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Re: [IPk] Lantus ( working out how much you need)

Hi Rob,

What are your night-time bgs like?  If you have a nice flat line through
the night, but it shoots up in the morning, then you could try moving
the timeing of the lantus, so that its peak co-incides more with your
peak.  If the line goes up during the night fairly constantly, then
increasing the amount of insulin is indicated.

Before making a move, check with your team that they think it
appropriate.  Also ask for some training on the measurements you should
be taking and whether to alter your bolus or basal, and how - this is
fairly daunting stuff for a newly diagnosed diabetic to take in, but
after six months or so, it's essential knowledge if you are going to
move on and take control of your diabetes.

Best wishes,


(dm 30+, 508 2+)

In message <email @ redacted>, rob cla
<email @ redacted> writes
>I have just started on lantus can anyone tell me what
>sort of amounts they are giving as i was on insulatard
>before this at the moment i am giving 46 units of
>lantus about 6pm but always seem high in the morning
>still can anyone suggest anything.
>--- Jackie Jacombs <email @ redacted> wrote:
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>> Helen wrote:
>> > Jackie
>> > I, and I think others from what I have heard on
>> here and from the DSN, find
>>  > that Lantus seems to cause early morning drops (3
>> to 6 am), even if the BG
>> was
>> > OK on going to bed. (Although I was told the
>> Lantus has a level background
>> >  right through). A snack before bed, without any
>> humalog tends to help this.
>> > I've
>>  That is one of the reasons why Sasha has her Lantus
>> in the Morning rather than
>> the evening.
>> > also found that I've needed to reduce the amount
>> of Humalog I take for meals,
>> > etc. Don't know if this is anything to do with the
>> Lantus providing a more
>> > efficient background level.
>>  I have found this too. Although I am not sure that
>> isn't because the Lantus is
>> too much at the moment.
>>  It seemed OK for the first day or so but I am not
>> sure if that was because it
>> hasn't had time to kick in
>>  fully or because Sasha has been extra active. I
>> guess its a matter of testing
>> on "normal" days to make a
>> clearer judgement.
>> > Do you normally give extra short acting for
>> correcting levels under 13? Just
>>  > that I was always told to only do this if it was
>> over 13. My BG would drop
>> too
>> > dramatically if I gave anything for a BG under
>> this. I would say next time
>>  > leave the BG if it is 12 or so. The Lantus should
>> kick in and take care of
>> this.
>>  The other regimen that Sasha used we found that if
>> we didn't correct a high
>> over about 10 mmols then her
>>  BG would carry on rising. Of course if it was near
>> to a meal time we would
>> wait. But of course we would
>>  take into account any extra exercise she might be
>> about to do etc. Previously
>> if Sasha was above 10
>>  mmols after 2.30 am we might correct using half a
>> unit otherwise we would start
>> the day high and mess up
>>  the whole day. It wouldn't drop her very much.
>> Because Sasha had experienced
>> nightime hypo without waking
>>  since she was diagnosed we have always given the
>> minimum long acting overnight.
>> She has no dawn rise.
>>  This means that sometimes we have to add a little
>> NR in the night. If we do we
>> always check 2 hours
>> later.
>>  I am finding with Lantus that Sasha needs less NR
>> to correct a high than before
>> on NR and Insulatard. So
>>  we are not correcting much at the moment until we
>> get more experience of using
>> it. I would have thought
>>  though that if a high of over 12 comes down by
>> itself that would mean that the
>> Lantus dose is too high?
>> What do you think?
>> >
>> > It took a few weeks for my BG's to 'level (as
>> level as they get anyway)! I
>>  > did need to experiment with the dosage a fair bit
>> and eventually come down to
>> > 10
>> > units whereas with the Humlin I was taking 12. I
>> had tried 8 but that led to
>> > too many highs.
>>  Sasha is taking 14 units on Lantus and about 10 of
>> short acting. Before she was
>> taking 17 unit of
>>  Insultard and 11 units on NR. It seems a bit top
>> heavy with Insulatard (taken
>> in a split dose) but if
>>  she had less that 12 units of Insulatard in the
>> morning she would be too high
>> at lunchtime.
>> I suppose it just a matter of taking BG levels more
>> often and making notes.
>> Jackie
>> >
>> > I do still get lows early am, though. My 'peak'
>> tends to be 9am to 11am. Glad
>> > the gym went better this week for you. What you
>> said about the exercise
>>  > affecting things later on could be true. I know
>> after a busy day, my BG's
>> will
>> > drop
>> > long after the event.
>> >
>> > Hope this helps
>> > Helen
>> >
>> > for HELP or to subscribe/unsubscribe, contact:
>> > HELP@insulin-pumpers.org
>> for HELP or to subscribe/unsubscribe, contact:
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email @ redacted
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