Time between evening meal inj and bed time inj

[Laura davies]

Anyone have any advice on this please? Im never too sure how much time i should leave between evening meal insulin and then when best time to take lantus long acting before bed? Any ideas please? If i ate at 7.30 and wanted to go to bed at 9.30 i would be afraid

 

[DeusXM]

It shouldn't make any difference - Lantus isn't supposed to lower your blood sugar, it's supposed to keep it at whatever it was when you injected it. So assuming your bolus is matched correctly to your carb intake and your Lantus is matched correctly to your liver's basal glucose output, it doesn't matter when you take your Lantus as long as it's the same time every day - and that can be at any time of day.

You could theoretically take your Lantus and your other insulin at the same time without any problems.

 

[Northerner]

Hi Laura, welcome to the forum 🙂 As DeusXM says, the timing of your lantus jab is total independent of your mealtime jabs, I used to take mine just before bed.

Have you been diagnosed long? What sort of blood sugar levels are you getting? One thing you need to be careful of is the potential for dropping low in the night, if you are going to bed so soon after injecting for your evening meal. This is because your evening meal insulin will continue to lower your blood sugar levels for up to 5 hours after injecting - if you go to bed two hours after injecting you can expect your levels to drop lower than the reading you take before bed. I would recommend setting your alarm for 2-3am so that you can do a quick check on your levels, at least until you are happy they are not dropping too low. What are your levels like when you wake in the morning?

 

[Copepod]

Welcome to the forum Laura.
As DeusXM and Northerner have already explained, there'e no issue about time between evening meal short acting insulin and bedtime long acting insulin injections.
As Northerner also explained, you need to be sure that your evening meal short term dose is right, so that levels don't continue to drop too low after you sleep. If you get the dose right, there should be no problem. You need to take into account things like exercise undertaken in previous 24 hours or so (vigorous and / or endurance exercise reduces insulin resistance) etc.
Lantus should be taken every 24 hours or so, so that if your bedtime varies between nights, you might need to take it at a time when you are likely to be awake every day. However, most people find varying injection time by an hour or so each way has very little effect on blood glucose levels.

 

[Laura davies]

Thank you so much, i have been in denial about the care of my diabetes for some time, i am just 40 and had a spine operation to remove a disc and shave the other as they were pressing on my sciatic nerve. I've had this for 7 months and have been in chronic pain. My control has gone out of the window due to this coupled by depression. My hba1c was8.5 i have to get it down and I am reading all about how to make myself healthy and am determined. I have an 11 year old son and i want to grow old with him. I wondered about lantus so thank you for giving me good advice. I am watching everything i eat and carb counting, i can't believe my original diagnosis that eat carbs is the way, jacket spuds, pasta, rice, but all these push up BMs. I have felt quite alone with this condition so its good that i have joined this forum and can get knowledge from you wonderful people. Thank u so

 

[Northerner]

Thank you so much, i have been in denial about the care of my diabetes for some time, i am just 40 and had a spine operation to remove a disc and shave the other as they were pressing on my sciatic nerve. I've had this for 7 months and have been in chronic pain. My control has gone out of the window due to this coupled by depression. My hba1c was8.5 i have to get it down and I am reading all about how to make myself healthy and am determined. I have an 11 year old son and i want to grow old with him. I wondered about lantus so thank you for giving me good advice. I am watching everything i eat and carb counting, i can't believe my original diagnosis that eat carbs is the way, jacket spuds, pasta, rice, but all these push up BMs. I have felt quite alone with this condition so its good that i have joined this forum and can get knowledge from you wonderful people. Thank u so

Sorry ot hear what you have been through, and also to hear the dreadfully outdated advice you have been given regarding diet There are lots of experienced, friendly folk here so you are far from alone in this - anything you want to ask, or if you just want to have a rant or a moan, just fire away 🙂 Here's to getting good control and a happier, healthier you! 🙂

 

[Laura davies]

Thank you Northerner that is so supportive and made me smile.

 

[Copepod]

Carbohydrate will only increase your blood glucose levels if you don't match intake with the right insulin dose. If you do that, you can eat anything you like.

Exercise, hot and cold weather also reduce blood glucose levels, unless you decrease insulin dose.

Other things, like stress, infections etc increase blood glucose levels, unless you increase insulin dose.

 

[DeusXM]

Exercise, hot and cold weather also reduce blood glucose levels, unless you decrease insulin dose.

Other things, like stress, infections etc increase blood glucose levels, unless you increase insulin dose.

Just to complicate things, I would say all these things AFFECT blood sugar levels, rather than specifically raise or lower them. Some people find cold weather raises their blood sugar while hot weather lowers it, while with others, it's the other way round. There are also some forms of exercise that actually raise blood sugar in a lot of people. What is true for one person may not be true for others.

 

[Laura davies]

Thank you for the advice. I so need it i wondered why in hot weather i get flushed and my BMs go up and I didn't know that if stressed you can increase insulin dose. I've been through a divorce and break up in a relationship and my BMs were all over the place and i never want to go through that again, thank you for good advice

 

[HERE TINTIN]

I seem to have messed up last night. I had my evening meal at 7.30 with my Humalog, then went to bed at 10.30 my bs was 10.0 so had my Lantus and thought that would be fine. Then at 1am had a hypo and after what seemed like an awful lot of lucozade finally felt better and bs 4.5 when I got up. I am beginning to think having evening meal at 6pm might be a better idea !

 

[Northerner]

I seem to have messed up last night. I had my evening meal at 7.30 with my Humalog, then went to bed at 10.30 my bs was 10.0 so had my Lantus and thought that would be fine. Then at 1am had a hypo and after what seemed like an awful lot of lucozade finally felt better and bs 4.5 when I got up. I am beginning to think having evening meal at 6pm might be a better idea !

I usually eat my evening meal around 5-5:30 so that my mealtime insulin is (usually!) 'expired' by the time I go to bed. I#ve still had a few occasions when I've hypoed 7-8 hours after injecting though. I also found, when I was on it, that lantus can have a bit of an early peak, so that's something to watch out for also.

 

[HERE TINTIN]

I usually eat my evening meal around 5-5:30 so that my mealtime insulin is (usually!) 'expired' by the time I go to bed. I#ve still had a few occasions when I've hypoed 7-8 hours after injecting though. I also found, when I was on it, that lantus can have a bit of an early peak, so that's something to watch out for also.

I am wondering why Lantus does peak like that because I definately get some hypo's from it. I thought the whole point of long acting insulin was it was working in the background to stay at an even keel so to speak. I wonder if all long acting insulins do the same ? It seems like a lot of people are on lantus so maybe it is the best one...Tintin

 

[Bloden]

Thank you so much, i have been in denial about the care of my diabetes for some time, i am just 40 and had a spine operation to remove a disc and shave the other as they were pressing on my sciatic nerve. I've had this for 7 months and have been in chronic pain. My control has gone out of the window due to this coupled by depression. My hba1c was8.5 i have to get it down and I am reading all about how to make myself healthy and am determined. I have an 11 year old son and i want to grow old with him. I wondered about lantus so thank you for giving me good advice. I am watching everything i eat and carb counting, i can't believe my original diagnosis that eat carbs is the way, jacket spuds, pasta, rice, but all these push up BMs. I have felt quite alone with this condition so its good that i have joined this forum and can get knowledge from you wonderful people. Thank u so

Sorry to hear everything you have been thru, Laura. It's very easy to end up feeling alone with a chronic disease. That's why forums like this one are so important. Good luck with getting on top of things...and keep posting. We're all in this together! 😱🙂

 

[Bloden]

I am wondering why Lantus does peak like that because I definately get some hypo's from it. I thought the whole point of long acting insulin was it was working in the background to stay at an even keel so to speak. I wonder if all long acting insulins do the same ? It seems like a lot of people are on lantus so maybe it is the best one...Tintin

My Lantus used to peak. First of all after 4 hours, then it went through a period of peaking at 6 hours, and now it doesn't peak at all!😛

 

[trophywench]

What do you mean, TinTin - 'Why' ?

Because that is the nature of it, the manufacturers make it like that, that's why !

As to why they think it's a brilliant idea to have it peak at c. 5 hours after injection, when most people have it before bed and the time the human body's natural circadian rhythm means their BG is lowest is at about 3am (the peak suicide hour) - is anyone's guess !

 

[Copepod]

So, if a long acting insulin peaks, say 4 or 5 hours after injecting, the obvious thing to try is NOT injecting at bedtime, but to inject on rising, so peak is during normal waking hours. Or have 2 injections of long acting per day, so that there are 2 smaller peaks, instead of 1 larger.

I'm not sure that it's a deliberate feature that Lantus profile has a peak, just that's what it does.

 

[PattiEvans]

Did the manufacturers make it like that on purpose, or was it just a "best effort" in trying to produce a completely flat insulin? I think it also has to be remembered that Lantus doesn't always last a full 24 hours, so could ramp down a couple of hours prior to the 24 hours, when it's often covered by people's mealtime insulin, it then takes 2 or so hours to ramp up again, so there you have another small peak. In my own experience (having been on both Lantus and Levemir) Levemir is much the easier basal to work with.

 

[HERE TINTIN]

Did the manufacturers make it like that on purpose, or was it just a "best effort" in trying to produce a completely flat insulin? I think it also has to be remembered that Lantus doesn't always last a full 24 hours, so could ramp down a couple of hours prior to the 24 hours, when it's often covered by people's mealtime insulin, it then takes 2 or so hours to ramp up again, so there you have another small peak. In my own experience (having been on both Lantus and Levemir) Levemir is much the easier basal to work with.

I have never heard of Levemir might ask about it.

Copepod I don't know why but I have always been advised to take my Lantus at bedtime. Maybe if it peaked in the day because your injecting fast acting as well that might be a worse nightmare hypo wise ?

 

[DeusXM]

It's a 'best effort' - the problem with insulin is that it fundamentally wants to act as soon as possible, so all synthetic insulins are approaches to try and and block that process.

While it's probably fair to say Lantus does have a peak, my personal experience (and I must stress it is just that) is that the peak is negligible - certainly when compared to other basals like Insulatard.

As for circadian rhythms and insulins, I'd be less inclined to blame the insulin and more inclined to blame the rather unthinking advice we're given. There is no reason whatsoever why you should be injecting Lantus at bedtime other than personal preference, but there is a prevailing blanket assumption that bedtime is the 'right' time to do it. I personally inject at around 7pm every day which is partially a hangover from my student days but also still convenient. I might be going to bed at 10.30 on a weekday but on a Friday I'll probably be going to bed much later. Injecting at 7 fits in at a time when I'm probably at home from work and just about to go out, so it saves me having to take another insulin pen out with me. It still works now because I will almost always be at home at some point between 7 and 8. For me it also works well because it's relatively easy to make adjustments for when I travel into other time zones.

I have considered moving my jab to the morning but to be blunt, on weekends I will be getting up a good few hours later than on weekdays. I'd rather have a lie-in than have to get up for the sake of doing an injection.