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Not enough lantus

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#1
oneluckyplay

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Lantus is supposed to keep your BG levels normal went you don't eat. So i have been trying to test that theory but find it very difficult. I realized i never go more than 5 hours without Humalog in my system unless i'm sleeping. i nomally only eat twice a day, the rest is corrections.that doesn't sound the way it should be to me. i have really bad DP and that is what i'm trying to control. i found that if i eat with in an hour of getting up my BG still rises but not as much as if i didn't eat. From 8:30 am to 12:30 pm is my worst time of the day, it's always high no matter what, after that it's usually pretty normal BG the rest of the day. i've slowly been raising my dose of lantus but wonder if splitting it would do a better job or different time of day might help. i know a pump would help a lot but at this time it is not an option. any ideas would be helpful.
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#2
DCaplinger

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Some schools of thought say that your basal insulin should account for 50 - 60% of your Total Daily Dose (TDD) of insulin. In order to do a proper basal test, you do need ot skip a single meal and test your sugars. It's easiest to skip breakfast to start.

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#3
ant hill

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i've slowly been raising my dose of lantus but wonder if splitting it would do a better job or different time of day might help. i know a pump would help a lot but at this time it is not an option. any ideas would be helpful.


Yes splitting Lantus is the go and do it 12 hours appart. ;) The highs in the morning is a sign that the Lantus that you take at night is not lasting the 24 hours as they say it would so but taking it in 12 hours would give a flatter reponce. And please test test test. :D

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#4
BlueSky

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... From 8:30 am to 12:30 pm is my worst time of the day, it's always high no matter what, after that it's usually pretty normal BG the rest of the day. i've slowly been raising my dose of lantus but wonder if splitting it would do a better job ...

You can try splitting your Lantus, but it may result in even higher blood sugars in the morning. Bear in mind that the Lantus action profile looks something like the bottom line in this graph:

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You may have better luck by switching to Levemir (the middle line in the graph), as it does have a bigger peak at 8-12 hours. If you inject most of it befire bed, it will peak the next morning, which is where you are having problems. You could also consider using NPH, but variability in action is weakness of it.
In my humble opinion :wink:

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#5
owlyn

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Until recently, I had the same problem. I wound up splitting my Lantus this way:

wake up (6-7 am) 24 units
before bed (11-11:30PM) 8 units

This has give me perfect fasting numbers and better control throughout the day. If you look at the action curve in a previous post, you will see that the bedtime dose makes sense for morning fasting, as the small peak that Lantus has happens starts just before waking, when the DP is taking effect. If you start out good, keeping control the rest of the day is easier. You may need to adjust the timing of the evening shot. I started out doing it with dinner, around 8PM, but I found that I was going hypo around 2am. That's why I moved it to later.
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#6
oneluckyplay

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By what the chart is saying my lantus is peaking between 8 am and 9am, i take lantus at 11 pm, that's why i think i need a bigger dose but i'm concerned about the rest of the day with lows. example: last night went to bed around 2 am BG was 96, now when i wake at 8:30 am it was 279. normally when i wake it is around 95 and then it starts to go up. today was not the norm. so i have to figure out if i went low or was it DP. i'm thinking i went low because i had to have 2 glucose tabs before bed because my BG was starting to drop, (62)at 1am. i am wandering how splitting my dose would help, it's not possible that the lantus is running out after only 9 or 10 hours. if i split it and take it at 11 am ( being 12 hours apart) then my DP already kicked in before i even take that dose. so i don't think that could help contol my DP.
Type -1 since 1997
6/08 A1C 6.4
9/08 A1C 6.0
12/08 A1C 6.4
2/09 A1C 5.8
Animas Ping 2/09

#7
BlueSky

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Levimer might do a better job because it has more of a peak and is not as long acting as Lantus. NPH is even better for fight the DP. If neither of those work, you will have to get a pump. :D
In my humble opinion :wink:

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Type1 since 1977
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