yet another lantus question

[christie]

i don't see the endo for 6 wks,but my morning b/s have been running high,like this morning i was 200,so i take lantus 2x a day,so which one should i increase to combat the am high.

[LancetChick]

If your morning highs are caused by dawn phenom, increase the night dose if that's the route you want to take. I don't take my Lantus at 12 hour intervals, I take it at noon and at 8:30PM so that it's firing on all cylinders in the AM (it doesn't last 24 hours with me), but I don't increase the Lantus dose to cover DP, since I'd go low later in the day. Instead, when I'm on a DP wave, I take a little NPH at bedtime, which seems to cover it well. Or else drink a bottle of wine.

[christie]

i take my main dose in the morning and i take 3 units at night since it does'nt last 24 hrs for me.so i will increase my night dose.

[JasonJayhawk]

If it helps any, you might explore just taking a couple units of fast acting in the morning.

I take my basal insulin twice a day, and do fine during "fasting" tests, with the exception of waking up in the morning.

No matter what, without a question, I find that I need a couple (variable) units of fast-acting as soon as I get up in the morning. If I wake up and test, I can be in a decent range, say, 100 mg/dl, but thirty minutes later, test me again, and I could easily be at 180 mg/dl.

Depends on how quickly you test upon waking up.

And if you suddenly change your routine (e.g., exercise, higher or lower-fat meal before bed), you'll find with time that even adjusting your basal by a unit or two can help your outcome!

And then, just when you get it down, your body finds a new routine...:T

[christie]

i test everyday before i get out of bed,i do take humalog as soon as i see i'm high,last night i increased my lantus to 4 units instead of 3 and this morning i was 27 yesterday i was 200,its really frustrating for me.

[Erin]

could you be going low during the night to cause the high?

And why the AM "big dose" of Lantus? Were you having lots of lows with a PM "big dose"?

I like to have the Lantus firing on all cylinders at night (when I am not eating and taking fast acting) because I find that I can cover any drop off in lantus coverage during the day with my fast acting. (this way I'm guaranteed to have good bsl's for 1/3 of my life (when I am sleeping), with 0 % effort)

[christie]

well the quack endo i had at the time i started lantus gave me a bottle and sent me on my way without telling me anything,he did say oh it only lasts this many days,etc,so he only said take it the way you did when you took u which like that i so thats how i started with it so i asked my new endo about it and he said it was ok to take it am since i was used to it that way.as to lows at night,who knows if i wake up i always check but i am one of those who don't wake up during lows.

[Erin]

Hrm... kick the idea of a pm lantus dose with your doc... I really find it works well that way.

and I'd set the good old alarm clock for about 3am for a few nights, just to see what was going on in the wee hours, before making any more changes.

[grace girl]

I take lantus 2x daily, and I take a much larger dose in the morning than at night. Before making changes you should definately do some night-time testing to make sure you know exactly what's going on.
If you're not going low at night, then rebounding with high, I would slowly increase the night-time dose. Remember that it takes three days (at least) of a new dose to see the actual results.
Good luck!

[christie]

i really can't set an middle of the night alarm cause my daughter sleeps in my room.my endo's philoshopy is if its not bad broke don't fix it,that was what he said when i asked about changing to nighttime lantus.thats about the same thing he said when i asked what his feeling about the pump was.