[lrohner]

I'm the Mom of a 21-year old diabetic (diagnosed 10 years ago). Since her diagnosis, she had been on a combination of humilin/hemalog (sp?).

As she progressed into her teens, we spent more time fighting low blood sugar than high.

Her doctors switched her a few months ago to Lantus. Since that time, she's been fighting average sugars of 200 to 300+ and has absolutely no energy. She's been seeing a nutritionist, eats absolutely perfectly, exercises daily.

I'm sure it's the Lantus, but she's not listening to me. Anyone have any experience with this?

[owlyn]

She should still be on the Humalog as well as the Lantus. How much of each is she taking and when?

[A_Darling]

ditto for what owlyn said.

I have my own questions about Lantus as far as lethargy is concerned, but if she's running high you might just need to up the dose. I've recently gone to a morn/night dose of lantus to keep the basal more level (lantus doesn't really last for 24 hours).

basically, talk to her and see what she thinks, and maybe suggest that she sees her endo.

[lrohner]

She's taking Novalog before meals (when she eats, that is -- her appetite is down severely as well), and I'm not sure how much Lantus she's currently taking.

She goes back to college in a few days and will see her endo a few weeks later. I just worry that 21 year olds don't always volunteer medical info or try to problem solve with their docs.

[Scratch]

Basal test. Yeah, basal test.

The job of the basal insulin, the one that Lantus is doing, is to keep blood sugars level when fasting, its purpose is to nearly match how much glycogen the liver is suppying the body for glucose.

Buy the book Think Like a Pancreas by Gary Scheiner. That book does an excellent job of explaining what a diabetic on a basal/bolus treatment plan should be trying to achieve and how to do it. If you know how, it can get done.

[Subby]

As has been said. BG's that high could easily account for much fatigue and all sorts of nasty effects, including psychological (myself and others experience depressed feelings, moodiness, flatness from being high a long time). If the correct dosage of Lantus was never ascertained, that could well be the main problem.

As another issue, Lantus has been known anecdotally, to cause depressed feelings and fatigue and the like, in and of itself. I am one person who will happily swear on a stack of bibles that it had a very detrimental effect on me, effects that cleared right up on leaving it, and came straight back on it entering my bloodsteam another time. But then there are very many people who appear to have no problems.

So, with those things in mind, what to do. As a process of elimination, upping the dose with the doctor's help first, (the dose is incredible important as I'm sure you're aware), so that Bg's return to a better level, has to be the first port of call. It should not be too hard to improve things somewhat. Basal testing referred to above is the optimum way to improve the effect of basal insulin.

Then if these other problems seem to persist even with improved BG's, potential side effects from the Lantus have to be considered (in my book). The doctor may or may not acknowledge this issue. But either way, it would be a case of trying another long acting for a while to see if the symptoms improve off the Lantus.

Please forgive me if this seems innapropriate. But, are you fighting about this issue? Why does she "not listen" about the Lantus (and what is it she is not listening to?) Why would she not try to solve a problem with her doc, yet do all those other things, exercise, eat perfectly, see dieticians, etc? It doesn't quite add up to me... (I have been known to be dense about such things, by the way). I'm not trying to be rude at all, please understand. I have no vested interest in knowing more about these things. You may have a vested interest in revealing more of the situation or how you feel, as someone may well have insight. Many of us know how much diabetes can put things off balance and make all sorts of relationships have their difficult times or problems.