[Hammer]

Okay, I have some more questions. First of all, I've seen some people suggest eating some peanut butter before going to bed to help with low BG levels. Why peanut butter? Is there something about it that makes it a good candidate to pull you out of hypo?

Next, is my usage of Lantus. When I increased my Lantus dosage to 34 units, I was able to obtain a morning BG reading of about 120. I've been increasing my dosage in an attempt to get my morning BG numbers down to under 100, but it seems that this isn't happening. I've gone from 34 units to 70 units by increments of 2 units, and I'm still getting a morning reading of about 120. This tells me that no amount of Lantus is going to make my morning BG numbers go below 120. What do I do now? Should I keep increasing the Lantus?

I have tried getting up in the middle of my sleep and testing to see if my numbers are lower, but they are steadfast at around 120, so there's no drop in my BG while I'm sleeping. It bugs me that I can't get them below 120. If I keep increasing the Lantus, is that bad? I mean, what happens to all the extra insulin that I'm injecting if my body isn't using it?

Also, why do you test 2 hours after your first bite? I thought it was two hours after you finished eating that you tested. If I make a salad, and it's usually a big salad, it takes me a long time to eat it, so wouldn't it be better to test after all the food has had a chance to enter my system? It doesn't take me two hours to eat a salad, but sometimes it can take an hour if I eat slowly.(and read the forums), so why test before all of the food has entered your system?

[fgummett]

Peanut butter (just crushed nuts... no need to add anything) is a source of carbs plus good fats and protein so it will last a while in your system.

---

Reminds me of the joke about the man who walks very slowly, hands resting on his knees into an ice-cream shop, shuffles up to the counter, leans against it, and lifts his eyes so he can barely see the shop-assistant...
He orders a vanilla cone.
She asks, "strawberry sauce?", "yes please"
... "chocolate flakes?", "yes"
... "crushed nuts?", "NO... I just hurt my back!"

[notme]

The only reason that peanut butter would help your morning blood sugar is if you were suffering from a low blood sugar in the middle of the night or DP. The peanut butter will help stabilize your blood sugar because of the effect of fats on your blood sugar long term.

If you have doubled your Lantus and you describe and you have not suffered from lowered blood sugar in the morning or during the day, I would suspect that something is wrong with your vial of Lantus. I would ABSOLUTELY not take that much more insulin or increase it until you talk to your doctor. Go back to your 34 units and open a new bottle of Lantus. If you got your supply of Lantus mail order, order a new batch. If you can't do that, I would tell your doctor what you suspect and see if he will write a prescription for one bottle to get at the local pharmacy.

[xMenace]

I suspect you are making plenty of your own insulin. The more lantus you use, the less you produce, so you see no impact.

[rmichaud]

I also take Lantus, 32 units each night at 11. I had the same problem as you with morning highs, especially after eating breakfast, but even if I didn't eat my BS would go from 120 to 150+. Dr add Janumet once in the morning and once at night. Worked like a charm. Mornings are now in the 90's, never passing 130 after eating breakfast and I don't have any lows from the Lantus anymore either. I used to get lows in the afternoon and now they are gone and I'm always between 85-140 depending on whether it's a pre or post meal reading.

Good luck.
Rich

[Hammer]

Notme.....I'm using the Lantus Solostar pen. There are five pens in a box, and I'm into my second box. I wouldn't think that there would be a problem with the insulin in different pens. I got these pens from my pharmacy. Keep in mind that this increase from 34 to 70 has taken some time, since I increase the Lantus by 2 units if my BG numbers remain the same after a few days of the same dose.

My doctor started me out with 8 units of Lantus. He told me this was a very small dose, and that I'd most likely need to increase it. After using 8 units for a few days, I called the doctor's office and told them my readings and I asked them if I should increase it by 2 units. They said that a 2 unit increase was fine. I called them a few weeks later and told them that I had been increasing it by 2 units if my numbers were still too high and they said that was okay. I've been increasing the dose by 2 units and I've reached 70 units so far so I figured I was okay to keep increasing the dose since I was still too high.(I haven't gone hypo or even come close to going hypo, so I figured I was doing the right thing). Anyway, I called the doctor's office just now and they'll get back to me tomorrow to let me know what to do.(the doctor will be in tomorrow.)

xMenace....I had asked about this before. By taking insulin, does my body produce less on it's own. You're saying that it does, so what I'm wondering is, if I keep increasing the dose, will it eventually lower my numbers, or will increasing the dose just cause my body to resist it more?

Rich....I'm taking Byetta to reduce the spikes that occur after meals. It works to some degree, but I might need to go to the 10mcg pen. Right now I'm using the 5mcg pen so I might need to switch.

[xMenace]

Originally Posted by Hammer

xMenace....I had asked about this before. By taking insulin, does my body produce less on it's own. You're saying that it does, so what I'm wondering is, if I keep increasing the dose, will it eventually lower my numbers, or will increasing the dose just cause my body to resist it more?

I really don't know, but your behavior suggests it. If the shoe fits ...

[BlueSky]

Originally Posted by Hammer

... xMenace....I had asked about this before. By taking insulin, does my body produce less on it's own. You're saying that it does, so what I'm wondering is, if I keep increasing the dose, will it eventually lower my numbers, or will increasing the dose just cause my body to resist it more?....

Hammer,

Logically, the production of insulin would only be reduced if blood glucose drops below normal. This being the case, one would expect raising the Lantus dose to reduce blood glucose. And beta cell production of insulin would start declining only when BG gets down to about 85. As this isn't happening, there must be another explanation.

All that insulin must be going somewhere. And it looks like increasing the Lantus dose is aggravating insulin resistance. The more you inject, the more insulin receptors on the cell surface get closed down. An insulin level test will probably show lots of the stuff is coursing through your veins. High insulin levels are a major cause of macro-vascular complications, so you should look for ways to reduce insulin resistance. The only way I know of improving insulin sensitivity is to get lots of exercise. I have found the results to be quite dramatic. Are you working out?

On the peanut butter issue, having a high protein snack is often suggested for T2s because it reduces the amount of glucose produced by the liver during the night. The liver gets busy when it has been a long time since the last meal, and a before bed snack stops this. But you want to avoid carby foods because they push BG up. With some people, a high protein snack seems to work very well.

When are you taking your metformin? Taking it before bed should also weaken that DP effect.

[Kim_in_TN]

I was told to eat a big spoon full of peanut butter the night before a recent surgery. It was to help my BG from going too low while fasting just before and during my surgery.

[slipperyelm]

What is your BG when you go to bed?

Beside exercise, weight loss, where needed anyway, can also reduce insulin resistance.

More on the peanut butter thing-- As BlueSky says, it is the high protein that works. It does not have to be peanuts. You can eat a nibble of chicken, a piece of cheese, a few bites of fish, half a boiled egg, a piece of tofu, a gluten patty, etc. Protein food.

[Hammer]

I'm looking at my chart to see what the readings are, and every time I increase the Lantus,(I take it every night at 10pm) the next morning when I do a fasting BG reading, it's dropped from the day before. However using the same dose that evening, the next day's BG readings have gone back up again. It's as if the initial increase of Lantus doesn't affect the body's resistance at first, hence the drop in BG reading, but after a day, it has adjusted itself and the BG numbers rise.

Also, I don't take Metformin. I tried, but my stomach can't handle it. I've tried various forms of Metformin with the same result. I've tried Amaryl and Prandin and they bother my stomach also. I've even tried cutting a 500mg metformin tablet in half and taking one half after breakfast and one half after dinner, but it still bothered my stomach. It seems that anything I take orally bothers my stomach, so I shy away from them. That's why I'm on Byetta....it's not oral.

Exercise....not really. I was trying to walk everyday, but my back just won't let me. I have plenty of energy and stamina to do most any type of exercise, but my back prevents me from doing anything. As much as I enjoy exercising, it gets to be a choice between trying to exercise and being in pain, or not exercising. The not exercising is winning out. When you know that you're about to do something that hurts you and makes it difficult to stand up, much less walk, you begin to avoid it. I've been thinking about maybe getting a bike (either a regular bike or a stationary bike), but for now, I want to see what my company is going to do with me....relocate me to another state is the most likely thing, and if they do that, I'd have no way to get a bike there, so I'm waiting for them to make a decision.

Other than a bike, there isn't any exercise that you can do that doesn't put a strain on your back that would also burn off calories.....the type of exercise you need to do to affect insulin resistance.

My before bed numbers are just a little bit lower than my morning numbers. For example, when I increased the Lantus to
64 units, my morning BG was 128. My before bed BG was 120. Moving up and comparing my morning numbers from 64 units, which was 128, to 70 units which is 120, it only dropped 8 points with 6 more units. Since I've only been on 70 units for one day, I'll know better tomorrow if it's still 120 or if it's gone back up again.

It gets discouraging because when I increase the Lantus, the next mornings readings have dropped and I get encouraged by it, only to have it rise again the next day. When I increased the Lantus to 52 units, the next morning reading was 104....down from 121 the day before. The next morning, my BG numbers were 117, so I increased the Lantus to 54 units and the next morning was 123. I increased it again to 56 units, and the next morning's reading was 115. I decided to go up 4 units, which I've never done, and taking 60 units, my next morning reading was 134. The day after that, still on 60 units, it was 133. My before bed numbers were 120.

I don't usually eat anything after dinner. If I eat dinner at 6pm, I may not go to bed till 3am the next morning, so taking a fasting reading before bed gives me a more accurate fasting BG than if I test when I get up, since there's no Dawn Phenomenon to figure into the reading. I figure that no matter what my liver does during the night and how it will affect my morning numbers, my before bed numbers aren't going to be affected that much by anything (unless I eat something), so that number is the most accurate.

[Hammer]

I figured I'd use this thread whenever I have more questions. First, if you're taking Byetta or any other medication that you have to take before you eat, when you do a before meal test, do you test before you take the medication, or do you take the medication, then do a test right before you take your first bite of food? I've always done a test before I took the medication, since the medication is going to limit the spike that occurs after eating. Taking a reading after you've taken the medication would give you a BG number that's lower than your basal numbers. I'd think that you'd be interested in knowing how much your basal numbers went up, not how much your numbers changed from a false low caused by the meds, to it's high spike after eating.

For example, I took a reading before lunch today and before taking Byetta and my numbers were 96. I had some frozen vegetable lasagna and my after meal numbers were 98. That tells me that most likely, the Byetta lowered my numbers below 96 before eating, and that there was a bigger jump than just 2 points after eating something like lasagna. So, wouldn't my main concern be that I went from a basal reading of 96 to a spike of 98?

Not knowing what my numbers were after taking the Byetta, but before my first bite of food, it's possible that they might have been really low like 60 or something, so the difference between 60 and the 98 would be 38 points.....not the two that I read before. Wouldn't you be more interested in the fact that your basal level only went up 2 points as opposed to knowing that the meds lowered your basal level to 60 first, then you spiked 38 points to reach 98?

Also, I see people commenting in other threads about how Byetta makes you lose weight. It hasn't caused me to lose any weight, so I'm curious how it does that? Does it make you less hungry?....does it do something to your body that causes it to burn calories somehow? I haven't experienced these things, so I'm wondering if Byetta doesn't do that to everyone.