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09-01-2009, 12:24 PM
|  | Junior Member
I am a: Type 1.5 | | Join Date: Oct 2008 Location: Santa Barbara, CA
Posts: 38
| | | Lantus question
I've just begun using Lantus at bedtime to bring my morning blood sugars down, and for the first 7 nights, it worked wonderfully. I've been awaking in the 80's and 90's! 
Last night, I took my usual dose, 7 units, and awoke at 122. Very odd....it's as if I didn't take it at all cuz' that number is more like what I used to awake at before Lantus. My 2 hr post pranial last night after dinner was normal. So, what I'm wondering is...is this normal?...to some times have mornings when it appears the Lantus did not work or was not absorbed properly? I KNOW I took the injection last night at bedtime, so it's not that. I'd appreciate any comments relating to your experience with Lantus and morning readings.
__________________
~Krista 
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Aug '08: Type 2 mis-diagnosis; tried metformin er with limited success (HbA1c dropped from 7% to 6.5%)
Jun '09: Fasting C-peptide=0.86 and GAD-65 Ab=5.0 ==> new diagnosis of type 1.5! 
Jul '09: off metformin er completely; taking Januvia 100 mg/day with BMI down to 21
Aug '09: HbA1c=6.7%; Endo adds nightly Lantus (10 units) to help with elevated basal blood sugars => HOPE THIS HELPS! 
Oct '09: HbA1c=6.3 YEAH! Lantus is doing its job!
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09-01-2009, 12:32 PM
|  | Senior Member
I am a: Type 2 | | Join Date: Jun 2009 Location: Missouri Ozarks
Posts: 1,886
| | | It might be just the meter variance too . . . did you test more than once?
I wakened today registering 88. Now I KNOW that's too low for me. I retested & came up with 103. That's lower than usual, but still in line with what I've been trying for, and I have actually HAD 103 fbg once before.
__________________  "Reputation is what others know about you.
Honor is what you know about yourself." Lois McMaster Bujold "Courage is not the towering oak that sees storms come and go;
it is the fragile blossom that opens in the snow." Alice Mackenzie Swaim
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09-01-2009, 12:36 PM
|  | Super Moderator
I am a: Type 2 | | Join Date: Dec 2006 Location: Knoxville, TN
Posts: 10,080
| | | Do you think you might have went low in the early morning hours causing the higher number on waking? My BIL was on Lantus and he had several nights/early mornings he'd wake up in a sweat and check and be quite low.
__________________
T2, diagnosed 8/31/06.
Metformin 500 mg twice daily
HCTZ 12.5 mg every other day for BP
Enalapril 20 mg 1 daily (ace-inhibitor)
Lower carb dieter (approx. 75 total carbs/day, more on weekends), taking chromium, multivitamin and fish oil tablets
Initial A1C 8/06: 9.6
11/06: 6.2.
03/07: 5.3
06/07: 5.4
10/07: 5.3
05/08: 6.2 (after dealing with shingles & bronchiti)
2/09: 5.5 |
09-01-2009, 12:38 PM
|  | Senior Member
I am a: Type 1 | | Join Date: Jun 2006 Location: New Brunswick Canada, eh
Posts: 8,672
| | | This is by nature a variable disease. I was 12.5 mmol (225) myself this morning after a 4.8 (86) bedtime reading. It could be a number of things like poor absorption, a higher than normal dawn hormone release, or the almost full moon. It's probably not Mars. Mars is an awful long ways away right now.
Once is not a trend. Tell us what tomorrow brings. |
09-01-2009, 12:42 PM
| | Senior Member
I am a: Type 1.5 | | Join Date: Feb 2009 Location: KCMO
Posts: 5,429
| | Quote:
Originally Posted by xMenace  It's probably not Mars. Mars is an awful long ways away right now. | Could be LACKAMARS, however ...
__________________
Linda Initial A1c Feb 6 09: 12%
Aug 24 A1c (MD office) 5.5%
Jul ... C-pep 1.3, GAD-65 > 30
metformin 1000 mg BID
Simvastatin 80 mg
Ramipril 5 mg
T4 125 mcg
baby aspirin
Vitamin D3, 2000 IU (blood values normal, advised to continue this dose by endo)
CoQ10 100 mg
Eating 70 - 90 g carb per day
Interval training on recumbent cycle
BMI is down to ca. 25.8 According to Joslin's Diabetes, 2005 ed., 5 - 30% of those diagnosed as Type 2 actually have LADA. |
09-01-2009, 03:29 PM
| | Junior Member
I am a: Type 1.5 | | Join Date: Oct 2008 Location: Santa Barbara, CA
Posts: 38
| | | You are absolutely right, xMenace...once is not a trend. I plan to repeat my normal dose again tonight and see what tomorrow brings.
I did not re-test, nor did I have any troubles sleeping or waking up in a sweat. Maybe it is the moon....
It's been ~15 yrs since I've had a hypo episode while taking insulin during pregnancy...but I do remember what they felt like....not fun!
__________________
~Krista
-----------
Aug '08: Type 2 mis-diagnosis; tried metformin er with limited success (HbA1c dropped from 7% to 6.5%)
Jun '09: Fasting C-peptide=0.86 and GAD-65 Ab=5.0 ==> new diagnosis of type 1.5!
Jul '09: off metformin er completely; taking Januvia 100 mg/day with BMI down to 21
Aug '09: HbA1c=6.7%; Endo adds nightly Lantus (10 units) to help with elevated basal blood sugars => HOPE THIS HELPS!
Oct '09: HbA1c=6.3 YEAH! Lantus is doing its job!
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09-02-2009, 09:43 AM
| | Member
I am a: Type 1.5 | | Join Date: Apr 2009 Location: Berkeley, California
Posts: 352
| | | I'm pretty stable on my Lantus dose, nearly always 80s and 90s, but sometimes have occasional unexplained forays over 100 and less often 120. Like everything with insulin I've learned that occasional is not a cause for concern, a pattern is.
__________________
July 09: Back in the Motherland! Now eating as a vegetarian-eating-disordered- diabetic-foodie becomes an adventure in creativity not an exercise in futility!
A1C 5/09-7.2
11/09-6.5
Lantus - 10IU
Apidra Bolus
Synthroid 125mcg
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09-02-2009, 02:41 PM
| | Junior Member
I am a: Type 1.5 | | Join Date: Oct 2008 Location: Santa Barbara, CA
Posts: 38
| | | Today's morning reading was 115, so that makes two days with 'abnormal' wake up readings. Question is...should I adjust my bedtime dose up from 7 units? The Endo originally told me to start with 7 units and increase 1 unit every 2-3 days until my morning readings were 90-110. Thing is, the very first time I took 7 units of Lantus, I awoke in that range, and the following mornings was consistently in the 80s and 90s. So, I never adjusted upward with my dose. Should I now?
__________________
~Krista
-----------
Aug '08: Type 2 mis-diagnosis; tried metformin er with limited success (HbA1c dropped from 7% to 6.5%)
Jun '09: Fasting C-peptide=0.86 and GAD-65 Ab=5.0 ==> new diagnosis of type 1.5!
Jul '09: off metformin er completely; taking Januvia 100 mg/day with BMI down to 21
Aug '09: HbA1c=6.7%; Endo adds nightly Lantus (10 units) to help with elevated basal blood sugars => HOPE THIS HELPS!
Oct '09: HbA1c=6.3 YEAH! Lantus is doing its job!
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09-02-2009, 03:11 PM
| | Member
I am a: Type 2 | | Join Date: May 2009 Location: Dallas, TX
Posts: 101
| | | When I started Lantus I was given a sliding scale to adjust my intake to keep my fasting blood sugar between 80 and 100. I adjust down or up as needed. If you've not made any adjustments you might want to call your Endo and confirm but it sounds like you do need to up your dose. My Endo had me use a 3 day average to figure out when to adjust. |
09-02-2009, 03:27 PM
| | Junior Member
I am a: Type 1.5 | | Join Date: Oct 2008 Location: Santa Barbara, CA
Posts: 38
| | | I like that approach, sridder. I would call my Endo but I happen to know he is on vacation for 3 wks as I saw him in late Aug the day before he left. Taking the average of the last 3 days seems like a good approach (i.e. not knee-jerk reacting to one high reading). Could you explain the sliding scale you used?
__________________
~Krista
-----------
Aug '08: Type 2 mis-diagnosis; tried metformin er with limited success (HbA1c dropped from 7% to 6.5%)
Jun '09: Fasting C-peptide=0.86 and GAD-65 Ab=5.0 ==> new diagnosis of type 1.5!
Jul '09: off metformin er completely; taking Januvia 100 mg/day with BMI down to 21
Aug '09: HbA1c=6.7%; Endo adds nightly Lantus (10 units) to help with elevated basal blood sugars => HOPE THIS HELPS!
Oct '09: HbA1c=6.3 YEAH! Lantus is doing its job!
|
09-02-2009, 04:49 PM
| | Member
I am a: Type 2 | | Join Date: May 2009 Location: Dallas, TX
Posts: 101
| | | As I understand it the sliding scale is different for different folks but mine was to adjust based on my 3 day fasting BG average. I find my average and adjust accordingly:
120-140 - increase dose by 2 units
100-120 - increase dose by 1 unit
80-100 - maintain dose
60-80 - decrease dose by 2 units
If your Endo is out of town but said to increase by 1 dose then I'd stick with that. Check 3 days in a row; take average. Adjust. Check 3 days in a row; etc. Note - the adjustment can sometimes require normalization. I'm decreasing my Lantus at present and the first morning after a 2 unit decrease it usually jumps up to 100 or even 115. But the 3 day average normalizes back to the target range. I hope this info helps you! |
09-02-2009, 04:52 PM
| | Junior Member
I am a: Type 1.5 | | Join Date: Oct 2008 Location: Santa Barbara, CA
Posts: 38
| | | Thanks, sridder. That looks like a reasonable sliding scale. I will wait til' after tomorrow morning reading cuz' that will be day 3 and take an average to see where do go. Since I'm new to Lantus, I was going to go in 1 unit increments.
__________________
~Krista
-----------
Aug '08: Type 2 mis-diagnosis; tried metformin er with limited success (HbA1c dropped from 7% to 6.5%)
Jun '09: Fasting C-peptide=0.86 and GAD-65 Ab=5.0 ==> new diagnosis of type 1.5!
Jul '09: off metformin er completely; taking Januvia 100 mg/day with BMI down to 21
Aug '09: HbA1c=6.7%; Endo adds nightly Lantus (10 units) to help with elevated basal blood sugars => HOPE THIS HELPS!
Oct '09: HbA1c=6.3 YEAH! Lantus is doing its job!
|
09-02-2009, 05:15 PM
| | Member
I am a: Type 1 | | Join Date: May 2009 Location: TX
Posts: 488
| | | I consider 3 days of consistenly abnormal readings as a trend.. 2 days could just be 2 days off.
I need more insulin from the time I ovulate to when AF starts.. so it's constantly variable for me.
__________________
Sarah, T1 since 2000
PINGing Apidra along with Dexcom 7+
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09-03-2009, 03:00 PM
| | Junior Member
I am a: Type 1.5 | | Join Date: Oct 2008 Location: Santa Barbara, CA
Posts: 38
| | | Thanks Sarahspins for alerting me to the fact that I need to follow my cycle closer in relation to my blood sugars and insulin needs. I hadn't thought of that, but I am about mid cycle so ovulation certainly could be playing a role too (along with the moon!). Another thing to consider... oh boy!
I like your statement..."consistently variable"!
__________________
~Krista
-----------
Aug '08: Type 2 mis-diagnosis; tried metformin er with limited success (HbA1c dropped from 7% to 6.5%)
Jun '09: Fasting C-peptide=0.86 and GAD-65 Ab=5.0 ==> new diagnosis of type 1.5!
Jul '09: off metformin er completely; taking Januvia 100 mg/day with BMI down to 21
Aug '09: HbA1c=6.7%; Endo adds nightly Lantus (10 units) to help with elevated basal blood sugars => HOPE THIS HELPS!
Oct '09: HbA1c=6.3 YEAH! Lantus is doing its job!
|
09-06-2009, 04:12 PM
| | Junior Member
I am a: Type 1 | | Join Date: Sep 2009 Location: BC
Posts: 3
| | | lantus
I regularly had the dawn lows (we call them rebounds) on my previous long term insulin so my endo switched me to lantus and I haven't had one since. You would know if you had a rebound - incredibly thirsty, sweaty, can't sleep and a really stunning high blood sugar.
I would agree you are just in the initial adjustment phase of a new insulin. It took me over a month to get to a somewhat steady pattern with my lantus.
If that doesn't work, it could be a mild virus, stress at work, an unusually unpleasant argument with your partner, mother, father... get the idea. After 44 years of this disease I have given up trying to figure out why a crappy BS showed up. 
I envy your steady am blood tests. You are doing a great job with the often frustrating nature of our disease. |
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