Lantus and hypos

[noblehead]

I had a hypo on Wednesday afternoon. 1.8 and I passed out on my living room floor. I was petrified. I only take lantus at 7am every morning as my pancreas is still spurting it out now and again. I recently increased my lantus to 10 and and suffered 4 hypos in one day I decreased it back to 8 and still I'm having hypos but it's at 4am and I wake up paralysed and often can't breathe and covered in what seems a few bucket fulls of water but it's actually cold sweat. I've spoken to my DN and she wasn't much help. I'm a dispenser and know about stuff and my brother has type 1 and my father in law. I'm 8st 3 and 5ft 7. Xx

You need to reduce your basal insulin (lantus) to reduce your night-time hypo's, try reducing it to 6 units and test your bg for a few nights to see if this is enough, I would suggest setting your alarm and testing around 1 & 3am.

If your not getting much cooperation from your DN then ask for a appointment with the diabetes consultant, in the mean-time keep a detailed record of all your insulin doses, bg readings and food intake and take it along with you.

 

[Josef1980]

I had a hypo on Wednesday afternoon. 1.8 and I passed out on my living room floor. I was petrified. I only take lantus at 7am every morning as my pancreas is still spurting it out now and again. I recently increased my lantus to 10 and and suffered 4 hypos in one day I decreased it back to 8 and still I'm having hypos but it's at 4am and I wake up paralysed and often can't breathe and covered in what seems a few bucket fulls of water but it's actually cold sweat. I've spoken to my DN and she wasn't much help. I'm a dispenser and know about stuff and my brother has type 1 and my father in law. I'm 8st 3 and 5ft 7. Xx

Why r u even taken insulin?

R u type1 or 2?

If you are type2 then:

You should be taken glucofage pill 500 or 800 or 1000 after each heavy meal if you are type 2.

Swith to glucofage 500/800/1000 per meal

http://en.m.wikipedia.org/wiki/Metforminc


If you r type 2 and you are still producing insulin. You should be on pills not insulin. At least not yet. Maybe in the future when ur insulin production is very low.

However if you are type1 then you need to reduce the lantus.

Are only taken lantuse? what else are you taken?

Ask someone to keep an eye on you
Keep juice and or choclate and or honey with you and in bedroom

 

[jack412]

my guess is T1 and a bit of honeymoon thrown in, with the pancreas in its last throws causing havoc

 

[Peachypuff72]

I'm type one. Only been diagnosed two months ago. X

 

[Peachypuff72]

I'm on 9 units of lantus and carb counting and adjusting my fast acting nova. X

 

[mopsy21]

Hi. I don't know if this well help,but when I was first diagnosed, I was getting too low for comfort every morning - not actual hypos, and nthing like you're suffering, but just too low to operate normally. The advice from the diabetes specialist was to reduce the ratio of Novorapid for breakfast (only the morning was affected, so the Lantus was okay for the rest of the day). The ratio went from 1:10 to 0.5:10 and ended up 0.2:10. This means that I very rarely take any Novorapid in the morning and the Lantus takes care of things until lunchtime. If I limit lunch to 10gcarbs, I don't take any Novorapid then either - unless the bg is over 6.8. This seems to be working - no hypos.

It is just a thought, but could it be that's the Novorapid that's causing the problems? Not overnight, but during the day. Whatever, I do hope you can get some help and advice - I was lucky in that I had a phone number to the diabetes team, and they were very helpful. Best wishes.

 

[AndyS]

How do you know how long its been working in your body whether its for 24h or 18h or ... how do you know?

Unlike fast acting insulin you can not tell when it is depleted or its active period is over?

I totally agree with you that it differes from one person to another.

I feel I need to wade in on this one since I had an issue with Lantus not lasting a full 24 hours.
I KNOW this because I did 3 carb free days and 3 different occasions and tested every 2 hours throughout the day (even at night) and I found that my levels started to climb at around the 16 hour mark. In discussion with my DSN we figured that it was dropping off at 16 and gone by around 18 to 20 so NOT lasting 24 hours.

I did ask about splitting the dose but was told that they had found doing this with Lantus was problematic for a lot of people, though they did admit it worked well for some (again we are all different), so since I was due for DAFNE within a few weeks of this I switched to Levemir and it made a HUGE difference to me. I think there is still a thread floating round someplace from when that happened.

I found I had more energy and felt better in myself all round.
Again I really want to point out that this was for ME. We are all different and what worked for me may suck for someone else. If you don't mind putting in the effort and going through a bunch of changes then I would say do it to find the combination that works for you.

/A

 

[AndyS]

Hi. I don't know if this well help,but when I was first diagnosed, I was getting too low for comfort every morning - not actual hypos, and nthing like you're suffering, but just too low to operate normally. The advice from the diabetes specialist was to reduce the ratio of Novorapid for breakfast (only the morning was affected, so the Lantus was okay for the rest of the day). The ratio went from 1:10 to 0.5:10 and ended up 0.2:10. This means that I very rarely take any Novorapid in the morning and the Lantus takes care of things until lunchtime. If I limit lunch to 10gcarbs, I don't take any Novorapid then either - unless the bg is over 6.8. This seems to be working - no hypos.

It is just a thought, but could it be that's the Novorapid that's causing the problems? Not overnight, but during the day. Whatever, I do hope you can get some help and advice - I was lucky in that I had a phone number to the diabetes team, and they were very helpful. Best wishes.

This ties in with working out what your basal should be. Get that right and then you just need to fiddle the bolus. I too am on variable doses, 1:1.5 in morning 1:1 afternoon (unless exercise or busy then it drop to 1:0.9) then 1:2 in the evening. If I go for a late snack a couple hours after my evening Levemir then my ratio is 1:1.5.

The key is that we all need to keep our logs while things are going all over the shop and, more importantly, analyse then. It took me months to work out my various ratios.

 

[roosta]

Hi been t1 for over 22years and on lantus for 10 or more years, take one injection at 5pm of twenty units and nearly same time next day/ night at 6.30pm i go hypo,but other than that it works fine,tried changing times and splitting but does not work,so now waiting for my pump will be here in six and hope this will do the trick,could this be the way forward for you ?

Sent from the Diabetes Forum App

 

[Josef1980]

Hi been t1 for over 22years and on lantus for 10 or more years, take one injection at 5pm of twenty units and nearly same time next day/ night at 6.30pm i go hypo,but other than that it works fine,tried changing times and splitting but does not work,so now waiting for my pump will be here in six and hope this will do the trick,could this be the way forward for you ?

Sent from the Diabetes Forum App

Hi roosta why r u changing from lantus to pump?
And what insulin will be in the pump?
How does it work?
And why is it considered any better?

 

[zed]

Hi been t1 for over 22years and on lantus for 10 or more years, take one injection at 5pm of twenty units and nearly same time next day/ night at 6.30pm i go hypo,but other than that it works fine,tried changing times and splitting but does not work,so now waiting for my pump will be here in six and hope this will do the trick,could this be the way forward for you ?

Sent from the Diabetes Forum App

Hi

My diabetes team have never mentioned a pump I wouldn't mind having one but the thought of a needle inside me all the time puts me off.




Sent from the Diabetes Forum App

 

[roosta]

Hi roosta why r u changing from lantus to pump?
And what insulin will be in the pump?
How does it work?
And why is it considered any better?

hi.changing to pump as have tried every thing with lantus if i split it (was told that you should'nt as they can over lap and have hypos) but for me my BG was 20+ over night ,and running high throughout the day if i'd changed my time for the one shot,have been on insulatard and levermir and both were just as bad for hypos,been a long road (3 years) to get to this point and the only thing i have'nt tried is a pump.the pump will have novorapid in,which am on now with injections so things will stop the same with meals half to one ratio,but then the pump mimics the pancreas by releasing insulin every hour.just need to find what basal rate is best for yourself.from as little as 0.005 units per hour and can be adjusted by 0.001 per hour.cant wait for it to come been told will take up to 4 to 6 month to set it myself/life style

 

[Spiker]

How do you know how long its been working in your body whether its for 24h or 18h or ... how do you know?

Unlike fast acting insulin you can not tell when it is depleted or its active period is over?

Well that's pretty easy. There is research on the action curves that is independent of the manufacturers claims, and more to the point there is personal basal rate testing which very clearly shows when the action of long acting insulin fades and ends. All it takes is a blood sugar meter and a day of fasting. There is no mystery, no rocket science.

 

[Spiker]

Josef can you see that the statement "Lantus has a lower hypoglycemia risk than NPH" is not the same as the statement "Lantus does not cause hypoglycemia"?

My point was that, contrary to your point, there is no official statement and no common belief that "Lantus does not cause hypoglycaemia".

Regarding 24 hour action, yes, the intention of all long acting insulins is to provide 24 hour coverage. That it no way means they need to be injected once every 24 hours. So for example Levemir attempts to deliver 24 hour coverage via twice daily injections.

While Sanofi with Lantus attempted to achieve 24 hour coverage with one injection, it's a fact that this does not work with all patients. In particular it is more likely to work with larger doses than with smaller doses, because all action durations of all insulins are dose dependent to some degree (bigger dose lasts longer).

And even for people who do get 24 hour cover from one injection, some can get superior results from two injections because that provides a closer match to their basal requirements. Basal requirements are rarely a straight line and rarely matched to the action curve of a particular insulin. The use of twice daily injections, at varying doses and varying intervals, provides flexibility to better match individual basal insulin requirements as they change over a 24 hour period.

 

[Spiker]

Hi roosta why r u changing from lantus to pump?
And what insulin will be in the pump?
How does it work?
And why is it considered any better?

Pumps use normal QA insulin for basal needs and deliver it continuously 24 hours a day. As the delivery rate can be fine tuned si much, it is far more flexible in exactly matching basal requirements than is possible with any long acting insulin.

 

[Spiker]

Hi

My diabetes team have never mentioned a pump I wouldn't mind having one but the thought of a needle inside me all the time puts me off.




Sent from the Diabetes Forum App

Yes that and the thought of having a device attached to you 24x7. But believe me you soon get used to it and there are many benefits over multiple daily injections (MDI) if you are willing to put the work in.

 

[Josef1980]

Well that's pretty easy. There is research on the action curves that is independent of the manufacturers claims, and more to the point there is personal basal rate testing which very clearly shows when the action of long acting insulin fades and ends. All it takes is a blood sugar meter and a day of fasting. There is no mystery, no rocket science.

Basal testing does not "shows when the action of long acting insulin (e.g. Lantus) fades and ends" whether it lasts for 24 Hours or less/more

It (the Basal test that is) only tells you that you need to adjust the dosage i.e. increase/decrease it.

It also does not take into account many other variables such as your level of activity during that day or what type of food did you eat how many meals did you eat... i.e. how sensitive to insulin (insulin resistance) your body is in a particular day.

Unlike the fast acting NovoRapid where you can know exactly when it ends.

There is no Meter or device that you can use that says you have 0 (zero) or any number of insulin in your body at a given time

 

[Spiker]

Basal testing does not "shows when the action of long acting insulin (e.g. Lantus) fades and ends" whether it lasts for 24 Hours or less/more

It (the Basal test that is) only tells you that you need to adjust the dosage i.e. increase/decrease it.

It also does not take into account many other variables such as your level of activity during that day or what type of food did you eat how many meals did you eat... i.e. how sensitive to insulin (insulin resistance) your body is in a particular day.

Unlike the fast acting NovoRapid where you can know exactly when it ends.

There is no Meter or device that you can use that says you have 0 or any number of insulin in your body at a given time

Hi Josef. You're just completely wrong on every point. Sorry mate!

Miraculously sent via Diabetes Forum App. Probably on the 4th or 5th try :-/

 

[Spiker]

The thing is Josef you have come on here very recently and you are making a lot of very sweeping statements and generalisations. You are advising people and questioning people about how they treat their diabetes with very little idea of their specific situation. For example, you don't believe in the honeymoon period because it didn't happen to you, despite the fact it is well documented, and you advise others on the basis there is no honeymoon period. You seem to take a "one size fits all" approach that what worked for you is the only thing that works and what you were told / what you believe / what manufacturers claim is the only thing that could be true.

I know you are trying to be helpful and to share, but please slow down with all the advice and perhaps do more listening and reading and more asking questions first?

 

[Josef1980]

The thing is Josef you have come on here very recently and you are making a lot of very sweeping statements and generalisations. You are advising people and questioning people about how they treat their diabetes with very little idea of their specific situation. For example, you don't believe in the honeymoon period because it didn't happen to you, despite the fact it is well documented, and you advise others on the basis there is no honeymoon period. You seem to take a "one size fits all" approach that what worked for you is the only thing that works and what you were told / what you believe / what manufacturers claim is the only thing that could be true.

I know you are trying to be helpful and to share, but please slow down with all the advice and perhaps do more listening and reading and more asking questions first?

I said:
It (the Basal test that is) only tells you that you need to adjust the dosage i.e. increase/decrease it.

reference:
"Any significant rise or fall in blood sugar during a fasting basal test probably means that the basal rates need to be adjusted – even if the blood sugar winds up near normal by the end of the test."

http://integrateddiabetes.com/basal-testing/

Spiker Said:
"Hi Josef. You're just completely wrong on every point. Sorry mate! "



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No one here is a diabetes doctor/professor/researcher please do correct me if am wrong. Again this is not a Diabetes Doctors' forum r u a Doctor by any chance?
This is a diabetes community forum and I make clear that I am not a Doctor people can take it or leave I just say what I believe is right and back it up when I can with reference or experience others may agree like they did with Lantus 24 hours discussion and other may not e.g.

AndyS Said:
"I did ask about splitting the dose but was told that they had found doing this with Lantus was problematic for a lot of people, though they did admit it worked well for some (again we are all different), so since I was due for DAFNE within a few weeks of this I switched to Levemir and it made a HUGE difference to me. I think there is still a thread floating round someplace from when that happened."

noblehead said:
"Never had to split dose lantus but night-time hypo's mean your injecting too much insulin, try knocking a unit or two off your evening injection to see if that resolves the hypo issues."


It is up to the reader to decide what works 4 him/here & what he/she wants to take or leave. Ok so

How can you claim that you are always 100% correct and others are 100% wrong?

If this is your way of trying to ban me from this forum by all means Ban Me and delete all my posts and replies to satisfy you
over controlling obsession sickness It does't take a rocket scientist to figure it out just like you said stop patronizing me Mr. Know it all.