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Basal Vs Bolus

A

azizdhl

Well-Known Member
his guys.. I've spend a week trying to figure out my carb ratio for the three meals and I finally managed that prefectly.. but seems there is a problem with lanuts time and am going to doctor next week and probably will change lantus timing.. now I have two question

1. if I changed lantus time from 10pm to 8am, I should also change all my carb ratio for all the meals?

2. if I change lantus by two units up or down.. I should also all my carb ratio for all the meals?
 
If it was me I would not change my carbs if you are happy with the amount you are consuming.

Changing the time of Lantus will only change when it will effect rather than have an effect on the carbs you have allowed for.

Again if you change you Lantus amount I would wait at least 3 - 4 days befre changing anything else because as you know it can a couple of days before and changes are picked up and metabolised by the body.

But like I said that is just my opinion and not based on any medical knowledge, your doctor maybe able to give you better advice.

Take care.
 

thank you so much for your advice

may I ask you something?
I was told that lanrush does not peak.. but I found the opposite.. I am on lantus for a week now.. everyday I faced 90 to 150 hypo and woke up around 40.. it happened usually after 6 hours of injection.. and sometimes after two hours of lantus injection am facing a little bit decrease in my blood
 
please guys anyone experience any change in lantus timing.. please advice me about in change in your carbs to insulin ratio for each meal?
 
I take lantus at 10pm. I use itmonly to get me through the night without hypos. I use humalog during the day and for any corrections. My lantus doses are small enough that it’s pretty much gone in the morning. Sad thing is i can still wake up high but it the rise doesn’t start until afitet 4-5 am. Then I just use a correction. In the morning
I tried lantus two times in the morning and I usually ended up feeding my insulin as I was hypoing.

But this is what works for me. What works for me doesn’t work for everyone.
 

It is really difficult to advise you, if you Google 'Lantus Profile' you will find that most show that there is slight peak after 5 - 6 hours BUT if you look on the official Lantus site it says at the top 'no pronounced peak' which could mean anything.

If you are finding that you are hypoing it may be that you are injecting to much Lantus, and AGAIN I stress that this is a conversation with your medical team about dose adjustment.

But only being on it for 5 days and any changes made usually take 3 days to pick up, it may just be your body is getting used to it and it may take more than a week for your system to sort itself out. Again this is just guess work based on my own experience.
 
Changing the time of your Lantus dose won’t affect your carb ratio, providing your Lantus dose is correct. If it’s too high, you’ll hypo after a meal even if your ratios are correct. The opposite is true if your Lantus dose is too low.

Getting your basal dose correct is the foundation of good diabetes control. If it’s wrong, very little else will be right. To calculate it, take the difference between your pre-bed and pre-breakfast BGs and for every 1.6mmol/l difference, change your Lantus dose by 10%.

For info, I inject my Lantus in the morning too.
 

All basal insulins have a peak, don't believe the pharma company line. It shouldn't have a peak like NPH did, but it can definitely have a peak that differs in time and intensity based on the dose and other variables. Your carb ratios shouldn't change per se, but you have to be attuned to when Lantus is waning off and if you are eating during this time you might need more bolus insulin. For example, if you find it starts to fade at 20 hours and you eat at or after this time, you will need to take more NovoRapid than if you ate at 16 hours. The timing of when you take Lantus will of course affect what time Lantus will fade out at and thus what time you will need more NovoRapid.
 

You can see from the graph that glargine (Lantus) is not completely flat. It has a period where it ramps up, peaks, and then slowly fades away for the next several hours. It is not as pronounced as NPH or even detemir (Levemir), which I think is a superior insulin despite possibly having more of a peak, but it has a peak nonetheless and is not completely flat for 24 hours like Sanofi would have you believe.
 

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Agree with all comments thus far. I am on a pump which helps iron out these problems! On MDI though I used to split the dose to get a smoother profile across 24 hours.
 
Just exactly yesterday I dropped 140 points overnight by Lantus alone... so now I have one option to sleep around 220-280 and I would wake up around 80-140. It is not fun, this is not how it is supposed to work but I guess it is just a passing phase for me. Anyway, you should really consider lowering Lantus. No need to wait 3 days before you decrease your dose if you are waking up hypo..
 
If you change your Lantus dose up or down I don't think this will change carb ratio.
 
I take my Lantus at 10pm and as I am eating a Ketogenic diet I generally don't need any Novarapid during the day. Works for me but it's not for everyone
 
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