[BlueSky]

Originally Posted by drummingfool

... I'll do basal testing, prolly on saturday. I dont want to go without breakfast on a day I have to work. I'll just have eggs or something until then. Nothing but eggs, all day. ...

The only thing that should pass your lips during a basal test is water. Eating anything will raise blood glucose, even if it contains no carbohydrate. As soon as something gets into the stomach, the liver spits out some glucose to balance the phase-one insulin response. So if you don't have a phase-one insulin response, blood glucose goes up.

It is also not a good idea to do a basal test if you are going to be stressed at work. Blood glucose will go up, and you won't know why. For a basaltest to be maningful, you need to remove all the controllable variables - food, exercise and stress.

[Lizzie G]

Originally Posted by walleyedave

I don't understand how people can say that your dose of lantus is high.
I have been told to keep upping my lantus untill my morning BG's(fasting) are normal. How do these people know your dose is high. I don't get it. I would love to hear there thoughts on this, as well as why they feel this dose should be split.
I don't know whats going on with your Bg. The more I read your other posts, the more you remind me of me. I have gone through some of the exact things you have. The weight loss and gain issues. The morning Bg issues. etc..
I can eat zero carbs for breakfast and still skyrocket in an hour..
I hope you get the answers your after bro, we'll both get some questions answered. I'll be subscribing to this 1 for sure.

Hi

My basal needs vary dramatically over the day and night and its kind of obvious to me by what happens in the absence of food. I take 6 units of lantus in the evening. If this was the only basal I took my BG would rise from say 90 when i went to bed, to between 140 and 150 at about 6am. Which sounds my my lantus is too low, right? However, on this same amount of basal I know my BG will drop by approx 30 to 40 between 4 and 7pm (which i cover with a small snack if necessary) which is around the time i am driving home - not good. If i raised my lantus to 8 units, going to bed at 190 i would wake up maybe around 130 to 140, but i would be STARVING all day and at risk of hypo late afternoon, so definitely too high.

The way I deal with this is to take my 6 units lantus, then to supplement this with 4 units of isophane/NPH/insulatard (whatever you call it) at around 10 pm. this seems to cover the night adequately and allow me to get up around the same level as i go to bed. As the dawn effect carries on a little longer i also take slightly more insulin in the morning with meals and limit carbs; the later in the day the less insulin i need per carb until about 8 pm where i start rising again.

Apologies for what a boring read this is! Im hoping to get a pump and my life will be much easier!!

[mazea]

I would like to ask do you get the vitamins/ vitamin C with no glucose added? 1 of those vitamin C tablets can have 6g carbs in glucose in them so I got some ones that have no glucose added.

[Lizzie G]

Originally Posted by Lizzie G

Hi

My basal needs vary dramatically over the day and night and its kind of obvious to me by what happens in the absence of food. I take 6 units of lantus in the evening. If this was the only basal I took my BG would rise from say 90 when i went to bed, to between 140 and 150 at about 6am. Which sounds my my lantus is too low, right? However, on this same amount of basal I know my BG will drop by approx 30 to 40 between 4 and 7pm (which i cover with a small snack if necessary) which is around the time i am driving home - not good. If i raised my lantus to 8 units, going to bed at 190 i would wake up maybe around 130 to 140, but i would be STARVING all day and at risk of hypo late afternoon, so definitely too high.

i meant in the above if i go to bed around 90 i wake up 130 to 140 not 190....chance would be a fine thing!

[drummingfool]

Alrighty. Let me answer some questions here.

1. I've tried splitting my Lantus dose into 2 12 hour sections, 35u at night and 15u in the morning. All that did was keep my BG in the 200s all day. So Ive tried it, and it was a no go.

2. All of the vitamins and supplements I take have a grand total of less than 1 carb. I make sure of it when I buy the stuff. Special Diabetes vitamins and fish oil, enzymes and cranberry with no sugar. Problem is, even when I skip out on the vitamins, my sugar rockets.

There ya have it. With it being 6:15 AM, Im going to proceed downstairs and scramble up some eggs, or perhaps I wont do breakfast. I'll let everyone kow how it works out today.

[jenb]

Hi again. About splitting your Lantus: Perhaps your BG was high during the day because you need more basal; Maybe you need 35u at night and more than 15u in the morning. You've certainly been dealing with this challenge onger than I have, but I hope you'll retest your daytime basal needs and consider the split dose again. How frustrating for you!!!

[Gary_W]

Originally Posted by drummingfool

Alrighty. Let me answer some questions here.

1. I've tried splitting my Lantus dose into 2 12 hour sections, 35u at night and 15u in the morning. All that did was keep my BG in the 200s all day. So Ive tried it, and it was a no go.

2. All of the vitamins and supplements I take have a grand total of less than 1 carb. I make sure of it when I buy the stuff. Special Diabetes vitamins and fish oil, enzymes and cranberry with no sugar. Problem is, even when I skip out on the vitamins, my sugar rockets.

There ya have it. With it being 6:15 AM, Im going to proceed downstairs and scramble up some eggs, or perhaps I wont do breakfast. I'll let everyone kow how it works out today.

It's not somuch splitting it into different times of day, but splitting it into different injections; if you are whacking 50u of Lantus into one place at one time, this can potentially cause absorbsion issues. I know of one member here who swears blind that he can only inject up to 7u in a single injection without getting problems, so he (for instance) would do 7 different Lantus shots.... I know this sounds extreme and I'm not suggesting you go this far, but the more you put in with a single shot, the more your chance of getting uneven absorbsion.

The other thing to keep in mind is that any changes you do with Lantus will not reap rewards (or make you worse!) for 3-4 days. This is one of its most irritating traits. You have to experiment and suffer whilst you wait for it to make its mind up as to whether it's good or bad...

Good luck

[Subby]

Originally Posted by Gary_W

I know of one member here who swears blind that he can only inject up to 7u in a single injection without getting problems, so he (for instance) would do 7 different Lantus shots.... I know this sounds extreme and I'm not suggesting you go this far, but the more you put in with a single shot, the more your chance of getting uneven absorbsion.

Yes, I can only take a very small instant dose (whether injection or "instant bolus" on the pump) - problems consistently occur over about 3units as opposed to slow release with the pump. By "problems" I mean, deferring action by between 30 minutes and 80 minutes. I seem to have it really bad, most people either don't have the problem or maybe would only get it at much higher dosages. But yes it is the kind of thing well worth keeping in mind, especially up at the 50u mark!

I only found this out when I went to the pump (no option to "slow release" with injection - no way to definitively troubleshoot these absorption issues). Previously on MDI I had very similar kind of problems especially though the morning, as you drummingfool, and never really found the answer! I really hope you do!

[drummingfool]

Well, Im really hoping to get said pump. My insurance kicks in on the first of the year, but its a 3000 dollar deductible. insane.

[drummingfool]

Alright, here's an update. Let me know what you think.

1. I've eliminated my morning cranberry pill. I believe the natural sugars that occur in it aren't helping my BG in the morning.
2. I've upped Lantus to 56u at night.
3. My sugar this morning @ 6:30 was 132. Upon arriving to work at 7:30, it was at 145. I find that my spike is usually between 100 - 140pts from where I start, so I took a bolus of 5 units. I had no breakfast, only a multivitamin and a fish oil capsule.

I would have done all of this yeaterday but I woke up REALLY high. I wanted a more normal base to test all of this. I'll keep everyone updated, but please post any ideas. Thanks all!

[drummingfool]

Looks like I found the solution in here somewhere! Let me give you all a breakdown of my morning after doing everything posted above.

6:30AM - 132
7:23AM - 146 (took 5 units)
8:35AM - 117
9:23AM - 113
9:55AM - 100
11:17AM - 113
11:53AM - 100 (lunch)

I havent seen numbers in the morning like that for a very long time

[BlueSky]

The numbers are looking good. Well done! But the fact that you need an extra 5 units of Novolog in the morning seems strange to me. And I would be very uncomfortable with having all that Lantus is one go at night. You can expect a lot of insulin action variablility. In other words, some days it works fine and other days you get unexpected results.

It would be interesting to know what your blood glucose is doing at night. Could all that Lantus be causing your BG to bottom out during the night and rebound to high levels in the morning? This is the so-called Somogyi Effet, which is not as common as many people think. But it is worth testing for it. On a night when you are in the target range before going to bed, set your alarm clock to wake you up so that you can test at 2am and 4am. Let us know what your results are.