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Type 1 Lantus... AGAIN UGH help please!

Update 2: Yesterday I slept with BG of 11.5 and woke up at 8.0
Total time between injection and test is about 8 hours. 10 units split into two injections each in a thigh. So far it looks stable, I was stable for the 3 hours after injection.
 
alphabeta said:
Hello @kitedoc
I understand what you are saying completely. I do agree with what you said and yes I had a scary experience with Lantus before, but to be honest it was my mistake because I injected into the top of the upper arm (imagine you are seeing me from the side, your eyes would be directly on the top of my upper arms). I injected 19 units directly into a muscle not into a fatty area and that was because I simply didn't know to be honest. Afterwards, I learned that I have to inject in the back of the upper arms. I do seem to have an irregular scheduale regarding my basal and that's due a simple reason: I have a weekly commute from my city to my parent's house at Friday night and back to my city at Sunday night. There is no specific time when I leave and when I return. By the time Lantus is due, I'm on the highway. I do inject my basal as soon as I arrive and that was my case yesterday where I arrived back pretty late! Regarding my high BSL, believe me, I do not like it, it is ugly, and constantly thirsty. Throwback to previous spring, I had a very very tight control over my BG because I understood completely how each unit of insulin affects me without even carb counting! The highest sugars I had were before bed (when I inject Lantus, usually around 10-12 mmol/l then i wake sometimes below 5 mmol/l) and before dinner around same range sometimes a bit higher if I delay my dinner. You might think 12 isn't a great number. Well indeed but it is MUCH better than the spikes from <8 mmol/l fasting to 17+ after breakfast! I was like this for 9 years ever since I was diagnosed in 2009 till January 1st 2018 then I switched to basal/bolus on Jan. 2nd.
My doctor didn't even care to tell me that it is wrong! I actually thought that all diabetics are like this until I came here and saw that some folks don't even go above 7.0. If it wasn't for dawn phenomenon, I still wouldn't be here probably. After spring ended this year, my bolus decided to die (expired March 2018) and my Lantus to spoil by heat (I keep it in the fridge all the time now). It wasn't until 25th August until I knew that my Lantus is spoiled by heat. I managed it better, then had to change the apartment so more stress and skipping meals. Now I have settled, I have learned from my mistakes and I think I am better equipped to fight diabetes. Sorry for the veeery long reply but it helps to pour my troubles out. I do feel sorry for what happened to me with the bolus because I have lost so much weight (64kg to 56.5kg lowest!!) After having a dream control I never achieved before... I can only hope it goes better and tomorrow is a new day :)
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Hi @alphabeta, Glad to see you have an optimistic outlook on life. I can understand if you are reluctant to inject your Lantus insulin on the bus home, given past troubles but given what you now know and information about the other basal insulins why would you stay with Lantus insulin? And why not have food with you so that you could stick to a regular regime no matter what the bus and travel schedule is? You would not be the first diabetic to do so. Also is there a better HCP you could see ?
 
tim2000s said:
It won't. the way that Levemir and Tresiba work is outlined in that article. They have no need to form a precipitate and can circulate in the blood happily, as the way they work is to cause the body to "unfold" them over a period of time, negating the risk of fast absorption.
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Thank you @tim2000s, I must have had a boy's look and missed that detail. It was certainly a worry for me when I was on NPH for 1966 to 1999 !!
 
kitedoc said:
Hi @alphabeta, Glad to see you have an optimistic outlook on life. I can understand if you are reluctant to inject your Lantus insulin on the bus home, given past troubles but given what you now know and information about the other basal insulins why would you stay with Lantus insulin? And why not have food with you so that you could stick to a regular regime no matter what the bus and travel schedule is? You would not be the first diabetic to do so. Also is there a better HCP you could see ?
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In the mean time I would rather stay on Lantus because I really feel that Tresiba isn't the insulin Novo Nordisk claims it to be. I don't feel like it is much of a prize because of what some users reported. It's flat profile might be the problem. Some notice that X units cause hypos, and X-1 units cause hypers so there is no in between. Levemir seems a viable option to be honest but injecting basal insulin outside home is a no no for me because I honestly fear I hit a vein or so, this would be a very huge deal when i am in class let's say. I have no access to huge amount of sugar needed nor a glucagon (although at home I don't have a glucagon kit). I know this fear might be irrational because maybe it is... Regardless of that, even if I were to switch insulins, I wouldn't do it now. I don't have a Libre, I don't have enough weight to lose just in case (typical hypers caused by switching insulins) and most importantly, I just want to live in peace in the mean time. I want to take a break from all the previous drama because it was hell of a ride this year... Another minor reason would be insulin prices. Although I am only partially insured, I still have to pay a fraction of the price. Lantus costs around 80$ a box of 5 pens where a single pen of Tresiba costs 21$. Not huge difference but still costy given that a box of 50 test strips costs 27$. Regarding the injecting in a bus (it is actually a car) there is no space to really inject and again if something goes bad.. well I don't want to imagine it scares me. I do inject bolus for meals in public and I like the looks I get when I inject in the cafeteria (so funny) but not basal.
 
kitedoc said:
Thank you @tim2000s, I must have had a boy's look and missed that detail. It was certainly a worry for me when I was on NPH for 1966 to 1999 !!
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NPH is a nightmare and this actually explains the fast drops I had specially in hot weather after meals!
 
Hi @alphabeta, Look at the post @tim2000s sent me about Tresiba and Levemir and the lack of risk from either if accidentally injected into a blood vessel. You would not believe some of the places where I have given myself injections of insulin. Provided you can inject without risk of infection what is the problem? And what does Lantus cost you? If it is possible that some of your recent drama revolves around use of Lantus and an irregular routine, does staying with same really help you?
 
kitedoc said:
Hi @alphabeta, Look at the post @tim2000s sent me about Tresiba and Levemir and the lack of risk from either if accidentally injected into a blood vessel. You would not believe some of the places where I have given myself injections of insulin. Provided you can inject without risk of infection what is the problem? And what does Lantus cost you? If it is possible that some of your recent drama revolves around use of Lantus and an irregular routine, does staying with same really help you?
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Other than being just afraid, with Lantus having my jeans rubbing against my thighs from the bumpy ride? No thanks. And as I mentioned I fear hitting a vessel or a muscle on the road. With Tresiba or Levemir it might be different, but with Lantus it is not. The irregular routine is changing, for example I eat my dinner before hitting the road so Humalog can cover me through the 2 hour ride, then I can take Lantus peacefully at home. Last week, the delay was sooo unexpected! Not even a single thought was in my head that might be late. Usually I am only off by a maximum of 1 hour from my basal which is not so bad I guess... I mentioned the prices above.
 
alphabeta said:
Other than being just afraid, with Lantus having my jeans rubbing against my thighs from the bumpy ride? No thanks. And as I mentioned I fear hitting a vessel or a muscle on the road. With Tresiba or Levemir it might be different, but with Lantus it is not. The irregular routine is changing, for example I eat my dinner before hitting the road so Humalog can cover me through the 2 hour ride, then I can take Lantus peacefully at home. Last week, the delay was sooo unexpected! Not even a single thought was in my head that might be late. Usually I am only off by a maximum of 1 hour from my basal which is not so bad I guess... I mentioned the prices above.
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Understood, ? cost of Levemir?. Glad to hear you have sorted out the meal before travel but is Lantus worth it - it seems to be ruling your life ??
 
kitedoc said:
Understood, ? cost of Levemir?. Glad to hear you have sorted out the meal before travel but is Lantus worth it - it seems to be ruling your life ??
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No idea about the cost of Levemir but when I get my Lantus sorted correctly, I can simply take 1 unit at 12 pm (Lantus) so it has negligible effect around dinner time. Maybe a little flexibility but this seems to me the best convenient solution in the short term
 
kitedoc said:
@alphabeta, You can be shown and fountain of knowledge but no one can make you drink from it unless you wish to.
Good luck !
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It is worth noting that because of Lantus my weight increased (due to good control) which is something I never had on premixed insulin... so Lantus may have some problems but it is not the worst and as long as I am able to manage my diabetes with Lantus, I really see no point whatsoever to change to a different basal..
Thank you kitedoc :)
 
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