Help with Lantus dose

[Expat in Turkey]

Hello Everyone,

I have been diabetic for 8 years, following a bout of acute Pancreatitis. For the first 5 years I was on pills. The type and strength of the pills increased until 2.5 years ago I was put on Insulin - Humalog 50/50 before Breakfast and Dinner. Last autumn I lost control of my blood glucose levels (My A1c went to 8.6!). I had lots of tests. My senior doctor said I had stopped producing Insulin and put me on a different insulin plan. Nova Rapid before meals. Dose is 8 - 14 units depending on what I will eat. In addition I take Lantus before going to bed. Now my daytime blood sugar levels go up and down between the target ranges set for me. No problem here. My Base level is stubbornly high. I was told to increase the dose of Lantus by 2 units at a time until my Waking blood sugar was 90-120. Up till now 40 units of Lantus appeared to do the job, but the last 2 nights I have hypoed (BS 48 and 54) at about 2.00 am at night. Of course I got up and ate something (a small mandarin + half a slice of brown toast). Problem is now my Waking Blood sugar is 140 - 150, much too high!

Now my question! Should I lower my evening dose of Lantus or should I split the dose? It takes a while to see the senior doctor who speaks perfect English but mt Turkish is not good enough to explain this to the nurse. I would appreciate your advice.

 

[noblehead]

Start with some basal testing:

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

 

[s.sollis]

I'm on latus and have been told it's not licensed for two doses.

 

[LucySW]

Hi Expat, Are you in contact with@RuthW ? She is based in Turkey too.

 

[Jovifreak]

I'm on latus and have been told it's not licensed for two doses.

I've been using Humalog & Lantus for around 7 years now and my Lantus dose is split am & pm.

 

[Jovifreak]

I'd try splitting the dose and see how you get on.

 

[martha]

I take lantus once a day normally around 5pm dose is 76 and this last 24 hours.
I see you take nova rapid before meals.I check my sugars after I have eaten my meals and only then inject depending on my results.You can not tell what you're level will be but base it on what you know is true.

If you find that without eating you are still high increase the Lantus by 2 until you have it at a controlled level.

Hope this helps

 

[TomGreen101]

Lantus is a one dose insulin. I take 64 units at 9 pm. It is designed to last 24 hours.

 

[treefrog]

I've been using Lantus & Novo Rapid for 16 years, I take Lantus in two doses AM & PM, I count my carbs before meals using an insulinx meter and inject Novo Rapid 15 minutes before the meal, I only take it after a meal if I am eating out, you have to see the meal before you can count the carbs, I also have Carbs & Cals App on my phone so it is easy to calculate, my Insulinx Meter then shows me how much insulin to take, easy.

 

[noblehead]

Lantus is a one dose insulin. I take 64 units at 9 pm. It is designed to last 24 hours.

True for some people but for others it doesn't give a full 24 hour coverage, some members here have seen the benefits of a split-dose which gives them a far better coverage.

 

[TomGreen101]

True for some people but for others it doesn't give a full 24 hour coverage, some members here have seen the benefits of a split-dose which gives them a far better coverage.

Yes some people do split doses, but Lantus was designed to last 24 hours.

 

[noblehead]

Yes some people do split doses, but Lantus was designed to last 24 hours.

It was, but like most things it doesn't always work for everyone.

When on lantus I was on one dose a day but know many people who do have to split-dose their lantus insulin.

 

[TomGreen101]

Try toujeo it might work better.

 

[mim1960]

Hello Everyone,

I have been diabetic for 8 years, following a bout of acute Pancreatitis. For the first 5 years I was on pills. The type and strength of the pills increased until 2.5 years ago I was put on Insulin - Humalog 50/50 before Breakfast and Dinner. Last autumn I lost control of my blood glucose levels (My A1c went to 8.6!). I had lots of tests. My senior doctor said I had stopped producing Insulin and put me on a different insulin plan. Nova Rapid before meals. Dose is 8 - 14 units depending on what I will eat. In addition I take Lantus before going to bed. Now my daytime blood sugar levels go up and down between the target ranges set for me. No problem here. My Base level is stubbornly high. I was told to increase the dose of Lantus by 2 units at a time until my Waking blood sugar was 90-120. Up till now 40 units of Lantus appeared to do the job, but the last 2 nights I have hypoed (BS 48 and 54) at about 2.00 am at night. Of course I got up and ate something (a small mandarin + half a slice of brown toast). Problem is now my Waking Blood sugar is 140 - 150, much too high!

Now my question! Should I lower my evening dose of Lantus or should I split the dose? It takes a while to see the senior doctor who speaks perfect English but mt Turkish is not good enough to explain this to the nurse. I would appreciate your advice.

Hi I am on novo rapid & lantus my doctors told me to split the lantus to half in the morning & half at night then depending what my blood sugars are doing I can adjust just one of my doses so they are not always equil works for me see how you go

 

[Deleted Account]

Until I recently went on the pump, I was on Novarapid and Lantus. Although I never split the doses, it was one suggestion I received from the doctor to balance out my levels.
When I first went on the pump, I was warned that although Lantus is supposed to last for 24 hours, it hangs around for up to 4 days. My experience in my first 4 pump days would confirm this.
My reason for mentioning this is that your hypo may be as a result of the build up of Lantus in your body from previous days.
Also, the profile of Lantus is not flat, it takes an hour or so to reach its plateau. This means if you take it just before bed, your insulin will increase and your BG drop for the first few hours whilst you are asleep ... and not able to notice. I too used to take my Lantus just before I went to bed but felt much better (less night time hypos) when I moved it to my evening meal times.
Unfortunately, all of our bodies are different and react differently to insulin and food. But stick with it.

 

[TomGreen101]

I take my Lantus at 9:00 pm and have been on it for 2 years. I have had great results but had to go on Novo Rapid to deal with meals. Lantus actually starts about 2 .5 hrs after injecting and Nov Rapid takes 15 mins.
Lantus is a base tine insulin. The idea is that it creates a even BG level while Novo Rapid deals with meal time spikes.
I started at 2 units of Lantus and gradually raised it to 64 units.
Novo Rapid I also started at 2 units before meals and now average 20 units.

 

[mumsie147]

Hello Everyone,

I have been diabetic for 8 years, following a bout of acute Pancreatitis. For the first 5 years I was on pills. The type and strength of the pills increased until 2.5 years ago I was put on Insulin - Humalog 50/50 before Breakfast and Dinner. Last autumn I lost control of my blood glucose levels (My A1c went to 8.6!). I had lots of tests. My senior doctor said I had stopped producing Insulin and put me on a different insulin plan. Nova Rapid before meals. Dose is 8 - 14 units depending on what I will eat. In addition I take Lantus before going to bed. Now my daytime blood sugar levels go up and down between the target ranges set for me. No problem here. My Base level is stubbornly high. I was told to increase the dose of Lantus by 2 units at a time until my Waking blood sugar was 90-120. Up till now 40 units of Lantus appeared to do the job, but the last 2 nights I have hypoed (BS 48 and 54) at about 2.00 am at night. Of course I got up and ate something (a small mandarin + half a slice of brown toast). Problem is now my Waking Blood sugar is 140 - 150, much too high!

Now my question! Should I lower my evening dose of Lantus or should I split the dose? It takes a while to see the senior doctor who speaks perfect English but mt Turkish is not good enough to explain this to the nurse. I would appreciate your advice.

Yes. Lower your evening dose of Lantus. Hypos at night, if your blood glucose on going to bed is in the normal range, is an indication your evening Lantus is too high. I'm sure you know Lantus is used to maintain a steady blood glucose overnight, between meals and when no carbs are eaten. Having a carb free meal (so no short acting insulin) should tell you if your dose of background insulin is right for you. Following this meal your blood glucose level should stay about the same. Lunch is the safest time to do this. 40 units seems a bit high. Glucose levels increase naturally in the morning before waking so it's not the ideal time to use as a guideline for fasting blood levels.

 

[s.sollis]

Lantus is a one dose insulin. I take 64 units at 9 pm. It is designed to last 24 hours.

That's what I was told, I take 66 in the morning

 

[TorqPenderloin]

That's what I was told, I take 66 in the morning

Something else to consider is that higher doses will also have a longer lasting profile. In short, your 66 units once a day would last longer than my 3-5 units twice a day.

 

[Expat in Turkey]

Hi Expat, Are you in contact with@RuthW ? She is based in Turkey too.

Hi, Turkey is a big country! I am in Alanya. It would be good to talk with someone who uses the Turkish Health service.
Thanks