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Sliding scale for Lantus dosing?

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#1
SB_Krista

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Hello all, do any of you use a sliding scale for Lantus dosing at bedtime? I've been taking Lantus at bedtime for about a month and I never seem to get any type of consistent morning blood sugar reading with the same dose. I use 8-10 units, and each waking reading is different, sometimes with hypo episodes with a dose that left me in the 110-120 range previously!

I've been basing my bedtime dose on the response to the previous night dose/morning reading, and I'm starting to wonder if it makes more sense to take a bedtime blood sugar reading and figure my Lantus dose solely on that. So, if any of you use this method, what type of sliding scale do you use based on your bedtime blood sugar reading?
~Krista :)
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Type 1.5 since Aug'09
Currently taking 14 units Lantus at bedtime, and 100 mg Januvia in the a.m.
Follow low-carb diet
Also take Simvastatin 10 mg, once a day and one baby aspirin at bedtime
Exercise regularly/daily
Just added 1000 mg fish oil supplement to regiment for dry eye syndrome
Feb'12: HbA1c = 6.2; Nov'11 total cholesterol =183 (HDL=96, LDL=79. VLDL=8), triGlyc = 39

#2
dbc

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I have never used a sliding scale for anything - yet. . .

I figured out my Lantus dose by specifically testing to "measure" how much basal insulin I need. Basal needs testing is simply a day of fasting with regular (every 1 or 2 hours) BG testing. Without food intake, your BG should remain fairly stable over the time. If it drifts up, you need more basal, downward drift means less basal.

Whatever Lantus dose changes you make, I think you should give the change a chance to have a consistent effect before changing again. Make a change, check the results over 3-4 days, then decide whether another change is needed.

I also split my Lantus dose, morning & evening. There's a fair amount of experience on this forum & elsewhere indicating that Lantus doesn't last 24 hours for everybody, so doubling the number of shots (which is not a problem for me) ensures that I don't have to deal with that problem

#3
Sneezer

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Lantus is not an insulin that you would use a sliding scale or an evening BG reading to help dose. It is for most folks a 24 hour insulin dose and is not to be used to bring down an elevated BG in a short time period. Your Lantus dose should be about 40% - 50% of your total daily dose of insulin.

Has your Endo given you a starting dose for Lantus? If so and it is not working your DE should be able to help you test to see how much you should adjust your basal insulin (Lantus). If you adjust your Lantus dose you should stay at that dose for a few days before you assume it is not working correctly.

#4
betsyz

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You may try talking to your doctor about splitting your Lantus dose into a nightime dose and a morning dose. I realize it's twice the injections, but it really helped me to deal with low episodes I kept having, and my RNP recommended it because of my sensitivity to basal. Your nighttime dose will impact the next morning's BG and your morning dose will impact that evening's BG. I take more at night than in the morning, basically a 60/40 split rather than 50/50 in order to avoid evening lows. It made a big difference for me. Also, I take a little less Lantus if I am planning strenuous or extended exercise, and more when sick or menstruating, so I suppose that is a little bit of a sliding scale...




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