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Re: [IPk] Lantus advice needed

Hi Jackie,

Before moving the dose (or possibly splitting it) I would make sure you
know what is happening throughout the day (e.g. by trying
delaying/skipping lunch next, then the afternoon snack, then the evening

15 hrs for an alleged 24hr insulin does seem a little fast - but perhaps
that's where lantus has variability (i.e. in length it lasts, rather
than when it's delivered). And then there is human variability:  I
found, for example, that Actrapid lasted 50% longer in me than it was
supposed to.

Best wishes,


(dm 30+, 508 2+)

In message <email @ redacted>,
Jackie Jacombs <email @ redacted> writes
>Hi All
> Sasha is a small nine years old and weighs about 62 lbs. We just started on
>Lantus about two weeks ago.
> We are currently injecting 11 units of Lantus in the morning (we started with
>the morning as we have
> often had problems with night time lows with NPH. The daytime numbers haven't
>been too bad in the last
> week or so but I am finding that when I give her enough Novolog to cover the
>evening meal she seems to go
 > low between 1 and a half to 2 hours later. Then even though I don't think I
>over correcting she seems
> to go higher later. Even when her blood glucose levels seem ok after a meal,
>she always seems to be just
> above 190 (10.5 mmol) at about 11.00pm when we test before we go to bed. If I
>give anymore Novolog
 > with the meals and bedtime snack she goes too low. We are having to correct
>11pm and sometimes later
>as well or her levels don't seem to drop.
> Today I was trying to see if the Lantus dose was correct for the daytime when
>she misses a morning
> snack. She had been having a small 5 or 6 carb snack at school. Today after
>giving 4 units of Novolog
 > for breakfast (Sasha was 122 (6.8 mmols on waking) and she was 120 (6.6
>a couple of hours
> after breakfast. I did not give her a morning snack and although she wasn't
>particularly active by 12.20
> lunchtime she had gone right down to 65 (3.6). So it seems like 11 units of
>Lantus is too much. If I
> drop the dose of Lantus I am concerned that it wont be enough to cover the
>evenings. I cant think that
 > it is running out and the action finishing that early! As it would mean it
>only lasting 15 hours.
> Has anybody switched from Morning Lantus back to evening Lantus for this
>reason. I just wondered if it
 > was peaking slightly in the morning, when it seems a peak in the evening,
>hours or so after the
> evening meal might work. We would give the Lantus at the same time as dinner.
>Its not much use asking
 > our D nurse as they have only just started using this insulin with children
>the UK
>Any thought on this welcome
>Jackie Jacombs
>email @ redacted
>for HELP or to subscribe/unsubscribe, contact:

Pat Reynolds
email @ redacted
   "It might look a bit messy now, 
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