Help changing Lantus times

[SarahJRobinson]

Hello I've had type 1 for 20 years now. Recently I've noticed my sugars rise every night so every morning I'm way too high regardless of what I've eaten drunk or what level I go to bed at.

I've changed my long lasting to toujeo as I was told it lasts a bit longer but it's the same. I've also started using the freestyle libre sensor and that picks up that at 1am every morning it starts to rise.

I'm due back at the hospital next week but thought before I go I should try having my insulin at night instead of in the morning (which I started going around 10 years ago as I was constantly going low in the night) but can't remember the best way to do this. Any ideas?

 

[Northerner]

Hi Sarah, welcome to the forum 🙂 A lot of people find that it helps to split basal insulin into two doses, as often a single dose either doesn't last 24 hours, or you end up having 'too much' at one period of the day and 'too little' at another period. Levemir is thought to be best suited to a split, as the impact of doses tends to be more predictable than alternatives like lantus. I have no experience of Toujeo, I'm afraid. Tresiba is something that is also supposed to last longer and I do know we have some members who have found that works well for them in a single dose. I always used to take my lantus at night and suffered from the early 'peak' that many suffer from, with resulting lows in the night.

Have you considered a pump? With those you can adjust basal on an hourly basis, so you can tailor delivery to more precisely match your requirements - single dose basal is really quite a blunt instrument in comparison. Have you done a basal test to see how your Libre shows your fluctuating requirements?

 

[Robin]

Hello Sarah. If I'm right, Toujeo is extra strength Lantus, so behaves in the same way? If so, when I changed my Lantus from morning to evening, I just missed out the morning dose and covered with extra Bolus for,the day, then did the Lantus at night. It saved faffing about over several days gradually moving it back, which is the other option.
I find my Lantus takes a good hour to start kicking in, so I avoid doing it last thing, and take it with my evening meal so I can cover the delayed start with extra Bolus.

 

[SarahJRobinson]

Hello Sarah. If I'm right, Toujeo is extra strength Lantus, so behaves in the same way? If so, when I changed my Lantus from morning to evening, I just missed out the morning does and covered with extra Bolus for,the day, then did the Lantus at night. It saved faffing about over several days gradually moving it back, which is the other option.
I find my Lantus takes a good hour to start kicking in, so I avoid doing it last thing, and take it with my evening meal so I can cover the delayed start with extra Bolus.

Thank you so much I will give this a go then see how I get on when I'm at the hospital next week.

 

[SarahJRobinson]

Hello Sarah. If I'm right, Toujeo is extra strength Lantus, so behaves in the same way? If so, when I changed my Lantus from morning to evening, I just missed out the morning does and covered with extra Bolus for,the day, then did the Lantus at night. It saved faffing about over several days gradually moving it back, which is the other option.
I find my Lantus takes a good hour to start kicking in, so I avoid doing it last thing, and take it with my evening meal so I can cover the delayed start with extra Bolus.

Hi Sarah, welcome to the forum 🙂 A lot of people find that it helps to split basal insulin into two doses, as often a single dose either doesn't last 24 hours, or you end up having 'too much' at one period of the day and 'too little' at another period. Levemir is thought to be best suited to a split, as the impact of doses tends to be more predictable than alternatives like lantus. I have no experience of Toujeo, I'm afraid. Tresiba is something that is also supposed to last longer and I do know we have some members who have found that works well for them in a single dose. I always used to take my lantus at night and suffered from the early 'peak' that many suffer from, with resulting lows in the night.

Have you considered a pump? With those you can adjust basal on an hourly basis, so you can tailor delivery to more precisely match your requirements - single dose basal is really quite a blunt instrument in comparison. Have you done a basal test to see how your Libre shows your fluctuating requirements?

Thanks for your response. Although I've had it for 20 years I've not been seen by a specialist for 15 instead I've been seen by a nurse at my GPs surgery so my knowledge is well off track and the tests you're talking about are new to me. I will ask them next week. As for the pump I've been ignoring it but now I'm so concerned about my health and scared for the future I think I'll have to start discussing it.

 

[grovesy]

Welcome, I am not on Insulin but many on hear use pumps and love them.

 

[Northerner]

Thanks for your response. Although I've had it for 20 years I've not been seen by a specialist for 15 instead I've been seen by a nurse at my GPs surgery so my knowledge is well off track and the tests you're talking about are new to me. I will ask them next week. As for the pump I've been ignoring it but now I'm so concerned about my health and scared for the future I think I'll have to start discussing it.

It's not uncommon to become settled into a routine that, on the most part, works for you - we get quite a few people here who discover they have got quite a bit behind with new thinking and treatments, so you are far from alone! 🙂 I'd suggest having a look at the INPUT website to learn a bit more about pumps - as @grovesy says, most people find that they are very helpful at overcoming what seem to be long-standing and intractable problems on injections.

Do you have any other concerns, besides the basal problem? We might be able to help 🙂

 

[miguel81]

I had a few problems some time ago and I was advised by some contributors here to split my 20 Lantus injections before bedtime to 2 x 10 - one in the evening and one the following morning - there are 12 hours in between. It has worked wonderfully for me and I am grateful for the suggestions and advice given to me.