Confused

[Pat91]

Hi all need some advice, I have been taking 18u of Lantus at night but have been waking up hypo. But throughout the day my bloods have been staying on the low side 4 to 4.5. last night reduced to 17u. Still woke up low but I'm creeping up between meals currently at 13.9 before lunch. ? Seems 18 is too much and 17 is not enough ?

 

[rebrascora]

Time of day when you take the Lantus might be a factor. It has a peak of activity about 5 hours after injecting it. You may be better taking it in the morning when you wake up rather than at night. many people don't need much basal insulin through the night but more in the morning, so if you inject it at say 7am or even 6am if you are an early riser, the insulin will be at maximum affect mid morning and over lunchtime and just the tail end of it active through the night when you need less. Worth discussing this tactic with your Health Care Professional or perhaps a change of basal insulin to something like Levemir which can be split into 2 doses, morning and evening so you can inject less at night and more in the morning to balance things a little better.

 

[Pat91]

Time of day when you take the Lantus might be a factor. It has a peak of activity about 5 hours after injecting it. You may be better taking it in the morning when you wake up rather than at night. many people don't need much basal insulin through the night but more in the morning, so if you inject it at say 7am or even 6am if you are an early riser, the insulin will be at maximum affect mid morning and over lunchtime and just the tail end of it active through the night when you need less. Worth discussing this tactic with your Health Care Professional or perhaps a change of basal insulin to something like Levemir which can be split into 2 doses, morning and evening so you can inject less at night and more in the morning to balance things a little better.

Hi there, ok thank you i shall mention it next time.

 

[Inka]

I agree with @rebrascora that a change of time is the first thing to try. If that doesn’t help, you could split the Lantus into two doses. Some people have found that works better for them. As mentioned, the other option is Levemir in two doses. You have more flexibility then to adjust your daytime dose while leaving your nighttime dose alone, and vice versa. The split doesn’t have to be equal.

 

[Pat91]

I agree with @rebrascora that a change of time is the first thing to try. If that doesn’t help, you could split the Lantus into two doses. Some people have found that works better for them. As mentioned, the other option is Levemir in two doses. You have more flexibility then to adjust your daytime dose while leaving your nighttime dose alone, and vice versa. The split doesn’t have to be equal.

Hi there, ok thank you for the info and advice.

 

[everydayupsanddowns]

Sorry to hear you’ve been having a bit of a runaround with your basal @Type1Pat

I have found over the years that sometimes (but not always) my liver can get a bit twitchy after hypos. So it may be possible that some of the hike in BGs you are seeing at lunchtime might be fallout from the overnight lows?

 

[Pat91]

Sorry to hear you’ve been having a bit of a runaround with your basal @Type1Pat

I have found over the years that sometimes (but not always) my liver can get a bit twitchy after hypos. So it may be possible that some of the hike in BGs you are seeing at lunchtime might be fallout from the overnight lows?

Is it advisable to try and find the right amount of carbs before bed ie if I'm having say 20g at the minute but still waking up low should I slowly increase the carbs before bed.until I wake up in range. Don't really want to have to lower to 17units of Lantus as my numbers stay more balanced on 18units. Thanks.

 

[everydayupsanddowns]

Is it advisable to try and find the right amount of carbs before bed ie if I'm having say 20g at the minute but still waking up low should I slowly increase the carbs before bed.until I wake up in range. Don't really want to have to lower to 17units of Lantus as my numbers stay more balanced on 18units. Thanks.

That sounds like a sensible precaution while you wait to speak to your DSN Pat, though obviously ‘feeding’ insulin isn’t a great strategy long-term, and you should be aiming for a basal regimen that allows you to stay steady(ish) both daytime and nighttime)