Question about Lantus

[Mama2Two]

Back in January or February, at a doctor's appointment for yet another sinus infection (long story), I mentioned to her that I wanted to go on insulin rather than take Met any longer. I was on insulin during both my pregnancies, and just before delivering my daughter, my HgA1C was 5.8 and my FBGs were in the 70s-80s. I felt GREAT! Once I delivered her, they had me stop the insulin and go back on Met. I was taking 500 mg PO BID (total of 2000 mg per day). My FBGs wouldn't go below about 120 and my HgA1C was 7.1. I was not happy.

She agreed, and put me on Lantus and told me to stop Met. She told me to start at 10 iu and every two days go up 2 iu until my FBG was under 100. I did what she said...got all the way up to 34 iu of Lantus, and I still can't get my FBG below 130!! Now, I have bad eating habits. I know that has to change. But I had the same habits, if not worse, during my pregnancy and had great success on regular (long and short acting) insulin.

I really want to do away with the oral meds (I take about 15 pills a day as it is for HBP, GERD, asthma and allergies), and it's a lot of stress on my already-enlarged liver. I've seen many things online (and on here) about taking Lantus in conjunction with an oral med. Is that how it's supposed to be? Was my doctor wrong to tell me to stop the Met? Is Lantus wrong for me?

[Hammer]

Back in January or February, at a doctor's appointment for yet another sinus infection (long story), I mentioned to her that I wanted to go on insulin rather than take Met any longer. I was on insulin during both my pregnancies, and just before delivering my daughter, my HgA1C was 5.8 and my FBGs were in the 70s-80s. I felt GREAT! Once I delivered her, they had me stop the insulin and go back on Met. I was taking 500 mg PO BID (total of 2000 mg per day). My FBGs wouldn't go below about 120 and my HgA1C was 7.1. I was not happy.

She agreed, and put me on Lantus and told me to stop Met. She told me to start at 10 iu and every two days go up 2 iu until my FBG was under 100. I did what she said...got all the way up to 34 iu of Lantus, and I still can't get my FBG below 130!! Now, I have bad eating habits. I know that has to change. But I had the same habits, if not worse, during my pregnancy and had great success on regular (long and short acting) insulin.

I really want to do away with the oral meds (I take about 15 pills a day as it is for HBP, GERD, asthma and allergies), and it's a lot of stress on my already-enlarged liver. I've seen many things online (and on here) about taking Lantus in conjunction with an oral med. Is that how it's supposed to be? Was my doctor wrong to tell me to stop the Met? Is Lantus wrong for me?

Hello again Moma2two! When they put you on Lantus, they always start you off with a very low dosage of 8 units. I did the same thing and it took me a while but I finally got my numbers down when I hit 72 units. That's where I'm at now.

Did they prescribe anything else to control your spikes? Lantus will only control your fasting levels, not your spikes. I was taking Prandin for my spikes but that upset my stomach so I switched to Byetta....much better.(it is another two injections per day though).

I wouldn't be concerned that at 34 units your numbers are still high. Just keep doing like you're doing and increase the Lantus till you see a noticeable improvement with you fasting numbers. It will happen and you'll see it when you get close to the correct dosage.:)

On a side note, I could only get down to a fasting level of 120 using 72 units of Lantus, until I started the Byetta. Once I started the Byetta, my fasting numbers dropped along with my spikes.

[shoreguyy]

i am having a bad time on lantus ...started out at 16units and my blood sugar readings were up in the high 200's and 300's ...totally unacceptable (note i am also taking 2000mg;s of metformin and 2 -10mcgm shots of byetta )...i called my dr and he advised to up my dose of "lantus" to 22 units ...my blood sugar is continuing out of control no improvement even had a couple readings in the low 400's ..i have been a type 2 for the past 10 years and only over this past year has my a1c been over 7 and my blood sugar over 200 and things aren't improving ...when i started the lantus the only modification the dr had me do was discontinue 1 -10mg tablet of glipizide er ...am starting to get really anxious over this...will be calling dr on monday and advising of current status ...am at quite a loss as to why i have deteriorated so ...have been very good at following diet regimens and doing what is right to maintain my health but this unacceptable blood sugar and a1c readings is really getting me anxious and upset which i know only exacerbates everything ...thanks for letting me get it off my chest

[BlueSky]

.....got all the way up to 34 iu of Lantus, and I still can't get my FBG below 130!! .... Was my doctor wrong to tell me to stop the Met? Is Lantus wrong for me?
It sounds like you have a strong DP (blood glucose goes up in the early hours of the morning). Metformin often reduces morning numbers because it inhibits the production of glucose by the liver. It also sounds like you would do better using NPH before going to bed. Unlike Lantus, which has a flat action profile, NPH taken before bed peaks when the DP effect kicks in the the next morning.

[Hammer]

i am having a bad time on lantus ...started out at 16units and my blood sugar readings were up in the high 200's and 300's ...totally unacceptable (note i am also taking 2000mg;s of metformin and 2 -10mcgm shots of byetta )...i called my dr and he advised to up my dose of "lantus" to 22 units ...my blood sugar is continuing out of control no improvement even had a couple readings in the low 400's ..i have been a type 2 for the past 10 years and only over this past year has my a1c been over 7 and my blood sugar over 200 and things aren't improving ...when i started the lantus the only modification the dr had me do was discontinue 1 -10mg tablet of glipizide er ...am starting to get really anxious over this...will be calling dr on monday and advising of current status ...am at quite a loss as to why i have deteriorated so ...have been very good at following diet regimens and doing what is right to maintain my health but this unacceptable blood sugar and a1c readings is really getting me anxious and upset which i know only exacerbates everything ...thanks for letting me get it off my chest

Hi Shoreguy! You should check this with your doctor but if he says it's okay, then you should increase the Lantus by 2 units every few days if your fasting numbers are high. It sounds like you're not at the correct dosage of Lantus yet.

Like I mentioned to Mama2Two, if you keep increasing the dosage of Lantus, you'll reach a dosage that will result in a dropping of your numbers. You need to increase the Lantus until your numbers are where you want them to be. Again, make sure it's okay to do this increase on your own. I think most doctors want you to do this, but it's a good idea to check with them anyway.

You're at 22 units, and that may be too low. I started at 8 units and doing the 2 unit increases, I had to go all the way up to 72 units before it worked for me, so don't be discouraged that your numbers are still high at 22 units.

[mortis505]

Like Hammer said, slowly increase the dosage. When I first started out on Lantus, I was at 18 units per day. Slowly increased until I was at 26. I was also taking a fast acting for meals.

It's a constant tweaking process that needs to be monitored. Patience and practice are the key factors. It can be frustrating, but don't give up.