Finally!!!

[alphabeta]

So here is my story:
Around mid April I started to have high BG although I increased my bolus. As days went, my BG only went higher. Fast forward to 28th June, I discovered that I have been using an expired bolus since March 2018. I fell devastated yet determined to get things under control. I lost around 8 kg at most due to high BG. I tried to get my Lantus right yet every now and then I get a problem... either a huge drop or God knows what happens with it so I felt that my Lantus was acting strange because I fell from 19 to 10 units and was still experiencing a drop with Lantus. Tonight however, being a curious boy, I tried not to drink water after taking my Lantus. Although I was running high at 19.0 before Lantus, (not my mistake my basal is messed up) I am still 18.9 after 2 hours of injection. Still no drop! This is great news for me because I now know the cause of the drop and can safely and happily increase my Lantus gradually to get my levels back!

I consider this a small victory to be celebrated with french fries tomorrow ‍ and it feels like mountains of stress were moved away from me to finally get answers and know what in heaven's name is happening! I thought of sharing my story for others might find helpful and something to be considered.

Diabetes is all about eliminating the variables, (good luck with that) but who would have thought that a sip of water was the root of over 3 weeks of high BG and restless nights?

 

[EllieM]

Diabetes is all about eliminating the variables, (good luck with that) but who would have thought that a sip of water was the root of over 3 weeks of high BG and restless nights?

Are you saying that a drink of water is causing your lantus to become short acting and act like a bolus? Everyone's body is different but that does sound strange.... Is it repeatable? If so, I suspect you need to ask for a different basal.... Very very strange.

Good luck.

 

[Alison54321]

You have to be very careful with injection sites for Lantus. You need a nice bit of subcutaneous fat, because it forms little acid particles in which the insulin is stored, and then slowly released.

So you want to avoid areas where you have too little fat, or areas that you have used too frequently for injection, because a different sort of fat forms there. Injecting in the wrong sites can also cause a rapid fall in blood sugar.

 

[alphabeta]

Are you saying that a drink of water is causing your lantus to become short acting and act like a bolus? Everyone's body is different but that does sound strange.... Is it repeatable? If so, I suspect you need to ask for a different basal.... Very very strange.

Good luck.

The water is carrying some sugar out of my body through urine to be expelled. This caused a drop that I didn't know the cause for it, but now I do. Lantus works just fine so far.

 

[alphabeta]

You have to be very careful with injection sites for Lantus. You need a nice bit of subcutaneous fat, because it forms little acid particles in which the insulin is stored, and then slowly released.

So you want to avoid areas where you have too little fat, or areas that you have used too frequently for injection, because a different sort of fat forms there. Injecting in the wrong sites can also cause a rapid fall in blood sugar.

I do inject in my thighs which were sitting in rest for about 5 to 6 months without injections. I injected into a muscle (Lantus) and my blood sugar did fall tremendously but we learn...

 

[Alison54321]

I do inject in my thighs which were sitting in rest for about 5 to 6 months without injections. I injected into a muscle (Lantus) and my blood sugar did fall tremendously but we learn...

That's good. That aspect of Lantus scares me, but as long as you are aware of it, I don't need to worry. Though you still do, but you just need to be aware.

 

[alphabeta]

That's good. That aspect of Lantus scares me, but as long as you are aware of it, I don't need to worry. Though you still do, but you just need to be aware.

It is ironic how the medicine that keeps us alive does have the potential to kill us but meh.. it is what it is.

 

[kitedoc]

So here is my story:
Around mid April I started to have high BG although I increased my bolus. As days went, my BG only went higher. Fast forward to 28th June, I discovered that I have been using an expired bolus since March 2018. I fell devastated yet determined to get things under control. I lost around 8 kg at most due to high BG. I tried to get my Lantus right yet every now and then I get a problem... either a huge drop or God knows what happens with it so I felt that my Lantus was acting strange because I fell from 19 to 10 units and was still experiencing a drop with Lantus. Tonight however, being a curious boy, I tried not to drink water after taking my Lantus. Although I was running high at 19.0 before Lantus, (not my mistake my basal is messed up) I am still 18.9 after 2 hours of injection. Still no drop! This is great news for me because I now know the cause of the drop and can safely and happily increase my Lantus gradually to get my levels back!

I consider this a small victory to be celebrated with french fries tomorrow ‍ and it feels like mountains of stress were moved away from me to finally get answers and know what in heaven's name is happening! I thought of sharing my story for others might find helpful and something to be considered.

Diabetes is all about eliminating the variables, (good luck with that) but who would have thought that a sip of water was the root of over 3 weeks of high BG and restless nights?

Hi @alphabeta, Does anyone expect a drop in BSL after 2 hours with a long-acting insulin like Lantus alone? I do not see how this is true and thus relevant to your argument. And the excess blood sugar will be filtered out by the kidneys and collect in the bladder and if one drinks a LOT of water that might slightly 'water down' the blood and give a slightly lower BSL. But dehydrating oneself to keep a blood sugar from falling does not really make sense. You are more likely to become dizzy and fall over in the summer heat plus put extra strain on your kidneys. !Also losing weight might reduce insulin requirements so hypos for the same dose of Lantus as before might be more likely to happen. As you said an injection into the muscle, and from other threads, injection into an area which is exercised will both increase insulin uptake I would think.

 

[alphabeta]

Hi @alphabeta, Does anyone expect a drop in BSL after 2 hours with a long-acting insulin like Lantus alone? I do not see how this is true and thus relevant to your argument. And the excess blood sugar will be filtered out by the kidneys and collect in the bladder and if one drinks a LOT of water that might slightly 'water down' the blood and give a slightly lower BSL. But dehydrating oneself to keep a blood sugar from falling does not really make sense. You are more likely to become dizzy and fall over in the summer heat plus put extra strain on your kidneys. !Also losing weight might reduce insulin requirements so hypos for the same dose of Lantus as before might be more likely to happen. As you said an injection into the muscle, and from other threads, injection into an area which is exercised will both increase insulin uptake I would think.

Hello, I usually can expect a slight drop after 2 hours but only with the correct dose. I am not dehydrating myself at all it was only an experiment made by me for one night which was yesterday because I used to drink about 2 litres of water and that dropped my BG. We are all different anyway and this seemed to be the missing key to my puzzle. I did drink some water but I limited it. Anyway, I am not in the UK, so there is no need to worry about heat exhausted I actually used blankets to sleep. It does make a lot of sense for me to be honest, but I will investigate more certainly by trial and error. I will try to be on lower BG than 19.0 tonight and will see what will happen.

 

[Alison54321]

Hello, I usually can expect a slight drop after 2 hours but only with the correct dose. I am not dehydrating myself at all it was only an experiment made by me for one night which was yesterday because I used to drink about 2 litres of water and that dropped my BG. We are all different anyway and this seemed to be the missing key to my puzzle. I did drink some water but I limited it. Anyway, I am not in the UK, so there is no need to worry about heat exhausted I actually used blankets to sleep. It does make a lot of sense for me to be honest, but I will investigate more certainly by trial and error. I will try to be on lower BG than 19.0 tonight and will see what will happen.

Two litres of water is quite a lot, your theory makes sense when you explain you were drinking two litres.

More on the job training for you, on how to manage diabetes.

 

[alphabeta]

Two litres of water is quite a lot, your theory makes sense when you explain you were drinking two litres.

More on the job training for you, on how to manage diabetes.

I just feel very very happy that I have answers!

 

[kitedoc]

Hello, I usually can expect a slight drop after 2 hours but only with the correct dose. I am not dehydrating myself at all it was only an experiment made by me for one night which was yesterday because I used to drink about 2 litres of water and that dropped my BG. We are all different anyway and this seemed to be the missing key to my puzzle. I did drink some water but I limited it. Anyway, I am not in the UK, so there is no need to worry about heat exhausted I actually used blankets to sleep. It does make a lot of sense for me to be honest, but I will investigate more certainly by trial and error. I will try to be on lower BG than 19.0 tonight and will see what will happen.

Most diabetics on insulin use correction doses of short-acting to reduce high BSLs and why is the level so high at that point ? ? Is it due to the evening meal? In which case is the bolus dose and diet part of the problem ? (assuming your Lantus injection is at night? Again long acting insulin is for basal usage.

 

[alphabeta]

Most diabetics on insulin use correction doses of short-acting to reduce high BSLs and why is the level so high at that point ? ? Is it due to the evening meal? In which case is the bolus dose and diet part of the problem ? (assuming your Lantus injection is at night? Again long acting insulin is for basal usage.

It was certainly not the evening bolus

 

[EllieM]

Most diabetics on insulin use correction doses of short-acting to reduce high BSLs

Agreed. I am very cautious about night time correction doses but I would definitely inject some bolus to correct a reading of 19, followed by the basal. (This is assuming that the bolus for the evening meal is mostly out of your system by then.)

@alphabeta, has your clinic explained to you how to calculate bolus correction doses?

 

[alphabeta]

Agreed. I am very cautious about night time correction doses but I would definitely inject some bolus to correct a reading of 19, followed by the basal. (This is assuming that the bolus for the evening meal is mostly out of your system by then.)

@alphabeta, has your clinic explained to you how to calculate bolus correction doses?

For every 2.25 points I correct with one unit. I usually do correct but I am trying to get a grasp of control back so I am trying to eliminate every variable including bolus after taking Lantus only in order to figure out the best optimum dose that fits me. Anyway, I seem to be back on track again so things are turning out for the better. I will keep everyone updated.

 

[kitedoc]

As I understand it if you are trying to examine your basal dose requirements that is done under fasting conditions.
But trying to do so with a starting bsl of 19 mmol/l does not sound not very helpful, particularly if some ketones are present.
I agree with @Alison54321, using 2 litres of fluid to reduce your bsl a tad is a bit extreme, and is not likely to conducive to a restful sleep, either.
I urge you to talk things through with your dsn FULLY and consider stopping your own current experimentation.

 

[alphabeta]

As I understand it if you are trying to examine your basal dose requirements that is done under fasting conditions.
But trying to do so with a starting bsl of 19 mmol/l does not sound not very helpful, particularly if some ketones are present.
I agree with @Alison54321, using 2 litres of fluid to reduce your bsl a tad is a bit extreme, and is not likely to conducive to a restful sleep, either.
I urge you to talk things through with your dsn FULLY and consider stopping your own current experimentation.

I am getting back on track, increased from 9 units Lantus to 10. Might seem very little increase, agreed, but I feel for the first time since weeks that my bolus is acting as it used to be! Couldn't be happier! After 10 units and 4 units bolus I woke up 8.4 this morning so I guess that is a good start (kinda)

 

[Alison54321]

I am getting back on track, increased from 9 units Lantus to 10. Might seem very little increase, agreed, but I feel for the first time since weeks that my bolus is acting as it used to be! Couldn't be happier! After 10 units and 4 units bolus I woke up 8.4 this morning so I guess that is a good start (kinda)

Waking on 8.4 is pretty good. Good to see you're getting it sorted. How you feel about your bolus matter, managing diabetes is definitely both an art, and a science.

 

[alphabeta]

Waking on 8.4 is pretty good. Good to see you're getting it sorted. How you feel about your bolus matter, managing diabetes is definitely both an art, and a science.

Not the best number but it is something at least to say, better than waking up 15+ each morning... aiming for 5s to a maximum of 8

 

[kitedoc]

I am getting back on track, increased from 9 units Lantus to 10. Might seem very little increase, agreed, but I feel for the first time since weeks that my bolus is acting as it used to be! Couldn't be happier! After 10 units and 4 units bolus I woke up 8.4 this morning so I guess that is a good start (kinda)

Can I ask what is your bolus insulin and when taken?