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RE: [IPk] Just started Lantus


 It would seem that if you are taking Lantus at 10pm then it is obviously not
"running out" early in the
 morning as I thought it might be doing. Sasha had a very pronounced drop in BG
2 hours after lantus
 which lasted until after lunch then her BG were always high at the end of the
day and into the evening.
 In the end we had to go back to NPH in a split dose. I have read an article
saying that some people are
 "fast absorbers" and so they don't get the same effect with Lantus as some
others do. I wonder if its
 because she is skinny? Sasha seemed to have this problem even on NPH the
insulin peaked before 4 hours.
 I would like to have another go with Lantus using it as a split dose sometimes
but the regimen we are
currently using it the best we've ever got it so far.

 Our DSN is also promoting split doses of NPH with Novorapid and Humalog as
studies show that the action
 of the fast acting insulins tend to finish before then next dose of short
acting is due. Some people are
now taking three shots of NPH.

Mum of Sasha

> Hi Jackie,
> I've been taking the Lantus at 10pm - although my DSN said that they had had
> good results with patients taking it in the morning - she said very stable
> blood sugars throughout the day - OK - but my blood sugars during the day
> aren't the real issue 1or 2 mmol here and there during the day don't make as
> much difference to your control as a spike of 17mmol first thing in the
> morning and I was concerned that the Lantus might not last the 24 hours.
> I will give it a go injecting it straight after dinner back at the old dose
> and see what happens.
> Thanks for the advice
> Adrian
> -----Original Message-----
> From: email @ redacted [mailto:email @ redacted]On
> Behalf Of Jackie Jacombs
> Sent: 07 October 2003 23:48
> To: email @ redacted
> Subject: RE: [IPk] Just started Lantus
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> Adrian
>  What time of day do you take Lantus? I assume that it's at night from what
> you
> say, but at what time?.
>  Lantus does have a peak for some people and is no means as "flat" as
> Aventis
> would have us believe. You
>  could try taking it earlier so that the peak, where you have a tendency to
> drop
> low, occurs at a "better"
>  time, with a meal for instance. If you take it late in the evening try
> taking
> it much sooner after the
>  evening meal. Some people (many people) find that Lantus does not last 24
> hours
> and tend to take it
>  between 6 pm and 10pm (at the same time each day, whatever time you choose)
> that way you can adjust your
>  short acting insulin to "cover" any missing lantus or give less Novo
> because of
> the drop from Lantus.
>  It sounds as though you cant really drop the dose much lower as you will be
> too
> high in the morning. It
> does take about 3 days for any adjustments in doses to settle down.
>  The thing is, if you need different basal rates, which most people do, then
> a
> pump is going to be the
> best solution.
>   Unfortunately our consultant thinks pumps are horrendously dangerous and
> wont
> let us have a trial.
> Jackie
> Mum of Sasha aged 9
> > -----Original Message-----
> > From: email @ redacted [mailto:email @ redacted]On
> > Behalf Of Adrian Miller
> > Sent: 07 October 2003 10:34
> > To: email @ redacted
> > Subject: RE: [IPk] Just started Lantus
> > Hi
> > I started on Lantus and Novorapid last Friday. It appears to work well for
> > me during the day - I get really stable blood sugar levels mostly in the
> > range 4-8 mmol. First night was pretty bad with a low at about 1am - so
> > reduced the Lantus the following night by 2 units to 24 units which seems
> to
> > have conquered that problem but I still have an enormous spike in the
> first
> > thing in the morning round about 17mmol sometimes even higher although it
> is
> > slightly lower than the spike I had with Insulatard. I am still convinced
> > the only solution will be a pump but it seems hard work convincing my
> > Consultant who is very pro Lantus. He told me at my last consultation that
> > if the Lantus/Novorapid solution worked then it was a good indicator that
> a
> > Pump would be a good solution (leaving me more than slightly confused!).
> > I guess so far I have been lucky with my diabetes in that I have only one
> > complication - a frozen shoulder - which has been getting progressively
> > better almost in parallel with the improvements in my blood glucose
> > control - however like my blood glucose level improvements its improvement
> > has plateaud - the Consultant Rheumatologist thinks they are directly
> linked
> > (sadly at a different hospital in North London), if any body can give me
> any
> > advice on how to progress getting a  Pump I would be really grateful.
> >
> > Adrian Miller
> >
> > Type 1 for 20 years - now on Lantus - Totally frustrated!
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