[Russyo]

Hey guys, I have a quick questions that Im hoping some of you more experienced folks can shed some light on for me. I recently got diagnosed as a 1.5 and am on humalog for my short insulin and lantus for my long acting insulin.

However when I take my lantus at night or in the morning I immediately shoot really high. Most of the time at night I cant sleep because the lantus injection sends me in the mid to upper 200's. Am I doing something wrong or is that just what it does? Any help is appreciated.

For right now I have stopped using the lantus until my next appointment and have been doing pretty good with only the shoot acting humalog. Whats up with this?

[Spbeyond]

I would suggest you not just stop a medication. Call your doctor, ask him what do do. At the very least you can have one of his nurses ask him and get back to you. When is your next appointment?

[Russyo]

agreed. Im gonna get back on the lantus and see what the results are. I am reading alot of other post and see that a lot of people have the same issue and it isnt necassarily the lantus doing the high BG in the mornings. SO Im gonna get back on the lantus and see what comes of it. My next appointment is at the end of January, we are trying to get some time in between my appointments to allow me to experiment and see what combos of insulin work best for me. But I dont really understand the reason for me to take the lantus.

Can anyone explain what a long acting vs. a short acting does. I understand the short acting, but what does a long acting insulin provide for the body. I asked once but got so much info I couldnt begin to understand any of it. Thanks again for the help.

[rocky]

HEY russyo, Welcome to the DF!!!

What the Lantus is doing for you is giving you a basal of insulin over a greater amount of time, like a properly working pancreas does for non-D when the proper amount is given it should keep you in range, for some people it lasts 24 hours, some split the dose and take it every 12 hours. It wouldn't be the reason for your high numbers after you have taken it. One thing that might be causing that in the evening is you are not covering your food with enough humalog at supper time. Just a suggestion. I was on Lantus before I started my pump and once it is fine tuned to suit your needs it is wonderful stuff.

[Russyo]

thanks Rocky. Im slowly learning all this new info so every new thing or thought helps me alot. I think Im taking the fast acting humalog and it drops me pretty quick after the meal like an hour or hour and a half and then I think Im fine, but Im finding out that the food is still not done be processed and then I go to bed and I start to climb back up again. This means I def. need to get back on the Lantus because it will help me alot and will probably help me lower my humalog some. Thanks guys for all the help.

[xMenace]

Russ, your liver constantly releases stored sugar into your bloodstream. Stored fat also gets converted but slower. There's a lot of biology there, so just accept that there's a constant background supply of glucose that needs to be covered.

One thing your doctors or diabetic educators will not tell you is that each of us has a unique pattern. I call it a basal profile. Us pumpers can put a lot of effort into determining our patterns and matching our basal insulin releases to it. This gives us much better control and much more flexibility to eat or not eat as there are no periods requiring food. This variation is largely due to our liver releasing hormones which make us insulin resistant. Search for Dawn Phenomenon.


The problem with basal insulins is they are smooth and flattish. If you have a humpy profile like me, you have times of the day with not enough insulin and other times with too much. These inefficiencies often lead to hypos, hypers, and weight gain as we add food to compensate. Dual dosages can help, but it's nowhere near as good as pumping. My profile is attached. The yellow is my dose and the blue the effectiveness.



The following image is of different nighttime patterns. It is important to know which pattern you fall into not only to treat effectively but to prevent nasty hypos while sleeping. I fall into pattern D which is the most common and hardest to manage. Search for Symogi Effect.



You may find this document helpful. BD: Problem Solving and Exercises

My personal opinion is you take Lantus to cover all the lows and suppliment with a short or medium acting to cover all the spikes. The trouble is that would mean me waking up at 5am to bolus.

[owlyn]

Thanks for the overnight charts. I didn't know that this was so common. I am also a type D. Your explanation and graph of background glucose is great. It makes me reconsider going onto the pump (never was on it, but thought about it). Who knows, if I can get good control on the pump, maybe I can give up exercise

[Russyo]

it seems that Im either a b or c. Im gradually rizing throughout the whole night. I wake up with pain in my feet usually around 3am and run in the 200 range, so I usually take some humalog(short acting) then go back to bed, and then I wake up still in the 200 range. So If I didnt use the humalog Im guessing I would steadily rise into the upper 300's maybe even a 400. So I will try to start mapping those better. I also shoot pretty high right after eating and the foot pain gets bad, then about 2 hours after eating and taking the humalog I come back down some and the foot pain goes away.

I honestly dont know a thing about how to map, and the pump and different types of insulin and what they do to me. I feel that I need soo much more education, I very glad I found this site and have you guys help now. Thanks to all of you, beginners and oldies.