INSULIN CHANGE AND LANTUS

Hi,

I changed my humalog mix insulin late last year to animal hypurin/porcine mix because after reading the IDDT report I felt that a lot of the conditions in there related to me and could potentially be human insulin.

Anyway after changing over I realised that animal was taking way too long to cut in, sometimes 5 or 6 hours for the fast acting to start working sometimes not at all. Although I wanted to low carb this kind of forced my hand slightly. I read Dr Bernsteins book and realised that I wanted to try and do it properly, not quite to his level of carb intake and with the odd day off too which wasn't possible with a mix insulin. What I have realised is that perhaps how bad I felt on the humalog was not down to the human insulin but more down to the spiking of the humalog and the overall control I was getting compared to now. I am currently getting average figures in the past month of 5.1 - 6.2 but with that a fair few numbers in and around the early 3's late 2's, more than I would like. A steady 4 would be good but not achievable on a mix routine I think.

So I decided basul/bolus was the way to go and am about to start. The theory is according to the Dr is that it is my tighter control and less spiking of the animal insulin is what has improved my symptoms so I am back on analogue. Lantus and Novorapid is the first try, but now I am slightly concerned, there aren't too many good things said on here about Lantus. There must be a lot of people out there who can achieve normal blood sugars and on this? I am also scared to death about night time hypos, how do people get round these and keep normal blood sugars. I have to inject lantus at 10pm once a day.

Please tell me some good stories about Lantus before I go mad...

I am struggling with the Lantus still.

I take 12u of Lantus, one at 10am and one at 10pm daily. I find that between 8pm and 3am my blood sugars rise and never recover really by morning so I am taking novorapid to correct this and cover breakfast. for instance last night I was 4.5 at 8pm, 9.30 it was 6.0 and 7.2 at bed at 11pm without eating anything and after vigourous exercise. At 2.30 am 8.3 and on waking at 6am 6.6 where it rose to 9.0 by breakfast. I generally have low to no carbs for breakfast anyway. So for most of the day the BS's are fairly good but not as stable as I wished especially that I don't snack between meals either.

So I am confused, very confused. I am low carbing, not to the point of Dr B's 6, 12, 12 but probably up to 6, 15, 25 approx.

Anybody with any advice?

Thanks everyone.

I think I have managed to potentially crack the evening higher readings by putting my second Lantus injection back to midday. It happened kind of by accident as I forgot 10am and ended up doing it around 11.15 to find that by the time it drifted out the 10pm shot was starting to kick in. I generally get upto to 1mmol fluctuation during the night now which is good. For instance last night I went to bed in 4.6, it was 4.4 at 3am and 3.7 on rising, the latter being a little low but then I played football the previous night.

So I am on 26u of Lantus twice daily and 3x Novo rapid at 6u each which seems to do the job although mornings I eat virtually no carbs for brekkie so I presume the readings are ok as it covers the dawn phenonmen or the increased insulin resistance after rising.

For what I eat and what I do for exercise it seems an awful lot of insulin to inject when I read other people's regimes on here. I am 5'10 and weigh 13st 6 but a lot of this is as I like to think muscle from years of footy and body building in the past. I have lost 1.5stone since starting low carbing in October and seem to be losing 1/2 - 1lb a week now. I really want to understand why I am taking so much insulin and eating very little. I have a 4g carb per unit of novorapid ratio and 1g of carb raises my mmol by 0.33. For corrective purposes I am about 1u per 1.4 mmol which seems low.

My concern is if I go out for a meal where counting carbs is going to be tuff I could end up injecting as much novorapid as Lantus of an evening which seems really scarey.

Oh and my BS's are generally in the 4-8 bracket. I test every two hours at the moment and my average for the past month is 5.7 which seems ok. Just a lot of insulin I sem to have to take.

Sorry Jopar I made a bit of a mistake in that. It's not 26u twice daily it's 26u in total 12at 10pm and 14at midday. .

I worked it out by trial and error mainly on what I ate to what injected.

Taking the 500 rule would mean 10g per unit which is way out in my case. I reckon 4g tops.