Hypos Through The Night - Lantus?

[LeonTee]

Hi

Hoping somebody may be able to advise. I’m Type 1 and have been using Lantus for years with no problems. 10 days ago, for a period of 5 days, I found myself waking to BG levels of under 3 - typically 2.4 (though this may just be a coincidence). This happened for 5 days until I got too scared to fall asleep - I’ve therefore been checking my levels every hour through the night. Needless to say I’m absolutely knackered now

I’ve noticed that the drop in BC levels happens straight after my 24u of Lantus in the evenings. I’ve started lowering the dose by 2 units per day and last night took 18 units - though I still ended up at 2.8 at 7am.

Getting out of the hypos is, in addition, proving difficult - and I’ve gone through a shedload of test strips which will undoubtedly please my GP.

Has anybody experienced anything similar and, if so, how did you resolve the issue. At my wits end now.

Cheers

Leon

 

[Ziggy2017]

Hi Leon I used to have hypos during the night mot as bad as your but my doctor decided it was best to take me off my nighttime insulin I now have very rare hypos during the night hope this helps

 

[Deleted Account]

Whilst the profile of Lantus should be flat, it tends to rise at the start and then come down to a plateau.
As a result, it is not uncommon to experience a low within the first few hours of taking Lantus.
This is most risky if you take your Lantus just before you go to bed because it is likely to peak whilst you are sleeping.
I overcame this by moving my Lantus injection to tea time which is early enough not to experience the night time hypos and I was also eating some carbs to soak up the Lantus peak.

However, it is unusual that you have only seen this night time hypo problem very recently.
I wonder if it is not related to the Lantus and perhaps caused by something else such as the hot weather either directly (some people experience low BG when hot and others go high) or indirectly such as eating less carby salads.

 

[DunePlodder]

It may be that the hot weather is making you more insulin sensitive. (assuming you are in th UK)

 

[Circuspony]

I'm not on lantus any more but my consultant told me to take it in the morning when I was going low overnight

 

[karen8967]

i was on lantus for over 12 months but started going low throughout the night my diabetes team changed me over to tresiba which has a flatter profile and has kept me steady throughout the night also i noticed i wasnt getting the full 24 hours out of lantus i used to take it at 10pm and would find it tailed off about 5pm the next day

 

[LeonTee]

Blimey, I’m using the app and since I hadn’t received any notifications I didn’t think anybody had responded to my post...

Thank you all for your responses - lots for me to consider.

The weather could well be contributing - I hadn’t thought of that. I think, therefore, that I will start taking the Lantus in the mornings - it seems a safer bet. I’m seeing the hospital diabetic team in the middle of August so I’ll see if they might suggest changing to a different insulin.

Thank you all!

 

[scotteric]

Hi

Hoping somebody may be able to advise. I’m Type 1 and have been using Lantus for years with no problems. 10 days ago, for a period of 5 days, I found myself waking to BG levels of under 3 - typically 2.4 (though this may just be a coincidence). This happened for 5 days until I got too scared to fall asleep - I’ve therefore been checking my levels every hour through the night. Needless to say I’m absolutely knackered now

I’ve noticed that the drop in BC levels happens straight after my 24u of Lantus in the evenings. I’ve started lowering the dose by 2 units per day and last night took 18 units - though I still ended up at 2.8 at 7am.

Getting out of the hypos is, in addition, proving difficult - and I’ve gone through a shedload of test strips which will undoubtedly please my GP.

Has anybody experienced anything similar and, if so, how did you resolve the issue. At my wits end now.

Cheers

Leon

If you aren't going low during the day it may just mean you need less basal at night. You could do this by splitting it and taking less at night and more in the morning. You could also switch to Levemir which is a good basal for splitting and take it 2x/day at different doses.

 

[LeonTee]

Thank you. I’ll research splitting doses as it’s not something I’ve had to do or considered before.

Cheers

 

[Knikki]

I've been on lantus for years and used to hypo regular at night time. Now I have started to split mine so some before I go to bed and the rest when I wake up, I'm not taking as higher dose as you.
It has reduced the really early morning hypos, like those at 3 in the morning but not got rid of them completely.
Still experimenting at the moment

What @ helensaramy says is interesting might have to think about that.

 

[scotteric]

Thank you. I’ll research splitting doses as it’s not something I’ve had to do or considered before.

Cheers

It's common practice for a lot of type 1s on Lantus or Levemir, especially once you're past the honeymoon phase.
http://www.diabetes-book.com/opinion-no-24-hour-basal-insulin/

 

[Ambersilva]

I attended a Hospital Diabetic Clinic today and during a very thorough assessment of my wellbeing I admitted to several unexpected hypo blood sugar readings during the hot weather. The registrar agreed that I am controlling diabetes very well but because of the recorded lows thought that I should try Tresiba. A Libre device was also ordered. I didn't even have to ask.

Hi

Hoping somebody may be able to advise. I’m Type 1 and have been using Lantus for years with no problems. 10 days ago, for a period of 5 days, I found myself waking to BG levels of under 3 - typically 2.4 (though this may just be a coincidence). This happened for 5 days until I got too scared to fall asleep - I’ve therefore been checking my levels every hour through the night. Needless to say I’m absolutely knackered now

I’ve noticed that the drop in BC levels happens straight after my 24u of Lantus in the evenings. I’ve started lowering the dose by 2 units per day and last night took 18 units - though I still ended up at 2.8 at 7am.

Getting out of the hypos is, in addition, proving difficult - and I’ve gone through a shedload of test strips which will undoubtedly please my GP.

Has anybody experienced anything similar and, if so, how did you resolve the issue. At my wits end now.

Cheers

Leon

Same here. See the post I recently posted

https://www.diabetes.co.uk/forum/threads/todays-diabetic-clinic-experience.153832/

 

[LeonTee]

Thanks all. For some reason the app won’t let me reply to individuals. I took 6u of Lantus before bed and woke at 7am to a reading of 7.7. I didn’t have breakfast, but took 14u, and my lunchtime reading (1pm) was 4.9.

Much, much better. As much as I didn’t want to take 2 shots of Lantus per day, these results mean that it’s definitely workable!!

Ambersilva - I’m going to my hospital clinic in a few weeks...I’ll be showing the consultant your post in an attempt to put a bit of pressure on them. I’d love a Libre

Thanks again

 

[handicapable]

I had the same problem within the first two weeks starting on insulin. To prevent it from happening as helensaramay mentioned you want to have the dose a good few hours before you sleep.

I've read that it peaks after an hour and then the effects stay constant for the following 24 hours. I also read this from Lantus' website 'Lantus should only account for around 33% of your total daily insulin intake'.

Since reading this I dropped from 20 units to 10 without even consulting my DN and my BG levels are no different, i just don't wake up having hypos.

If your DN gives you the same BS as mine gave me.. 'well, it's not an exact science' check out the University of California, San Francisco's website.

Diabetes has been being treated with insulin for 96 years now so while doses may need tweaking there is plenty of science behind itand the best place I've found that explains it is UCSF.

 

[LooperCat]

I was on Lantus for years, before being switched to Tresiba, and dutifully took my 36u before bed each night. I’d have really bad night hypos three or four nights a week, and go really high in the afternoons. I had no idea you could split the dose until I did the DAFNE course and we covered that. I split it 18:18 morning and night, which improved things but not completely. It never occurred to me that you could take more at one dose and less in the other, I just did as I was told...I’d happily fiddle with my Novorapid doses, but never thought to fiddle with the Lantus other than that split.

I fiddle with all of it now, admittedly having Libre on prescription (plus the add on of a MiaoMiao transmitter that I bought myself, which gives me high and low alarms) really helps with my experiments, and I’m splitting Tresiba too, even though allegedly it lasts 36-42 hours. It seems to last less than 20 for me.

So keep fiddling, keep detailed records, and work out what works for your body. Basal testing is a really good idea too!

 

[Circuspony]

I'm not on lantus any more but this thread is explaining why I don't get hypos after doing my horses in the morning any more. I just thought I was really insulin sensitive and a bit of exercise in the morning was sending me through the floor. I was taking lantus at about 6am so I think I was being hit by the peak. On tresiba I'm running higher in the morning, no hypos and upping the novorapid ratio.

I don't think the diabetes team ever knew lantus had a peak.