Any Tips

[2610]

Morning all

I was diagnosed about 10 years ago and never really took things seriously until this year. I've been on Lantus (21 units a day) for 3 months, with 1000mg Metformin and got my HbA1c down from 102 to 67. I've got to wait until the 1st August to see the nurse so I thought I'd see if anyone has any tips.

I'm 76kg which is 1kg more than the doctor told me to get down to. My weight probably fluctuates +/- 2kg of 75kg so I'm not worried about weight. I walk about 3 miles a day but I don't get much opportunity to exercise apart from that. My diet is healthy (ish).

When I was ramping up my Lantus, I went as high as 23 units and had a couple of hypos. To be fair, this was on days when I hadn't eaten a great deal. My fasting BG is usually between 5.5 and 8.

So, 2 questions:

1. This is my first 3 month check. I started on 10 units and built up to 21 over a few weeks. Is my HbA1c likely to come down when I've had a full 3 months on 21 units?

2. Should I modify my dose based on what I eat? It seems to me that Lantus is preparing me for the next 24 hours, not covering me for what I've already eaten so I don't know if that would work.

Cheers
AJ

 

[azure]

Tagging @Mep for you as she's Type 2 on insulin.

Can you give us an idea of your daily blood sugars?

 

[DCUKMod]

I'll tag in @satindoll , who is quite a long time insulin user, with T2.

 

[Ann1982]

Welcome to the forum. You will find lots of helpful and kind people here. Ask lots of questions and someone will find an answer for you. Just remember not everything affects everyone the same way. You should try looking for info on basal testing for your lantus and carb counting for your bolus. Have a look at the low carb diet as well.

 

[Mep]

Morning all

I was diagnosed about 10 years ago and never really took things seriously until this year. I've been on Lantus (21 units a day) for 3 months, with 1000mg Metformin and got my HbA1c down from 102 to 67. I've got to wait until the 1st August to see the nurse so I thought I'd see if anyone has any tips.

I'm 76kg which is 1kg more than the doctor told me to get down to. My weight probably fluctuates +/- 2kg of 75kg so I'm not worried about weight. I walk about 3 miles a day but I don't get much opportunity to exercise apart from that. My diet is healthy (ish).

When I was ramping up my Lantus, I went as high as 23 units and had a couple of hypos. To be fair, this was on days when I hadn't eaten a great deal. My fasting BG is usually between 5.5 and 8.

So, 2 questions:

1. This is my first 3 month check. I started on 10 units and built up to 21 over a few weeks. Is my HbA1c likely to come down when I've had a full 3 months on 21 units?

2. Should I modify my dose based on what I eat? It seems to me that Lantus is preparing me for the next 24 hours, not covering me for what I've already eaten so I don't know if that would work.

Cheers
AJ

Hi AJ - welcome

My responses to your questions:

1) If you have been on 21 units for most of the 3 months then it would give a good indication in your hbA1c whether or not it helps. Although when it comes to testing whether you're on the correct basal rate (lantus is a basal insulin which is long acting), you probably need to be doing basal testing. This site has info on how to do that: http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

2) Lantus doesn't really work on bringing your sugar down quickly when you eat food. You'd need bolus insulin (quick acting) for that. Lantus just keeps your sugar level when you're not eating at a normal level. After you establish what your basal rate should be (as above) then you may need to adjust the dosage. Although it appears your doc has you on just the basal insulin and metformin to help control your sugar levels. If you find this isn't working too well you may need to discuss your treatment options with your doc. Also carb counting is helpful when you're on any treatment for diabetes... this free course, although targeted at type 1's is good as it is really for all insulin users. Here's the link: https://www.bertieonline.org.uk/admLogin.asp

I wish you the best.

 

[satindoll]

Hi @2610 .
You are right in that Lantus is a Basal insulin and is only covering you for background numbers, I was on fixed amounts of insulin for years and it worked quite well, I found by splitting my dose and having smaller doses in the morning and then a larger dose about an hour before eating my evening meal I could get some kind of control over my numbers.
I learnt with trial and testing I needed 1unit of insulin to cover a 2mmol rise in numbers, or put another way 1 unit would cover 20grms of carbs, this of course will be different for you, and the only way to find out how much 1unit will cover is by testing your numbers then injecting 1unit an hour before eating a fixed amount of carbs say a slice of bread and butter then testing again at 1,2 and 3 hours after first bite, this testing should give you a rough idea of how high that particular food will spike you and how long it takes you to return to normal and whether that 1unit is enough.
There is no shortcut the testing is the only way to get to grips with dosages........and I will warn you IF YOU DO NOT CUT DOWN ON THE CARBS THE WEIGHT WILL PILE ON, unlike t1's we need to reduce the carbs to make best use of the insulin.
Hope this helps and yes your hbA1c will come down but may take longer than 3 months so don't be disappointed if its not an overnight drop.....

 

[leslie10152]

Morning all

I was diagnosed about 10 years ago and never really took things seriously until this year. I've been on Lantus (21 units a day) for 3 months, with 1000mg Metformin and got my HbA1c down from 102 to 67. I've got to wait until the 1st August to see the nurse so I thought I'd see if anyone has any tips.

I'm 76kg which is 1kg more than the doctor told me to get down to. My weight probably fluctuates +/- 2kg of 75kg so I'm not worried about weight. I walk about 3 miles a day but I don't get much opportunity to exercise apart from that. My diet is healthy (ish).

When I was ramping up my Lantus, I went as high as 23 units and had a couple of hypos. To be fair, this was on days when I hadn't eaten a great deal. My fasting BG is usually between 5.5 and 8.

So, 2 questions:

1. This is my first 3 month check. I started on 10 units and built up to 21 over a few weeks. Is my HbA1c likely to come down when I've had a full 3 months on 21 units?

2. Should I modify my dose based on what I eat? It seems to me that Lantus is preparing me for the next 24 hours, not covering me for what I've already eaten so I don't know if that would work.

Cheers
AJ

Morning all

I was diagnosed about 10 years ago and never really took things seriously until this year. I've been on Lantus (21 units a day) for 3 months, with 1000mg Metformin and got my HbA1c down from 102 to 67. I've got to wait until the 1st August to see the nurse so I thought I'd see if anyone has any tips.

I'm 76kg which is 1kg more than the doctor told me to get down to. My weight probably fluctuates +/- 2kg of 75kg so I'm not worried about weight. I walk about 3 miles a day but I don't get much opportunity to exercise apart from that. My diet is healthy (ish).

When I was ramping up my Lantus, I went as high as 23 units and had a couple of hypos. To be fair, this was on days when I hadn't eaten a great deal. My fasting BG is usually between 5.5 and 8.

So, 2 questions:

1. This is my first 3 month check. I started on 10 units and built up to 21 over a few weeks. Is my HbA1c likely to come down when I've had a full 3 months on 21 units?

2. Should I modify my dose based on what I eat? It seems to me that Lantus is preparing me for the next 24 hours, not covering me for what I've already eaten so I don't know if that would work.
Welcome to the forum @2610. Lantus does not actually cover you for a full 24 hours. 16-18 maybe. Your fasting bgl's are not too bad, but it would help to know dosage and medication prescribed.