you, I had awful and dangerous swings on NPH (not helped by my infrequent testing), but some of the Lantus haters who do well on Levemir didn't have the wild swings with NPH that I did.

Lantus doesn't last 24 hours for me, so I split my dose, but it's about as even as you can get peak-wise, despite vastly different experiences in other people. Funny.

[Philippa]

Thanks to everyone for sharing; it's nice to know other people have had similar experiences.

A little more information for you: I was very wary of changing onto Lantus, but my endocrinologist at the time"sold" me on the idea, promising me that I would have no more hypos! He worked out my dose by taking the 20% away from my total daily dose of Protophane.

What confused them so much when I went low was the fierceness and intensity of it. Lantus is "supposed" to work for 24 hours, but I was lucky if it worked for 8 - 12 hours for me, and it seemd really super concentrated while it was working.

I woke up in hospital and I couldn't hardly breathe, I couldn't walk, and just to add icing to the cake I was being violently sick from the natural glucagon (not injected stuff).

I hadn't had a hospital trip for over 15 years (I've been a diabetic for about 19), and then my endocrinologist was telling me similar things, that I must have taken the worng dose, that I must have eaten the wrong food...well, I was being extra careful cos chagning two types of insulin at once meant that all my warning signals were gone, I had no idea what was going on so I was testing every 15 - 30 minutes.

I think most of what really upset me was my endocrinologist telling me it was my fault and that he had done everything right and he took no responsibility - I left him and now have a lovely doc, but unfortunately he cannot explain my fluctuations either. It' left me feeling a bit scared to try somehting new, especially as the docs seems to have no clue!

[xMenace]

PUMP!

Thankfully I've never damaged anything important: nearly broken foot, nose, and jaw.

[Philippa]

Hmmm, hta's what my new doc has been hinting at. He also mentioned the idea of admitting me into hospital for about 3 days to do that changeover to Lantus...but I'm not sure I wanna go on it now after all that!
I think I will have to have a think about the idea of a pump. I want to know what's wrong before I try to fix it eh.

[cheryl]

Can I ask if you tried another bottle of Lantus after you tried this one, someone on another forum said they got a faulty bottle and the Lantus was working like a fast acting insulin, just a thought, or it could be it is not for everyone. I cannot get my Lantus perfect at all period, I finally decided to stick with a dose that I am comfortable with that most of the times works for my body, any lower I get higher any more i suffer bad hypo's so I stick with it because day by day and such don't know how much I really need. With all these swinging sugars for you have you thought about a pump, I have gotten really fustrated because even thought lantus or levemir have been a life saver from the nph it is given once every 24 hrs so you can't control what it does at all every hour of your life. So I feel certain times of day i need it more than others that is why I am awaiting a pump because it is very fustrating.....I understand and i do get low with Lantus but any less then what I take i will be higher in the morning so I deal with the hypo I get four days a week till i get the pump oh well such is life.....I don't get bad ones though if I did I would of switched to something else........

Cheryl

[MJM]

I'm currently using Protophane and Actrapid, but I don't have the best control. Over a daily basis my results range from a low 2mmol/L up to possibly 18 or more and back again. I'm type 1, reasonably good fitness, good diet.
The speed of the fluctuations leaves me really tired and worn out. So my old endocrinologist put me onto Lantus and Novorapid, which sent me into the worst hypo I've had in 15 years! I had such a bad siezure they thought I may have fractured my back.
Anyway, I got off Lantus pretty quickly, and back onto my old regemin. Does anyone know the answer to these two questions:
1. Has anyone else had a bad super-sensitive reaction (in blood-sugars) to Lantus? My doctors are stumped as to why I reacted the way I did.
2. Has anyone hurt their back really badly from a hypo? There is very little info online about it.
thanks heaps :fisheye:

Phillipa, I used to use Lantus and Actrapid and had massive fluctuations also resulting in me being put on the pump. I still get highs and lows but not near as many or as severe. Do you count carbs and do you use Carbohydrate Ratios for instance? You may be just taking the wrong amount of insulin. What you eat may also be a factor. Could you have a chat with a dietition on that aspect? Now with me I used Novorapid and Lantus but didn't count carbs (because I wasn't advise to) and in such situations the insulin I was taking for meals was only guessed. Needless to say it wasn't at all accurate. Would you consider spliting the Lantus, i.e. taking some in the morning and the balance at night. I seem to recall that it was a factor in fixing the problem for someone on this forum.You are a diabetic for some time now, so you are aware of the so many factors that have to be taken into account at all times. I'm of the opinion that there is always an answer. The problem though is to find it. I wish you well in your endeavours, but you must keep trying.

[Philippa]

I do a form of carb-counting, and I've been sent back to my dietician, who sez I should be doing ok on what I'm doing now. <sigh> All my specialists say "yes, do this, that's right" and it still doesn't work.:rolleyes: I've got to figure this out cos it's starting to drive me crazy. My doc reackons I should be taking one unit of actrapid for every 10g carbs, plus a base amount for my blood sugar, but I take less than half of that, cos otherwise I spend all day being hypo.

[Philippa]

I only had the one bottle, and I wan't on it very long either, just two days. So it wasn't a very good scientific experiment, but after waking up in that much pain I would have to think very long and hard about trying it again.

[REDLAN]

I'm wondering...

Lantus is one of the new genetically modified insulins - what they've done is switched around one of the amino acid pairs - it doesn't affect the action of the drug, but it does change it's absorption.

change one pair and you get a very rapidly absorbed insulin, change another and you get a very slowly absorbed insulin.

not sure how much it's been tested, but....

...it sounds like the absorption of lantus is not slowed as much as expected - and if your dose is passing thru in 12 hours instead of 20, then you're gonna get monster hypos, and highs.

grabbed some info by googling that may help...

Lantus Insulin (http://www.diabetesnet.com/diabetes_treatments/insulin_lantus.php)

seems to describe your problem.

[Philippa]

Hey thanks, that is quite interesting reading, espcially after my doc had assured me that it couldn't be the insulin! My new doc has said that I seem to react very sensitively to insulin anyway. I am actually wondering if I maybe have some sort of other condition that could maybe be affecting the way I use/absorb insulin. Maybe I'm just one of those "rare individuals"!