I have been a type 1 for along time now (19+ years) and I have always just used R and Nph insulin as I was very comfortable/controlled with this combo and my medical plan/Local Doctors make getting up to the minute diabetes updates a nightmare.
After deciding about 6 months ago that I wanted to increase my knowledge I went to the Doctor and he suggested dropping the nph and switching to Lantus. So far so good I would say I have the combo 90% figured out and my blood sugars are pretty much dialed. (My average over the last 2 weeks has been 128 fyi)
The question I have is lantus is suppsed to last a full 24 hours and release pretty steady. I have seen a graph where it appears to release a little stronger in the first 1-4 hours before tabeling off. I have found that if I go to bed with my blood at anything below about 180 I wake up to lows around 40-50 between 3-6am. I would love to get that last test of the day to a respectable # and hold around 100 for the entire day. I am purposefully testing before bed and if my blood is close to 100 or less I drink a cup of juice jacking up my BGL.
I have always been more likely to experience lows than highs but I was wondering if everyone had the same issue or different experiences?
My daughter is on Lantus and i have learned of course through trial and error that if i don't give her at least a 20 carb snack then she will go very low by morning (in low 40's). When she first was diagnosed last month i did every single thing the doctors told me to do. One of their directions was to give her only a 10 to 15 carb snack before bed, well that caused her to go really low by 3am. Then of course here i am trying to wake up a 6yr old at 3am to drink some juice or something to spike her numbers. Maybe 2 weeks in i tried giving her a larger carb snack and now when i test her at 3am she is usually around 100 which to me is good numbers. The doctors also said that if the bigger carb snack didn't do the trick then try giving a smaller dose of the Lantus. So right now she is on 10 units of Lantus at night and getting about a 20 carb snack before bed. Dont know if you like choc. chip cookies but Nibsco has the 100 calorie pack and they are like 15 carbs. that with half a glass of fat free milk seems to do the trick for us......I know its all about trial and error and what works for one may not work for the other, so BEST OF LUCK and keep us posted if you come up with a good fix.....
Just back your dosage down a bit (1 unit) and see what your BGL looks like. That worked for me. You just gotta find a good balance.
Yea thats totally normal..especially when you take it before bed (which I do). I cut back my dose by 10 units (I was on 34 when I was in my teens and now I take 24) because I was falling low every morning. Days that I excercise more or go out all night to the bars (even though I don't really drink all too much..its just the calories that I burn from walking around and stuff).I cut back even more.by about 2 or 3 units. Lantus is a great insulin but it definetly causes more lows..but you'll feel so much better on it..thats why I like it...its trial and error really. My doctor told me that its normal to cut back your Insulin by 30% at least when going on lantus. I would talk to your endo though!
I started at a dose of 38 units and have backed down to 35.
I have tried less but my numbers for the rest of the day tend to run closer to 200 if I go that route. Thanks for all teh replys sounds like maybe I can move the lantus shot to about an hour earlier and follow it up with a bed time snack.
my doc once told me a long time ago a pretty good way to determine your lantus is you should wake at about the same number u went to bed with then adjust your humulog accordingly.
I too have this problem infact my Diabetes New years resolution is to have less low blood sugars, which i never thought id say considering were always trying to keep them lower... I find i go low almost everyday, my low time has been 6:30 am lately ugh
Recently i tried splitting my lantus into 2 doses. i went from 23L to now 18L total by doing that and i still need to cut back because i increased my excersising and ive just been low all the time... besides taking less lantus i notice no difference with the 2 shots so i am going back to one...but maybe u should try the 2 doses...
When I was on Lantus (before pump) I had to take it in 2 doses as well. Mostly because the amount I needed to last the full 24 hours would cause me to drop as well. When I cut back, the Lantus wouldn't last the full 24 hours and I would be high about 6 hours before it was time for my next shot. So, I would try doing 2 shots. I had one before I went to bed and one in the am. I still took more when I went to bed (20 - 24 U) and only a few (12 - 24U) in the am. It really helped me.