[webpundit]

I think I'm experiencing something I'm going to call the 'Dusk Phenomenon.' Unlike the dawn phenomenon, I've been having consistent highs in the evenings before dinner.

Anybody else with a similar problem? If so what are you doing to rememdy it?

If it'll help, my post-lunch BG readings are usually within range. I check again only before dinner which is when they are unusually high. Eventhough I don't eat anything in between. Maybe a cup of tea...but no way is that enough to get a 140 reading to 300.

What do you think?

[HeatherP]

Since you're on Lantus, my first question is how often/when do you take it? I had to start on 2x a day to cover me 24 hrs. If you're not splitting it currently you may want to consider it. (my after lunch and pre dinner sugars would go high)

Have you recently stopped excercising/changed times you excercise?

[Clint]

I would also like to ask about the 'fat' content of your lunches? I notice that when I eat something high in fat ie pizza or similar, my 2 hour readings are in target, but 3 or 4 hours after lunch i am high... my 2 cents :smartass:

[webpundit]

Exercise.....I wish!!

I'm taking 28 units of Lantus at night. Things were good until about last month or so. So, I should try splitting it into two shots of 14 each? I'll run it by my endo.

Still what's the point of advertising it as a 24 hr insulin when I have to poke myself twice anyway!!

[webpundit]

Fat content...that sounds plausible too. I'll experiment with that. Thanks, Clint!

[Clint]

np, doing my best to help when I can

[dixiepixie64]

For my two cents worth, I agree too about the Lantus possibly not working the full twenty four hours for you and that is causing the late afternoon - early evening spikes. I discussed that with my doctor when I was using it and he said that it was possible it was wearing off earlier than 24 hours.

Yepper, those pizza/high fat lunches are sneaky. The same thing happens to me. Two days ago I ate pizza at noon, tested at 71 at 2p.m. and then was up around 200 at 4:30 and had eaten nothing else.

[may]

I talked to my Dr. and he also said there is a possiblility that it was wearing off sooner. BUT..if that was the case I might just as well go back to the 75/25 for a few months and see if I am happier. That way I don't have to use the Humalog. And, I don't want to shoot 5 times a day!
I do like the Lantus..although just because it is never...remember Newer is not always better! But, I hated the Humalog..I swear all I wanted to do is eat! So starting this week I went back to my 75/25 + metformin and believe me with two shots a day I am much happier. My readings so far are about the same!
Even though I do like Lantus, I guess I don't get the point of two injections. If it isn't working the way the company says it will, let them go back to the drawing board with it till they can get it to last for 24 hours. It's a high price to pay if it isn't going to work like intended.

[sparkle9]

I had the same experience as Heather - highs in the afternoon because the lantus was not lasting 24 hrs. Also, with one shot at night I had a problem with lows at 2:00 or 3:00 AM. So I'm taking it twice a day. Shots have really never bothered me, so I would rather take an extra one if it means better control.

[Shalyndria]

Do you always experience that much of an increase, even when you don't drink tea? Is the tea caffeinated (caffeine can cause increases in BG, as it is a stimulant and has been blamed for decreasing insulin sensitivity), and what do you put in it?

Just a thought...

Shy

[MarkMunday]

Originally Posted by webpundit

.... I've been having consistent highs in the evenings before dinner.....

You could test your basal rate to establish if running out of Lantus is the problem. You do this by having your normal Lantus shot on the previous evening. And then skipping lunch. Test every hour during the afternoon.

For it to work, you need to get your blood sugar back into the target range after breakfast. Then don't eat anything and don't get any unusual exercise. If your basal action is being maintained at the right level, the hourly readings shouldn't change much. But if they increase sharply, you are probably running out of basal insulin. And splitting your Lantus shot should help.

Cheers,

Mark

[may]

Pizza will do that to me to too.
So, I stay away from it.
Even thin crust.

I pay 65.00 a bottle for Lantus. And, yes I expected it to last the 24 hrs. like it was advertised to do. Either it is or it isn't a basil insulin. Actually I would think if you have having to split doses..then some are using it as an intermediate insulin since its not working as as long insulin. Isn't that what splitting a doze would be?

I have a couple of bottles in the frig...however for a couple of months I have gone back to the 75/25.

Thanks Mark for the way to test..I will wait to see if I go back on it.
If I don't I will give them away to a sis whose Dr. has put her on it to.
You have good ideas, and I will pass that on to my sister. Thanks!

[webpundit]

Just as all of you diabetes-whiz-kids have mentioned above, it was the Lantus!

I talked to my doctor and she recommended that I take the Lantus later and eat my dinner sooner. That way, my postprandial spike would fall within a 20-hour Lantus bracket. So I started eating my dinner at 7.00 and taking my shot at 10.00. Voila...the 'dusk phenomenon' is gone.

I'm pretty peeved at Aventis for marketing Lantus as a 24-hr insulin too. It's a great product but they really need to work on making it last longer!!

Thanks again, all of you who contributed.