Trying to balance insulin with food

[Robert42]

I am on Lantus insulin 35U/37U. My glucose levels are unstable. If I take 35 units, I will have a good night's sleep, then have glucose jump up in the 12–13 mmol. Will stay there for the rest of the day after eating 45 G of muesli for breakfast. It's as if there is not enough insulin there. Fasting, about 45 mmol.
Now if I shift the insulin to 37 units, I get alarms going off like about 3AM, but it does seem to be better controlled during the day. Any ideas what I am doing wrong. 1 unit increments seem insignificant.

 

[Inka]

1 unit increments can be significant @Robert42 Sometimes that little tweak works well. Perhaps Lantus isn’t the right insulin for you? If, for example, you had a twice daily slow/basal insulin, you could have enough at your morning dose to keep you in range during the day, and not too much at your evening dose so that you didn’t go hypo. It gives you more flexibility.

Another option is to keep the Lantus and add a fast/bolus insulin to cover the carbs in your meals.

Finally, what time do you take the Lantus? Perhaps moving the time you take it might help.

 

[mashedupmatt]

I'm definitely no expert but it would seem a twice daily basal insulin regime would be worth trying (switch to Levemir?) at a lower dose, plus low level ratio insulin before meals (0.5 units per 10g of carbs) - might keep you more stable? Worth speaking to your healthcare team though

 

[helli]

Any ideas what I am doing wrong.

I am not medically trained but it does not look to me as if you are doing anything wrong. More that you do not have the right tools.
Lantus is a background insulin which is active throughout the day at the same level. This works with the glucose that is constantly dripped from our liver. However, as you are seeing carbs also make your BG rise and you do not have the tools for this - you are trying to get the Lantus to cover it.
Maybe a mixed insulin pm which includes fast acting insulin for your meals, would suit you better. Or maybe a separate fast acting insulin before meals.

 

[Robert42]

Thank you everyone for your replies. Changing insulin is not an option at this stage. After doing more reading 1 unit of Lantus to 36 units should be OK I think. Last night I took 37U and no alarm on the Libre 2. The other reason no change Wil be made at this stage was the stopping of gliclazide. It caused chaos with the BSL clearly my pancreas is still producing insulin. So all is back to where it was.

Where I am lacking is a formal meal plan. I live on my own and a senior. I think I can work on this with some ready meals from Wiltshire. I used to get them. The latest catalogue has a full break down of meals.

t is hard reading up on meals online as everyone has a different philosophy.