on new insulin/appointment

[-sammy-]

so like i went to see my diabetes nurse today to sort out what i have to do because i have never been able to get my sugars right and they have always been all over the place. sky high one day, really low the next.

and she changed my insulin to lantus, long acting one.

and because of my eating disorder, she said it will help me more, and wont really make me go low if i dont eat and take my insulin. and if i do eat to just tke novorapid to cover the food, which is better for me. which i think will not stress me out as much.
so i take lantus at night and just keep trakc of my sugars and shes going to phone me tomoro or wednesday.
i hope this gets my sugars under better control.

is anyone else on lantus?

its supposed to be one of the best insulins around because it lasts 24 hrs and just stablises the sugars straight through.

i just hope this one is finally the right one for me :)

also i have another appointment friday with a diabetes consultant, probably to talk about why i was in hospital.

pooooo

lol

:)

[xMenace]

its supposed to be one of the best insulins around because it lasts 24 hrs and just stablises the sugars straight through.

i just hope this one is finally the right one for me :)


For many if not most, Lantus does a good job. Many split their doses in practice, it often does not last 24 hours.

It is also spikeless. That might seem a good thing, it probably is, but many of us do not have flat basals. I read an article once, and of course I can't find it again, that suggested 35% of us have very up and down basal patterns. I fall into that category. Lantus almost killed me. I've resolved my issues by pumping. Knowing what I know now, I could make Lantus work, but I'd have to augment it with other insulins to match my crazy patterns.

Good luck. Test in the middle of the night. That's the most dangerous time. You're trying to determine your tendency compared to before bed: flat, rise, or fall. If the latter, you'll likely have high morning numbers to deal with. Search for "Dawn Phenomenon."

[-sammy-]

oo thanks. yeh my nurse told me about dawn phenomenon. and she did say i will have high numbers in the orning, like i always do anyway lol.
i have crazy sugars too.

[UpNorth]

It sounds like you'll have better chance to gain control now anyways! Once your Lantus dose is right for you, you should be able to be quite steady even if you skip a meal.
I've been on Lantus, the first months with Diabetes, then i started pumping and when i went back on MDI i switched to Levemir as basal instead. They're quite similar, but i find Levemir works better for me than Lantus did. Both insulins are great though :) I've been on Novorapid since diagnose (just had Humalog in my first pump for a while) and it's great stuff for me at least.
If you can't handle poking your fingers too many times per day, try to do it at least in the morning and evening and maybe a couple of times through the day. It's especially important that you test as much as you can handle now in the beginning with Lantus so you know if your dose needs to be changed or not.

[-sammy-]

yeh i know thanks. my nurse told me to cheak it defo in the morning.

but today yeh i did 6 units novorapid with my dinner like she said. then she writ post meal and blah blah on a piece of paper and how much to give myself and im not sure if i inject again 2 hours later aswell as before i eat my dinner.

and if my sugars are high in the morning i have to up my dose of lantus 2 units every two days.

obvoiusly there gonna be high at first as my body gets used to this new insulin.

i have to go one one of those 72 hr things to check what my blood sugars are aswell i think on monday.

[UpNorth]

It can take a few days for Lantus to reach its full effect, so you might not notice much difference after just 1 or 2 injections with it. So don't be disappointed if it seems like it doesn't work well for you the first couple of days.

Ah, so they're going to run the 72h on Continous bloodglucose monitor on you. Hope that will give some answers too :) I've never been on one of those, but i've heard they're helpful.
My basal profile is pretty flat and most of the time my bloodsugar is fairly predictable, so there hasn't been any need for me to have that 72h test. I test a lot too, and even sacrifice my sleep every now and then and test at night when i have time for it :T

But i really hope this will work for you :)

[-sammy-]

yeah i hope it gives some answers because even my diabetes nurse dont know whats going on lol. so i hope its helps it should do though.

and thanks for chatting with me :)

i should test in the night aswell because i sometimes dont sleep very well. lol

[UpNorth]

If you're awake, you might aswell use that and test :) I test a lot in nighttime if i'm up late. Been up to 4am a couple of nights lately, and those nights my fingers were even more abused than normal:D I was up anyways, so now i know what my sugar looks like until that time these days :)

[Gary_W]

yeh i know thanks. my nurse told me to cheak it defo in the morning.

but today yeh i did 6 units novorapid with my dinner like she said. then she writ post meal and blah blah on a piece of paper and how much to give myself and im not sure if i inject again 2 hours later aswell as before i eat my dinner.

and if my sugars are high in the morning i have to up my dose of lantus 2 units every two days.

obvoiusly there gonna be high at first as my body gets used to this new insulin.

i have to go one one of those 72 hr things to check what my blood sugars are aswell i think on monday.

Whoa there!

Before you go upping it by 2u each time to 'get your morning sugars down', realise what Lantus is supposed to do. It is supposed to make your morning blood glucose reading the same as the one you went to bed with. If you are going to bed high, you should wake up high. The 'up it by 2u until you wake up level' is NOT good advice as it assumes that the patient is going to bed at a reasonable blood glucose. Taken to its ultimate conclusion if you keep upping it, you'll be forced to eat before bed to avoid night hypos.

Go to bed as a safe blood glucose and test before bed. Test at 3am and then test in the morning. Only if you get a rise in BG overnight do you go raising the Lantus dose. Once you raise it, don't do anything with it for at least 3 days as Lantus takes 2-3 days to settle down after dose adjustment.

Once you have a stable basal, learn to carb count and you'll find that diabetes becomes a lot more manageable.

Most Diabetes nurses crack me up.... Sorry for the sweeping statement, but it is advice like this that caused me to be ill for years :mad: I had exactly the same advice and did not understand what Lantus was supposed to do. For that reason, I ended up on 35u per night when I actually needed 20u. And that really is no fun at all.

Gary

[DanG]

Search for "Dawn Phenomenon."

Tell me about Dawn Phenomenon - in your words, not some medical diagnoses that turn out to be either too long to comprehend, or arcane, or not specific.

I think I have read here that some do not have DP?
Can we train our physique against DP effect?
I used to do lantus at night, but now do it at breakfast. I wake up at what I go to bed. Assuming lantus doesn't last 24 hours, I would guess I do not know DP?

I tried the split lantus, but had severe hypo, so I quit that right away and have been happy with AM lantus for a while now.

Thanks for any experience about DP any can offer, or ideas about fooling out body against DP, etc.

[Gary_W]

Hello Dan,

Our bodies vary through the day in terms of the amount of insulin our liver squirts out per hour AND in terms of how resistant we are to insulin. There are apparantly hormones that we produce at certain times of day which make us a bit more insulin resistant.

Everyone varies in the times of day when this kind of thing happens and in the extent to which it happens, but the most likely time for a person to suffer is in the early hours just before waking up. Your liver gets ready to start the day and gives out a healthy slug of glucose so you have something to work with until you eat and then your body also produces the insulin resistant chemicals. As you are not moving around a whole bunch to burn this off, this tripple whammy effect makes your blood glucose goes high. This is Dawn Phenomenon. It can last well into the morning and is what makes breakfast a very tricky meal for a lot of us.

I never used to get DP to a great extent. My body, in its wisdom, changed and now I do. I currently pump in 0.8u per hour from 4am through to 9am. When I go to bed, I am only putting in 0.2u per hour. It used to be less at this time, but vive la change.... My body requires very little insulin in those early hours, especially compared to the DP busting dose from 4am. Not doing it this way results in me getting a nasty visit from the Sugar Reaper at 3am and then being very high in the morning. That's what Lantus did to me in the end. Whilst it is not an entirely flat insulin, it's a lot flatter than I need for the overnight pleasures.

If you are doing Lantus in the morning and it keeps you flat overnight, it seems likely that you don't suffer from DP currently so you don't need any neat tricks to fool it (if indeed any such things exist). Long may it continue, as life is a whole bunch easier when this stuff does what it's supposed to... I don't think you can stop your body doing it as such, just try and manage it with the insulin. It's pretty straightforward on a pump, but on shots it can be a complete pain in the rear end to sort out if it's bad. Some folks do NPH before bed (so the peak corresponds with DP). Come what may, it isn't fun.

Hope this answered your question. I know you asked John, but I'm awake and I'm guessing he's still in bed suffering from DP as I type :D

Gary