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Background insulin

D

DiabeticDi

Well-Known Member
Messages
260
Type of diabetes
Type 1
I have been on Lantus for ages and take it before breakfast and before bed. Recently my before breakfast readings have been very high and it seems from talking to my nurse that it is running out about 2 to 3 hrs before I have breakfast (this morning I was 10 at 6.30am and 17 at 8.30 !!!). Also my 3am reading is pretty perfect and it is not dawn phenomenon so that is the conclusion I have come to. Has anyone else had this?

What other background insulins are people on? I know Levemir but don't know how that works. Any advice greatly appreciated!
 
I'm on Levemir, two doses 7 am and 10.30 pm which is my waking and bedtime times. My blood sugars are stable. I can even miss breakfast and run for 40 minutes in the morning without a rise. But I'm the wrong person to talk to as I'm new to this insulin malarky and it could be my honeymoon insulin causing this also. Or my insulin sensitivity factor. Whatever it is, I will still claim that Levemir is the bees' knees.
 
I changed to Tresiba from Lantus earlier this year. Much better control and hba1c figures. I recommend changing if at all possible. According to my medic, Lantus is an inferior insulin compared to the new ones, but the NHS won't change en bloc, just case by case.
 
I wouldn't make blanket statements that any insulin is 'inferior' in spite of what any medic says. Remember we are all different ? Azure used to say that a lot, I think with good reason. I developed a problem with Lantus running out after 21 and a half hours. I only needed it once a day originally, but then again I am very sensitive to insulin. Our insulin requirements are all very different. Lantus may still be the perfect choice for some of us.

I would be curious to know what the OP regards as a perfect result at 3am. A few more tests during the night would provide more information, inconvenient as it is.
 
 
Hi

Thanks for your reply. Did you ask to be changed or did they suggest Tresiba?
 
 
Hi

My Lantus is running out about 2 hrs early which is incredibly annoying! My teamsuggest i inject and eat breakfast then, which is impossible for me. Do i not worry about the mid teen level for 2 hrs each morning or do i change the insulin. My teamdont seem to be that bothered.
 
 
Thank you! Did you ask for Tresiba or did they suggest it?My overnight alantus is running out about 2 hrs before i normally inject and eat so i need to change.
 
 
Thank you, i appreciate your thoughts. Well i've been diabetic for 38 yrs and still dont know stuff!
 
I've been on both Levemir and Tresiba. Levemir is a lot shorter duration than lantus I think like 16-18hrs?, better split dose for better coverage and lots of flexibility because you can tweak either morning dose or evening dose. However no matter how I tweaked it, I was going hypo and nocturnal hypos were a concern of mine when I had my accident. So consultant told me to try Tresiba, it's one inject and lasts 36 hours? so if you miss your dose by like 2hrs it wouldn't be an issue but I don't suggest missing your basal. With Levemir if you miss it, you'll start running high. It is much flatter profile compared to lantus and levemir. I've been quite happy with Tresiba.
 
Hi, it seems to me quite possible that the massive rise in the early morning could be down to your BS just dropping slightly too much overnight and triggering a hypo. I totally agree that a dramatic rise like that you describe can't be down to DP. I have just had a look at what you had posted before about overnight BS levels. Several people suggested at that point that some testing overnight to check what was going on would provide an answer. I realise the DSN has told you the Lantus taken the night before is 'running out', but HCPs are not always correct - as I know to my cost ! Your team sound pretty useless judging by what you've said.
 
I'm on Levemir and until very recently was on one dose a day as I had been told just to inject it before bed, needless to say my bloods were all over the shop (explains the Hba1c of 69 that nearly floored me!). A bit of adjusting, a bit of trial and error and about a week of intensive testing and I am on two doses per day, 8pm and about 7.30am and things have calmed down considerably.
 
I've been on Lantus and Levimir - one injection at night - but the diabetes consultant suggested I try Tresiba. This is much better for me stabilising my blood sugars overnight. Small dose before I go to bed but I eat very small amounts of carbohydrate.
 
Some possible solutions (if rather unlikely)
1) Less morning and more evening lantus. (I assume the issue is with the morning dose running out?) Then you might be short on insulin in the evening but you presumably have bolus on board then....
2)A pump?
3) Are you sure it isn't Dawn phenomenon? I agree that a rise of 7 in 2 hours is high, but maybe you are just very insulin resistant in the morning....

Anyway, good luck.
 
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