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RE: [IP] Lantus question



Boy, the pump sure is simpler.  My husband goes from .6 uts of insulin per 
hr from 3 pm to 4 am.  Then, he goes to 1.0 ut from 4 to 6 am and then back 
to .6 until  10 am when he falls to .3 until 3pm.  With exercise he goes to 
.2 sometimes.  The continuous glucose monitoring system showed over 3 nights 
that he never went low, even with that much of a climb in the basal.  
Iindeed he is still a bit high at 1.0 ut for two hours.   I'd sure hate to 
have to get up and give him an extra ut to cover his dawn phenomenon.


>From: "margo2" <email @ redacted>
>Reply-To: email @ redacted
>To: <email @ redacted>
>Subject: RE: [IP] Lantus question
>Date: Thu, 13 Nov 2003 17:08:48 -0600
>
>Insulin Pumpers is made possible by your tax deductible contributions.
>Your donation of $10, $25, or more... just $1 or $2 per month is
>needed so that Insulin Pumpers can continue to serve you and the rest
>of the diabetes community. Please visit:
>
>     http://www.insulin-pumpers.org/donate.shtml
>
>Your annual contribution will eliminate this header from your IP mail
>
>The last time I saw my endocrinologist he explained that they were using 
>the
>Lantus twice a day for those that don't get the full 24-hour coverage.
>So....that's what he told us to do with the
>dog....:)
>
>Margo
>
>-----Original Message-----
>From: email @ redacted
>[mailto:email @ redacted]On Behalf Of Juan Antonio
>Dominion
>Sent: Thursday, November 13, 2003 5:01 PM
>To: email @ redacted
>Subject: RE: [IP] Lantus question
>
>
>One of the advantages of Lantus is that it's not supposed to have much
>variability of absorption timing.  Thus, it should last only about 24
>hours in the body.  One of the reasons that I do not take it any longer,
>in fact, is that it used to wear off at about 20-22 hours, leaving me
>with a tremendous high during the last few hours of the period.  I don't
>believe that it's recommended to take the dose twice daily either, for
>this reason.  It is usually prescribed to be taken in the evening,
>sometimes in the morning, but not both.  So, what's happening is that
>your brother is getting an overlap of the dosage.  He probably needs
>that much during the day, or is compensating for it with extra carb
>intake, but at night while sleeping, he cannot do this, so he is in
>effect getting too much insulin.  Of course, we all know the solution to
>this is pump therapy.  In the absence of that, however, I have read
>recently that people were using the Lantus for their basic basal
>insulin, then supplementing it with NPH, if necessary to cover any dawn
>phenomenon, and Humalog or Novolog as needed for food intake.
>
>Antonio in Los Angeles
>Dx Type 1 1993 @ Age 27
>Paradigm 512
>
>-----Original Message-----
>From: email @ redacted
>[mailto:email @ redacted] On Behalf Of
>email @ redacted
>Sent: Thursday, November 13, 2003 2:21 PM
>To: email @ redacted
>Subject: [IP] Lantus question
>
>Insulin Pumpers is made possible by your tax deductible contributions.
>Your donation of $10, $25, or more... just $1 or $2 per month is
>needed so that Insulin Pumpers can continue to serve you and the rest
>of the diabetes community. Please visit:
>
>     http://www.insulin-pumpers.org/donate.shtml
>
>Your annual contribution will eliminate this header from your IP mail
>
>I have a question concerning Lantus.  My brother is currently using it
>along
>with Humalog.  It seems he is going low, around 40, in the early morning
>
>  hours. He eats his glucose tabs and is still only around 70 when he
>gets up at
>6
>am.  His doctor has told him to play with his numbers on both his
>morning and
>evening Lantus as the doctor is not sure which could be causing the lows
>as
>  Lantus can stay in the system from 24 to 36 hours. That seems like a
>big
>overlap
>to me.
>Has anyone else had this problem?  And if so, which dose did you end up
>reducing?
>My brother has been a diabetic for 20 years, me for 40.  (He always
>wanted to
>be like his big sis!).
>
>Thanks in advance for any insight on this.  By the time I talk to him he
>may
>already have solved it but thought I would ask the "pros" anyway.  LOL
>
>Debbie dx 3/63
>pumping 3/00
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