[Metermaid]

Originally Posted by BlueSky

What is more of an issue to my mind is the fact that our bodies' requirement for basal insulin action varies substantially during the 24 hour cycle. Most of us need much more basal insulin during the morning hours than we do in the afternoon and at night. I find that if I set my Lantus dose at a level that keeps me even during the morning, I will go low in the afternoon and/or at night. This is because the flat action of Lantus is adequate in the morning but excessive in the afternoon and overnight. It sounds like the same could be happening with you, Metermaid.

For me, Lantus on its own is not adequate to satisfy basal needs. Some extra coverage in the morning is essential. You could also try using NPH in a similar fashion. The big advantage of working with Lantus, IMO, is that it is like building on level foundations.

Blue Sky,
Thanks for your input..yes, exactly right about the different basal needs throughout the 24 hr day... I was just wondering how you all handled that and I see your method is interesting and I had not considered that. I am going to get J.Walsh's book on Using Insulin to better equip myself before doing any major insulin changes.
Another question for you Blue Sky; is not the pump the answer to our dilemma? Is there a reason that you are not on the pump? I have had the MM 522 delivered and am in the process of reading through all the handouts/CDs/information before setting up my training session...I am also procrastinating because I have never really wanted to go on the pump....wanting the control myself with the MDIs. Being an RN, control comes with the territory...just wondering about you.
Thanks so very much for taking time to help out a fellow Diabetic! Rita

[grace girl]

Originally Posted by Metermaid

When do you take your Lantus...do you split also? I just learned from you all, that Lantus has peaks!! Now I have to figure when it peaks for me?? Another math problem... I am wondering if I shouldn't take another kind of basal insulin?

Well, just to be clear, "peak" really isn't the right word. A peak would imply going up, peaking, then coming down. For me it's more like a rising plateau...my bs drops for 4-6 hours after the injections, then it flatlines.
I take it twice a day with the higher dose in the am and timed so that by reducing my humalog for breakfast I can, for the most part, control the peak.
I've struggled with over-night for years. I had been taking it at 9pm, and I've been back it up recently, trying to get the peak finished before I go to sleep.
When I took it in one dose I had 200-300 point drops overnight constantly. I cut the dose in half and still dropped over 150 pts a night, with a snack, yet I was high all day long because I didn't have enough basal during the day. It was a nightmare. Splitting has helped, but I'm not going to lie...my life revolves around math. I hate math. But since I like being alive, I deal with it.

[BlueSky]

Originally Posted by Metermaid

..... Another question for you Blue Sky; is not the pump the answer to our dilemma? Is there a reason that you are not on the pump? ...

Yes, using the pump enables you to solve these problems by customising the basal rate. It was while I was trialing a pump that I figured out just what my basal insulin requirements are. They vary from .25 units per hour in the late afternoon, to .95 units per hour in the morning. Achieving this level of action with only Lantus is not possible. But where there is a will, there is a way .

The pump worked very well, but I was not able to keep it for financial reasons - we don't get any financial support from the public health system or private insurance for pumps here. So I would have to pay the initial cost and running expenses myself. Maybe next year, or the year after that. I am doing reasonable well with MDI. I have found an unconventional way (using Regular in the morning) to match insulin action with the varying underlying requirement. It works very well, and I am in no hurry to stop using it.

If you don't want to or can't use a pump, you can still have good control. But you might have to take control of the situation and be unconventional. Don't expect too much help from medical professionals. They are, in my experience, naive and unimaginative. So, yeah, using the pump is certainly the easiest way to go

[ant hill]

Originally Posted by Metermaid

Another question for you Blue Sky; is not the pump the answer to our dilemma? Is there a reason that you are not on the pump? I have had the MM 522 delivered and am in the process of reading through all the handouts/CDs/information before setting up my training session...I am also procrastinating because I have never really wanted to go on the pump....wanting the control myself with the MDIs. Being an RN, control comes with the territory...just wondering about you.
Thanks so very much for taking time to help out a fellow Diabetic! Rita

Hello Rita Metermaid, Just had to say that LOL. I thought that by having a pump would confuse you more with maths I think but that's up to you and the Basel is very fine in the pump!! like you would have half unit doses on MDI as with a pump you could do quarter units!!!! Yeah it's that fine! and because that you're are on a very low dose the pump would be good as because that you can able to do fine doses. and it's good like when you are about to eat you cannot forget to bolus ether as it just a press of a button.
By the way, I am not a sales person to pumps. LOL

[Metermaid]

Originally Posted by Stuboy

... and dont eat before you sleep otherwise you wont know if the lantus is at the right dose.

OOPS I just ate...and took one less unit of Lantus at dinnertime....that was a waste of an experiment....oh well, I will try it again tomorrow night.
Thanks, Rita

[Metermaid]

Originally Posted by xMenace

One thing to consider is combining your doses and taking it all first thing in the morning. This may give you a much lighter effect through the night and into the morning. That would be totally wrong for most of us, but it may help you. Do you have morning rises from your Dawn Phenomenon?
.

No, my am bg are fine after a night time low. Thanks for the input!!! Rita