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Re: [IPk] Late blood sugar rises

Hi Jackie,

could you try giving Sasha a small dose of Lantus some other time in the day 
in addition to her morning dose?  I have heard that Lantus in a reasonable 
amount of people doesn't last the full 24 hours.  Also what happens to her 
bgs if she doesn't have dinner?  Does she rise anyway?

Good luck Jackie, it sounds like you are almost there!


>From: "Jackie Jacombs" <email @ redacted>
>Reply-To: email @ redacted
>To: "Insulin Pump List" <email @ redacted>
>Subject: [IPk] Late blood sugar rises
>Date: Thu, 17 Jul 2003 13:33:01 +0100
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>Hi all
>  I am wondering if anyone has any advice. Sasha has now been on Lantus for 
>two weeks. Things
>  aren't going too badly and Sasha's blood sugars are more predictable. We 
>had to reduce the starting
>  dose of Lantus which was 14 units ( Sasha previously took 17 units of NPH 
>Novorapid with meals) Sasha
>  now takes 11 units of Lantus which we give in the morning, as in the past 
>have always had problems
>  with overnight hypos. We seem to have to level of Lantus set correctly, 
>in that
>two hours after
>  breakfast Sasha's blood sugars are still within the target range and 
>later they haven't changed
>  that much. They have been dropping very slightly after 10.30 am so Sasha 
>has an
>apple or biscuit which
>  would have been her normal snack time. By the time 12.00 midday comes her 
>BG is
>usually still within the
>  target range 4.5 - 7.00. However the problem we are having is that, if I 
>her the same insulin to
>  carb dose for 65 carbs for the evening meal (or usually slightly less, as 
>has a higher insulin to
>  carb rate at breakfast) Sasha seems to go low and sometime below 3.5. 
>the levels are OK , but
>  later on, after about 9.30 pm her blood sugar levels seem to rise and 
>carry on rising until we
>  correct. Last night Sasha was 9.7 mmols at 10.30 but then her BG rose 
>again and
>at 2.00am it was
>  11.5 mmols. I don't know if this is due to the sort of meal that she is 
>Tuesday was a large GF
>  chicken burger, Wednesday was curry and rice. Both of those meals had 
>protein in than Sasha usually
>  eats as she doesn't really like eggs or meat. If we correct the levels 
>early in
>the night then the
>  levels will stay about the same level throughout the rest of the night. 
>although two hours after the
>  evening meal her BG is low, or in range then it continues to rise to 
>16-17 mmols sometimes but this
>  is usually 5 hours after the meal. I don't think we can increase the 
>more as she already drops
>  slightly in the morning. If it is protein or fat causing the rise how do 
>dose for this. I cant
>  really give any more Novorapid with the meal. Does one just have to wait 
>the rise had happened or
>  The only other thing I can think of is switching the Lantus to the 
>evening to
>see if this helps. Which
>we didn't really want to do.
>Any ideas of what might be happening.?
>Mum of Sasha aged 9 dx 1999
>email @ redacted
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