Grab your hat, Gracegirl's asking 1000 questions again!

[grace girl]

In my never ending quest for perfection, here it goes!

If you have a day where you are more active than usual all day long, and you don't eat anything at all after supper....no snacks, nothing....do you experience a bigger drop in bg over night?
I've been doing so well overnight, then yesterday, busy all day long...much more so than usual, ate nothing after dinner and had yet another massive over-night drop. Humalog given at 5:15, went to be early, around 10:30, so it wasn't humalog. I was at 200 when I went to bed, and I was going to give a correction, but I just had this sense that I shouldn't, so I didn't. Woke up at 7 am at 80. I'm only taking 4 units of lantus at night....I'm not going to drop it again for this one thing, I just want to know if this is a usual experience.

[xMenace]

Ya.

You do know that Lantus can last a looong time. Lantus Activity (http://members.tripod.com/diabetics_world/lantus_activity_curve.htm)

[David]

I'll answer yes to that question. Being very active for a long time can cause delayed hypoglycemia hours later. That's one circumstance when I'll do a 2 AM check. Here's more info:

Low Blood Sugars Or Hypoglycemia In Diabetes (http://www.diabetesnet.com/diabetes_control_tips/hypoglycemia_prevention.php)

>>>Prolonged exercise or activity can cause the blood sugar to fall for 24 to 36 hours afterward. After a day of increased exercise or activity, it is wise to reduce the carb bolus for dinner and the evening basal dose as well. Extra free carbs at bedtime that you do not balance with a bolus are also wise.<<<

Pediatric Advisor 2006.2: Diabetes: Insulin-Reaction Hypoglycemia (Low Blood Sugar) (http://www.med.umich.edu/1libr/pa/pa_hypoglyc_hhg.htm)

>>>Delayed hypoglycemia means your child has low blood sugar several hours after exercising. It may occur 3 to 4 hours or up to 12 hours after exercise. This can sometimes cause an insulin reaction in the middle of the night.

To prevent delayed hypoglycemia:

* Lower the insulin dose, especially the long-acting insulin, after heavy exercise even though the blood sugar may be high.
* Eat extra carbohydrates at bedtime (even with high blood sugar).<<<

David

[kel4han]

I have days of crazy activity, like yard work ALL day, house cleaning ALL day, I mean for 8hours or so. I will always be much lower the following AM, and even most of that following day! I have to change my ratio from 1:15 to like, 1:25 to keep from lows. Crazy. I guess I could just eat an extra no count snack! DUH! Should have done that sooner!

[grace girl]

Ya.

You do know that Lantus can last a looong time. Lantus Activity (http://members.tripod.com/diabetics_world/lantus_activity_curve.htm)

I think I'll print that out and take it to my endo next visit! They really think I'm crazy when I tell them that it can drop me like it does...even though I only get about 20-22 hours out of a dose.
I think all of that "peakless" talk is total bs....at least in my case. I know you read my post about how I'm reducing it. I've got my am dose down to 13 units and I'm still dropping 80 points when I do the am test....and remaining steady all afternoon. I'm beginning to wonder just how little I'll be using when I get this right. Shocking when I stop to think about how much they pushed me and pushed me to take 26 units total a day!

I'm starting to think that a nightime snack is going to have to be a part of my life just for comfort level.

[LancetChick]

If you think that the "peakless talk" about Lantus is baloney, you may be one of many who just can't get along with it. Ask your doctor about Levemir, which seems to satisfy Lantus haters pretty well. About the activity changes.... this is oddly similar to my reaction to alcohol in that I need to reduce my basal a couple of units the first night, more the second (assuming the increased activity continues), more the third, by which time it has reached a plateau and no more adjustments are needed as long as the activity continues. I get the feeling my reaction is pretty unusual, but it's something to keep in the back of your mind so that you aren't confounded if you react the same way.

[SueM]

Lantus is not peakless.
The manufactures have changed the wording of the blurb on their advertising due to a lot of people finding out the hard way it is not peakless.

[LancetChick]

Lantus really is peakless for some (like me), just not everybody. It seems that the absorption rates can vary greatly from person to person, with some having no peak at all, to those who have severe peaks that alternate between Humalog-like activity to no activity at all.

[cheryl]

If your really active all day long it appears lantus will be a bit peaky, but it is technically because your body doesn't really need the insulin for all the activity, I know I have had days like that, on lantus completely utterly active, and I actually had snacks and ate like a normal person.....not being a diabetic and eating, that is why i chose to pump just cause I know there are time's where I am way too active and didn't want to deal with it. Girl it was just a fluke day, as long as it doesn't happen everyday and u see this only happens when your extremely active, just keep notes so you know eventually how to deal with it for those extrememly active days.....


Cheryl