Lantus high in morning

[xmas]

Hello I use lantus as my long action insulin 40 units in morning but I've been waking up high so I thought I'd check so after 5pm last night no food and I checked at 9pm and i was 5.5 and I've just checked this morning at 5.30am and i am 9.1

My question is how many more units shall I take every morning to get me level again

Thanks

 

[SamJB]

If your levels change by more than 1.6 then you will need to adjust your insulin by 10%.

 

[xmas]

10% yes so I need to take roughly 25% lantus more yes so 10 units more!!!

Could someone confirm this please

 

[AMBrennan]

No, 10% more means that you should take 10% more. Start taking 44u, and if it remains too high after 3 days then increase to 48u etc.

[exact numbers may vary but 10% is reasonable; the point is that you need more insulin if you are less sensitive, and thus will need a bigger change in insulin dose to get visible results in a reasonable timeframe ]

Increasing your morning basal insulin may not be sufficient to reduce high morning fasting BG.

 

[xmas]

Ok today I took 42 but in morning I will increase to 44 and C what's happens. I wonder why it's changed?

 

[SamJB]

I change mine almost on a daily basis depending on how much exercise I'm doing, how busy I am at work, if I'm stressed, if I've had alcohol.

I follow the 10% rule. In your case:

9.1 - 5.5 = 3.6
3.6 / 1.8 = 2

A change of 1.8 means that Lantus needs to change by 10% and you need to change it by 20% which gives:

0.2 x 40 = 8

So increase by 8.

 

[xmas]

Can I up it by 8 in one go if so I will do in the morning when I normally take my lantus. It was perfect until a few days ago

I stopped drinking on NYE would this cause the change Do u think

 

[SamJB]

Perhaps. It can be quite difficult to figure out why things change sometimes. If you're anxious about increasing it by so much, increase in increments to make sure its the right amount.

 

[ivinghoe]

The only other thing to try is splitting the dose if the increase makes you go too low or ask to change to levemir if by splitting you end up going low over night?

 

[noblehead]

Can I up it by 8 in one go if so I will do in the morning when I normally take my lantus.

I wouldn't, at best increase the dose by no more than 2 units and wait 2-3 days to see what effect it has.

 

[xmas]

Went to 44 this morning and I will wait 2/3 days now then test again

Thanks

 

[bethan90]

Aa question to Sam about changing lantus regularly- does it effect you immediately? Changes in lantus always take 2-3 days to show themselves with me therefore I would have to know if I was going to be exercising/stressed 2-3 days in advance (this is just me personally) I was wondering if its the same for you? I was also told when exercising to change my quick acting rather than slow acting but that's not really working for me at the mo as im having big drops around 4-5am!

 

[bennyg70]

If the Lantus is holding you steady @ 5.30 PM then might it be that its not lasting its 24 hour course, rather than not being enough units? There fore timing issues ? Have you tested through the night to see when it starts to rise?

 

[SamJB]

Nope, not for me. I inject before bed and the results of it show overnight. I dont understand how it can take a few days for a Lantus changes to kick in when it has a lifetime of around 24 hours. I'd be interested if someone can answer why.

When I exercise I give myself one unit less of short acting insulin for the next meal and drop my Lantus too. When you exercise your body produces hormones that makes your cells more absorbent, this lasts for 48 hours so after that time I put my Lantus back to what it was.

It works really well for me. I dont get exercise-induced hypos anymore and manage to keep my numbers good.

BTW if I have a moderate exercise session (weights followed by 15 min run) then I drop my Lantus by 10%. If I have an intense session (30 mins hard cardio, rugby training, etc) I'll drop by 20%. Always put it back up after 2 days.

 

[Pearsall85]

Hey Sam, I train on a Monday, Wednesday and Friday and currently take 12 units of lantus of a night. Using your method how would I go about changing my dose to suit?

Stu

 

[SamJB]

I'd only consider changing your insulin if you are having swings in your levels because of exercise. If I do exercise on Friday morning before work I'll drop my Lantus, then on Sunday I'll need to increase it back to what it was.

There is a plateau that I get to where my Lantus will not decrease any more. Its around 6 units. If I were in your routine I'd need to drop it by about 2 units (depending on how intense the session was) on Monday, Wednesday's exercise would keep me on the plateau as its within 48 hours and Friday is within 48 hours of Wednesday. So from Monday to Friday I'd be on the same then on Sunday I'd need to increase only to decrease on Monday.

If I wasn't on the plateau and started off at say 10u on Sunday, on Monday I'd drop it to 8, Wednesday to 6 and because that's my plateau id stay there on Friday. Does that all make sense?

Therefore if I had that routine I dont think I'd need to change my Lantus (except perhaps on the Sunday) because the exercise is evenly spread. Unfortunately, sometimes I can't be ***** to do exercise (work and life in general gets in the way too) so I can go a few days or a week without exercising. Hence I need to be dynamic with my Lantus because I go more than 48 hours between exercising.

The only way you can find out is to test intelligently and give your body the amount of insulin that it wants.

 

[xmas]

I'm still high in the mornings and im on 46units now

So god knows

With lanus would I be better injecting half when I wake up and half around tea time?

Or change and have the whole lot in the evening instead of the morning

I use to take it in the evenings but I was never sure where I would be so the mornings are easier for me but the lanus isn't lasting through the night

I was 7 at 9.30pm, 9.2 at 3am. And 11.2 when I woke up at 5.40am

Any ideas

Thanks