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Re: [IPk] To Jos (glargine and Hypos)

On 5 May 2003 at 21:39, Jackie Jacombs wrote:

> This is really where a pump would work very well. But as you
> know our Consultant wont hear of if for Sasha, even for a
> trial!!
>  I will have to investigate how people manage a twice a day
>  Lantus regimen. I  suppose if Sasha had her
>  Lantus in the AM it would be wearing off toward the middle
>  of the night to early morning and that is the
> danger time for us.
> I have forgotten when you said Emily has her Lantus
> injection?

Hi Jackie,

I thought we were having a problem with the Lantus lasting 
longer than 24 hours, overlapping and causing hypos at 
night so we moved it to 6pm from last thing at night for a 
while. There were no problems with hypos during the evening 
though so I think I was wrong about the overlap and I just 
needed to reduce the dose. I've moved her Lantus injection 
back to about 10pm now. Lantus has a 6 hour build up period 
so it should reach peak level by around 4am.

Would you be able to give Sasha an injection just before 
you go to bed? If you could leave it until around 11pm it 
wouldn't reach peak effect until 5am. You would only have a 
problem if it lasted longer than 24 hours. 

It hasn't solved the problem of night time hypos 
completely. We are tending to run Em's BG's higher than we 
would like overnight to avoid them. I'm trying to get her 
BG's level over night before I try to bring them down. If 
her HbA1c is higher this time though she may be more likely 
to get a pump, it was 6.9% last time. It depends if they 
count low blood sugars at night as hypos needing third 
party help. The ability to lower the basal rate after 
energetic days would really help.

Mum to Emily aged 10, dx Oct '99
Novorapid x 3 or 4, Glargine x 1, 
Robert aged 12 dx Mar '03 
Novomix 30 x 2 (+ Novorapid when hungry!), 
and Matthew aged 7.
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