Lantus

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Harri0723

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Type 1
Hi, I eat plenty of food throughout the day and I never miss meals. I'm finding that I am having to eat and snack more than I would like to keep my BG up. What's the best way to try and reduce this please? Do I reduce my lantus? I currently have 26 units in the morning. I'm down to 1 unit of nova rapid for my meals so I can't take that any lower. I have started light session back in the gym and I have read that this can reduce your BG for hours after.
 
Effects of exercise frequently last approx. 48 hours - always remember the DSNs running our BERTIE course saying as a joke that T1s should only be allowed to take exercise on Saturdays and Wednesdays LOL

Seriously though - have you done a full 'Basal' test? Lantus does NOT release itself in an absolutely straight line, which is a bit daft anyway since nobody's actual need for background insulin is flat either.

Anyway, here's how

https://www.diabetes-support.org.uk/info/?page_id=120

then, if you go to the side menu of the page and click on 'Insulin profiles' you'll see how Lantus releases itself into the body.

Lantus because of it's crystalline nature, sometimes forms itself into 'pockets' within the body and then can suddenly release itself up to 12 years later and cause very long hypos - think 3 x 380ml bottles of Lucozade and half a packet of custard creams - both of which I hate, cos I'd already drunk best part of a same sized bottle of Orange Lucozade I carried with me, in case ….. and it happened when I was sitting in the waiting room of my diabetes clinic as I felt odd aafter my appt, so decided to test there and then rather than after I walked back to the car!

Frankly - I'd much rather you'd opt for something you can adjust far more readily as the needs of your body subtly and gradually change, which simply happens and that's that. Lots of us prefer Levemir which although it really needs 2 daily jabs not necessarily of the same amount nor 12hrs apart, just have to try it and adjust to suit, because the efficacy of those adjustments are so much easier to spot and change again if they ain't absolutely correct for you. None of this waiting round for 3 days after you adjust your dose to assess whether it worked or not, like you always have to do with Lantus!
 
trophywench said:
Effects of exercise frequently last approx. 48 hours - always remember the DSNs running our BERTIE course saying as a joke that T1s should only be allowed to take exercise on Saturdays and Wednesdays LOL

Seriously though - have you done a full 'Basal' test? Lantus does NOT release itself in an absolutely straight line, which is a bit daft anyway since nobody's actual need for background insulin is flat either.

Anyway, here's how

https://www.diabetes-support.org.uk/info/?page_id=120

then, if you go to the side menu of the page and click on 'Insulin profiles' you'll see how Lantus releases itself into the body.

Lantus because of it's crystalline nature, sometimes forms itself into 'pockets' within the body and then can suddenly release itself up to 12 years later and cause very long hypos - think 3 x 380ml bottles of Lucozade and half a packet of custard creams - both of which I hate, cos I'd already drunk best part of a same sized bottle of Orange Lucozade I carried with me, in case ….. and it happened when I was sitting in the waiting room of my diabetes clinic as I felt odd aafter my appt, so decided to test there and then rather than after I walked back to the car!

Frankly - I'd much rather you'd opt for something you can adjust far more readily as the needs of your body subtly and gradually change, which simply happens and that's that. Lots of us prefer Levemir which although it really needs 2 daily jabs not necessarily of the same amount nor 12hrs apart, just have to try it and adjust to suit, because the efficacy of those adjustments are so much easier to spot and change again if they ain't absolutely correct for you. None of this waiting round for 3 days after you adjust your dose to assess whether it worked or not, like you always have to do with Lantus!
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Ok thank you I will look into that.
 
Hi

It sounds like you are eating to feed the insulin you are using instead of adjusting your insulin to your needs but if you are not confident of doing basal testing and adjusting your own basal insulin then speak to a Diabetes Specialist Nurse about what is happening and they will help you adjust it.
 
Seems like an odd division between the insulins you have ended up with @Harri0723 - do you eat a fairly regular diet or LCHF?

typically the split between total background and mealtime doses throughout the day is usually something like 50:50 (well... somewhere between 40:60 and 60:40) and it doesnt sound like yours is anywhere near that.

plus you are eating to stop BG dropping, which also makes it sound like something is amiss.

Hope you can find a balance that keeps you on a more even keel.

Do you usually adjust yourself? or wait for advice from your DSN?

Theres a new online/phone support for people with diabetes with insulin questions during the lockdown which I can hunt down if it would help?
 
everydayupsanddowns said:
Seems like an odd division between the insulins you have ended up with @Harri0723 - do you eat a fairly regular diet or LCHF?

typically the split between total background and mealtime doses throughout the day is usually something like 50:50 (well... somewhere between 40:60 and 60:40) and it doesnt sound like yours is anywhere near that.

plus you are eating to stop BG dropping, which also makes it sound like something is amiss.

Hope you can find a balance that keeps you on a more even keel.

Do you usually adjust yourself? or wait for advice from your DSN?

Theres a new online/phone support for people with diabetes with insulin questions during the lockdown which I can hunt down if it would help?
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I would same I eat similar meals most days. I have emailed the nurse to help me adjust things. Is it something that can be easily fixed? I'm still new to all of this.
 
Aaaah - are you fairly newly diagnosed Harri?
 
Harri0723 said:
I would same I eat similar meals most days. I have emailed the nurse to help me adjust things. Is it something that can be easily fixed? I'm still new to all of this.
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Glad you are in contact with your nurse Harri 🙂

Yes it should be perfectly possible to tweak those doses so that they work better. With a little more experience, adjusting your background and mealtime doses is something you will learn to do quite regularly as your insulin needs change through the year.

But good to get advice and support to begin with!
 
everydayupsanddowns said:
Glad you are in contact with your nurse Harri 🙂

Yes it should be perfectly possible to tweak those doses so that they work better. With a little more experience, adjusting your background and mealtime doses is something you will learn to do quite regularly as your insulin needs change through the year.

But good to get advice and support to begin with!
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Ok thanks. That's great I will see what they say in the morning
 
everydayupsanddowns said:
Just checked back... looks like Harri was diagnosed in February TW 🙂
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Not easily spotted without hunting - sorry Harri.

Anyway, read the first half of the other page I posted and see what the Lantus is supposed to do, at least! It's clearly not limiting itself to that - so defo looks like you need to reduce the dose, but if you are speaking to your clinic tomorrow, you'll get expert individual advice then anyway. Will you please come back and tell us what you've been advised to do - and then once you know - whether it's improved things!
 
I was started on about 20 units of lantus ,I had to keep gradually reducing I am now on 5 units which is enough to keep my levels steady . I am a relative newby almost my one year anniversary. I have recently increased my walking drastically as I find it has helped during lockdown to keep me sane . I have been testing overnight to check my levels as having a big problem with Dawn Phenomenon, I am at around 5 all night then goes to 8 or 9 between 4 and 5 in the morning. Any ideas on how to deal with this ?
 
By the way I’m not saying reduce your lantus , I’m just saying it takes time to find out what you actually need as everyone is different
 
@Freddie1966
When do you inject your Lantus? Morning or Evening?
Switching to twice daily Levemir might help in that the evening injection of Levemir might start hitting it's peak activity as your DP kicks in if
I am really lucky that my DP doesn't kick in until I get up so I can bolus for it..... or perhaps it is as a result of the night time Levemir slowing it's progress. I need 2 units of Fiasp when I first wake up to counter act it plus whatever I need for breakfast.
 
rebrascora said:
@Freddie1966
When do you inject your Lantus? Morning or Evening?
Switching to twice daily Levemir might help in that the evening injection of Levemir might start hitting it's peak activity as your DP kicks in if
I am really lucky that my DP doesn't kick in until I get up so I can bolus for it..... or perhaps it is as a result of the night time Levemir slowing it's progress. I need 2 units of Fiasp when I first wake up to counter act it plus whatever I need for breakfast.
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I take mine in the morning. It’s so frustrating as my levels are around 5 all night and then DP . Thanks for the advice I’ll email my DSN
 
The peak of Levemir is nothing like anything else, it's a much more gentle curve up and down and it all depends on dose per kg of body weight.

@Freddie1966 - what time do you go to bed and thus, jab the Lantus? Say bedtime was midnight, the insulin peak would (more or less) coincide with the increase in BG anyway so I'd say you go to bed earlier, which actually means your BG is a lot higher than 5 whenever the Lantus peaks so it's already dealt with that and is tailing back down again when YOU happen to measure the higher BG.

What you could do is experiment in a different way - take jab and go to bed earlier, on the third night do the overnight test. Then revert to normal timing, then the following week go to bed an hour later, on the third night test etc. Easier though, if you can, to get hold of a Libre and let it do the overnight checks - cos I swear my BG isn't the same if I sleep then wake up then sleep then wake up - as it would be if I just slept.
 
trophywench said:
The peak of Levemir is nothing like anything else, it's a much more gentle curve up and down and it all depends on dose per kg of body weight.

@Freddie1966 - what time do you go to bed and thus, jab the Lantus? Say bedtime was midnight, the insulin peak would (more or less) coincide with the increase in BG anyway so I'd say you go to bed earlier, which actually means your BG is a lot higher than 5 whenever the Lantus peaks so it's already dealt with that and is tailing back down again when YOU happen to measure the higher BG.

What you could do is experiment in a different way - take jab and go to bed earlier, on the third night do the overnight test. Then revert to normal timing, then the following week go to bed an hour later, on the third night test etc. Easier though, if you can, to get hold of a Libre and let it do the overnight checks - cos I swear my BG isn't the same if I sleep then wake up then sleep then wake up - as it would be if I just slept.
Click to expand...
Thanks for this I’ll give it a go . I do go to bed very early as we walk our dog at 6 in the morning. I don’t sleep well never have so normally awake reading around 2.30 TIL about 4
 
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