Lantus---Swings, Correction Factor, how long does food last?

[airtas]

I have some questions

is the reason we need lantus because our bodies use Sugar stores when we eat nothing?


also currently I am taking 30 units of lantus at around 11 PM some days I will go to bed 120 and wake up 90 other days I will wake up 150, why is that?


Should I use more lantus?


Also I want to determine how much 15 grams of carbs increases my sugar levels, after how many hours is it safe to test my sugar?

[CarrieJett]

Your liver is constantly releasing a little sugar, so the lantus deals with that, and gives you a good level base. Your rapd-acting insulin deals with your food. Sometimes you do different activity or eat different food, and so your levels will vary. If you wake up 120-150, you could try more lantus, but you want to be sure to not have night time lows. Are you working with an endocrinoligist? A good one will help you with all of this... I have a very variable schedule of work and exercise, so it has been hard to pin it all down! Goodluck!

[airtas]

I want to test out how much lantus brings me down an hour, how long is a good fasting period?

[CarrieJett]

I think your endo wil have some methods- I have been a big-time DIY diabetic, so I've never done any of the basal testing, etc, but if you have a good doctor it seems like all the tests will help you understand.
The lantus shouldn't bring you down, it should provide a level playing field for your other activities- eating, exercise, insulin.
I definitely recommend reading some books- after I was dx'ed I had no insurance or doctor, but I sat in the bookstore and read the whole diabetic section. That helped!

[Subby]

"Using Insulin" by John Walsh (or "Pumping Insulin" if you are considering a pump at all) are truly excellent books. Pumping Insulin has instructions for testing your basal rates on the pump, which can be extrapolated to long acting insulin use as well. Here's a page for the rules of basal testing, Basal Testing (http://www.integrateddiabetes.com/pump_bt.shtml) and an article on basal testing for MDI. Basal Testing for MDI - Diabetes Daily (http://www.diabetesdaily.com/forum/articles/16675-basal-testing-multiple-daily-injections)

I don't know if a book has basal testing for MDI, someone might know. Feel free to ask questions as you work on this. Don't do anything you are not justifiably confident about, without asking your doctor.

[TommyC1]

We might be able to help more with a little more information.

Type 2 using Lantus as your only insulin? Any other diabetes meds?

Type 1 using Lantus and some sort of fast acting insulin?
Matching your fast acting to your carb intake or on some sort of sliding scale?

Gary Schiener's "Think Like a Pancreas" has basal testing for MDI as well as anything else you might want to know. I own and refer to that often but John Walsh is pretty sharp as well. I've used a good bit of his stuff that is on the web.

[airtas]

what does basal rate mean?


I do not use a pump, I am type 1, Lantus Daily and Humalog Kwik Pens for meals.



The main thing I want to figure out is lets say I am at 45 and having a low, if I eat 10 carbs how long until all those 10 carbs are used because I want to determine the best amount of carbs to treat a low.

[Subby]

Basal rates are similar to long acting insulin like Lantus, but let's just completely forget the term "basal rates" for the moment. Not important. Let's go back to your questions:

I want to test out how much lantus brings me down an hour, how long is a good fasting period?

Basal testing, could be very valuable to you. Your Lantus is your "basal" insulin, basal testing is getting your Lantus dosage right. Sounds like Tommy above, has a good suggestion for a book that will step you through basal testing for MDI (multiple daily injections).

The main thing I want to figure out is lets say I am at 45 and having a low, if I eat 10 carbs how long until all those 10 carbs are used because I want to determine the best amount of carbs to treat a low.

As far as "how long until they are used", you just want the fastest carbs to bump you up to a better number ASAP.

As far as how much to take, a common rule is to start with 15g and see how you go. If you find that this leaves you high some time after the low (say, 20min to an hour) then you might try reducing your normal hypo fix.

But be careful, because sometimes when we treat a hypo, we are not only "bumping" our blood sugar up, we are also fighting active insulin, the requirements are greater. So the amount you need may change each time. The best way is to check your BG again 15 min or 30 min later, and if your blood sugars are not back to normal, have another 15g carbs (or whatever amount usually works for you.) Repeat this check until you are in a safe zone. And be careful for a few hours.

[airtas]

is it common to have 2 different glucose reading 30 seconds apart?

[Granny Shanny]

It's possible (and likely!) to get two different readings from the same drop of blood 10 seconds apart!

[xMenace]

is it common to have 2 different glucose reading 30 seconds apart?

Out of the hundreds of times I've tried this, I've had three ever be the same.


There are basal patterns. These are affected by the sugar output of your liver metabolism and by hormonal releases which affect your insulin sensitivity. Each of us has our own basal "fingerprint". Basal testing is designed to aid us in figuring out what our patterns look like.

On the other side are insulin patterns. Lantus has a fairly flat 24 hour (YMMV) curve. Using just Lantus with a roller-coaster shaped basal curve produces both highs and lows. It can be impossible to manage. But once you and your doctor understand your patterns better, other insulins can be added or even replace the Lantus.

A big advantage of a pump is we can tailor our basal doses to our needs pretty closely. I use 24 hourly basal rates with 16 rate changes. It's posted below for illustration only. Your mileage and curves will certainly be different.

Yellow=my dose Blue=action. If I went off the pump, I'd try to match my basal action to this curve. Please don't ask how I calculate this.
http://www.diabetesforums.com/forum/attachments/diabetes/2337d1185295996-basal-questions-xbasals.jpg

[airtas]

how much of a difference is common to test on the same strip of blood, and why they difference?

[jenb]

I don't know if a book has basal testing for MDI, someone might know. Feel free to ask questions as you work on this. Don't do anything you are not justifiably confident about, without asking your doctor.

Both "Think Like a Pancreas" and "Using Insulin" describe basal testing for MDI. A short synopsis: Don't eat for several hours before begining the test, do a BG test at the begining of the test period, then at intervals during the period; if, at the end of the test period, your BG is within 30 points of the begining level, basal rate is good. Otherwise, adjust up or down as indicated. (Disclaimer...NOT a detailed description of the process)

Jen

[jenb]

The main thing I want to figure out is lets say I am at 45 and having a low, if I eat 10 carbs how long until all those 10 carbs are used because I want to determine the best amount of carbs to treat a low.

If you are using glucose tablets or any pure glucose, you should begin to see a difference within about 20 minutes. Other carbs may take somewhat longer. The glucose action should be done within 1 to 2 hours.

You can test this hypothesis by doing a BG test every 20 minutes after you ingest the carbohydrate. Then calculate the difference between your starting BG and peak BG, divide by the number of carbs you ate and you will have your carb factor determined. Do this a few times and you will develop a good range. For me, 1 gram of carb increases BG between 6 and 10 points. For a low of 45 I would start with 1 4-gram glucose tablet and expect to increase to 69 to 85 within about an hour.

Jen

[airtas]

Why does the same drop of blood get different readings on the same meter?