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Lantus and hypos

Discussion in 'Type 1 Diabetes' started by zed, Jun 6, 2014.

  1. zed

    zed · Active Member

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    Hi

    I have a few questions and I know they might have been answered beforehand but am confused.

    I have been taking lantus for 5 years I feel really hungry and have gained around 2 stones apart from that I feel depressed and sluggish I thought it was normal until now. Although am changing to levemir soon, I am having problems suddenly with no change to my lifestyle with lantus I keep having hypos around half 2 every night.

    I currently split my intake 18 in the morning and 16 in the evening this is nearly every night and I am sure the novo rapid should be out of my system because I tend to eat before 7 giving enough time before I sleep.

    Sorry for the long post!





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  2. Josef1980

    Josef1980 Type 1 · Active Member

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    I take Lantus at 6 AM everyday because Lantus causes me hypoglycemia if taken at night

    That solved my problem with Lantus night hypoglycemia

    Also you might want to reduce how much Lantus you are taken

    maybe you are insulin sensitive i.e. low insulin resistance therefore you don't need that much insulin

    If you are always low in Blood Sugar that will make you always hungry

    you only need Lantus once a day no need for two shots

    cut the dosage (reduce) and take one in the morning

    remember I am only speaking from my experience I am not a Doctor

    15 years type 1 diabetic on Lantus and NovoRapid

    The end goal of insulin is to make your Blood Sugar level to normal: 5-6 mmol or 80-120 mg/dl for most of the day

    Do not kill yourself with too much insulin

    I used to take 15 Lantus then 40 then 5 then 12 , it depends on your insulin sensitively

    If I get hypos because of lantus that means I need to cut the dosage i.e. Reduce

    Lantus is not supposed to cause hypoglycemia but in reality too much Lantus does cause hypoglycemia


    So what affects insulin sensitivity ?

    Sport, exercise i.e. level of activity (how much sugar you are burning during the day), skipping meals, what food do you eat; for me If i eat from McDonald I have to take twice the number of units compared to eating home cooked meal.
    McDonald is bad food.

    Bread, rice.... slow digested Carbohydrates : need insulin shot

    ice-cream, juices, chocolate... fast burned Carbohydrates: no need to take insulin injection Lantus will burn it
     
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    #2 Josef1980, Jun 6, 2014 at 2:22 PM
    Last edited by a moderator: Jun 6, 2014
  3. zed

    zed · Active Member

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  4. noblehead

    noblehead Type 1 · Guru
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    Never had to split dose lantus but night-time hypo's mean your injecting too much insulin, try knocking a unit or two off your evening injection to see if that resolves the hypo issues.
     
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  5. Daibell

    Daibell LADA · Master

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    With Levemir you may want to split it. I don't but most users do as it doesn't last the full 24 hours. I agree you may need to reduce the Lantus a bit. I aim to be between 5 - 7mmol fasting
     
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  6. Spiker

    Spiker Type 1 · Well-Known Member

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    I disagree with Josef about the split dose. If your split dose Lantus is working, stick with it. Splitting Lantus or taking it overnight is not causing night hypos. Too high an overnight dose is what is causing night hypos. Too high total daily insulin dose is what is driving your weight gain. Reduce the overnight dose and the morning dose slightly to eliminate the night hypos. Reduce your total daily insulin slightly further if necessary to eliminate weight gain. Make changes slowly and monitor blood glucose closely.
     
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    #6 Spiker, Jun 6, 2014 at 6:09 PM
    Last edited by a moderator: Jun 6, 2014
  7. Spiker

    Spiker Type 1 · Well-Known Member

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    I don't agree with this. For many people, once daily Lantus is not effective and twice daily is superior. Switching from twice to once daily is a particularly bad idea if you are suffering hypos from Lantus (because the peak concentration of Lantus will be roughly double).
    This is very alarmist. Killing someone with insulin is extremely hard even if attempted deliberately, let alone accidentally, let alone with Lantus.
    I don't think anyone says Lantus does not cause hypos and hypoglycemia is listed as the first side effect warning on the patient information leaflet.
    This is very bad advice and incorrect in my opinion.
     
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    #7 Spiker, Jun 6, 2014 at 6:22 PM
    Last edited by a moderator: Jun 6, 2014
  8. Heathenlass

    Heathenlass Type 1 · Well-Known Member

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    It's a very individual thing.

    I split Lantus because if I don't, I get severe night time hypo's, and get them if I inject one dose, morning OR evening. My night time dose is much smaller than the morning dose, but the important thing is that it works for me, and may not work for anyone else.

    My dose is not fixed, in fact I suspect it's too high again at the moment so I'm basal testing to get it corrected.

    It has to be what works for you.

    @Spiker has given some advice on this elsewhere but I can't remember the name of the thread....Spiker ??:)

    Signy
     
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  9. zed

    zed · Active Member

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    Thank you for the advice I will try to knock off two units of lantus tonight in relation to the weight gain it's really anoying because I have to inject a lot more then 1:10 ratio I actually don't eat much just three small meals I am also celiac. For example for breakfast it's one slice of gluten free toast and a boiled egg that takes 8 units of novo rapid if I decrease it my BG Id above ten.

    My hba1c was 10.1 that last time I went to the clinic but I have had one since and get the results soon, I am also doing DAFNE and changing to levemir next week so i will have to see how that goes. I just feel like I eat really small meals but I have to inject to much.

    It's so frustrating because I am actually trying am turning 21 and most of my life well ever since I was given freedom from my parents it's been in controlled hopefully after the DAFNE. Course I will be able to get better control.

    Thank you for your advice :)



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  10. Heathenlass

    Heathenlass Type 1 · Well-Known Member

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  11. Spiker

    Spiker Type 1 · Well-Known Member

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    Errr..... :oops:
     
  12. Heathenlass

    Heathenlass Type 1 · Well-Known Member

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    Sorry, Spiker !:D
    You're not losing your marbles, and neither am I !

    There was a thread recently that wasn't titled anything to do with basal testing, but the subject came up. I just can't remember what is WAS called, and now I'm driving myself nuts trying to find the ruddy thread . :banghead:

    OP - ignore my wittering, and I'll post the link up when I finally emerge from the archives. By which time you will have switched to Levemir, or they have cured diabetes anyway !:D

    Signy
     
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  13. Julie1471

    Julie1471 Type 1 · Well-Known Member

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    I got told by my consultant to split my Lantus doses , to 1 morning 1 evening. Told my DSN, got told you shouldn't do that, as I was hypoing durring the night. So split them, DSN said not to do it and asked me who told me to split it. When I told her,she backed of and shut up. I think weight gain, might be a side effect, if I remember correctly.
     
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  14. zed

    zed · Active Member

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    I think a lot of health care professionals all give advice that contradicts each other. I guess it's different for each person am happy with split dosage as when I used to inject lantus once I made an error and injected twice the result was a seziure and the outcome was a recurrent dislocation to my shoulder some how during the process


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  15. Julie1471

    Julie1471 Type 1 · Well-Known Member

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    Ouch Zed, that must have hurt one hell of a lot. If you split, lower night time, by an amount and then start to raise.
     
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  16. Josef1980

    Josef1980 Type 1 · Active Member

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    Firstly:
    "Lantus (R). Once-a-day. 24 Hours."
    "it should be taken once a day at the same time each day to lower blood glucose"
    http://www.lantus.com/considering/lantus-solostar-features

    Spiker: You make it sound as if i was making it up!

    Secondly:
    • "Hypoglycemia: May be life-threatening. Monitor glucose, administer rescue therapy and treat underlying cause.(5.3, 6.1)"
    • or
    • under Full prescription information
    Also do not forget about Diabetic coma

    If you underestimate Diabetes and underestimate the effects of insulin you will be a goner sonar or later

    FYI My Granpa died of Hypoglycemia.


    Thirdly:

    Lantus job is not to lower Blood Sugar after meals. It is the job of NovoRapid.

    [​IMG]
    http://dtc.ucsf.edu/types-of-diabet...therapies/type-2-insulin-rx/types-of-insulin/


    "CONCLUSIONS—These results confirmed that insulin glargine given once daily reduces the risk of hypoglycemia compared with NPH insulin, which can facilitate more aggressive insulin treatment to a HbA1c target of ≤7.0% in patients with type 2 diabetes."

    http://care.diabetesjournals.org/content/28/4/950.full

    Meals burning is NovoRapid Job.

    The whole idea behind Long acting insulin is:
    1. That it facilitates i.e. make it easier for patients to control their Blood Sugar rather than having severe and uncontrollable ups and and downs,
    2. To be like normal people since normal people have insulin in their bodies 24 hours

    If you eat little chocolate or small ice-cream and you have an active life style you really do not need to take 1 or 2 units to burn it.
    However if you are an overweight "Couch Potato" and are saturated with sugar then that is a different story.

    [​IMG]


    & Lastly: I quote myself:

    "remember I am only speaking from my experience I am not a Doctor" :stop:

    I am not perfect and I can not claim to be 100% correct about anything ok :p

    I am not trying to win any argument :stop:

    This is just a friendly discussion :cat:
     
  17. Julie1471

    Julie1471 Type 1 · Well-Known Member

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    Josef1980, that's the Sanofo material says, but what an insulin does and how it performs will never be the same person to person. Lantus NEVER WORKED FOR 24Hrz for myself LIKE SANOFI claimed it would, so what manufacturers claim is different to how it really works.
     
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  18. Josef1980

    Josef1980 Type 1 · Active Member

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    How do you know how long its been working in your body whether its for 24h or 18h or ... how do you know?

    Unlike fast acting insulin you can not tell when it is depleted or its active period is over?

    I totally agree with you that it differes from one person to another.
     
  19. Peachypuff72

    Peachypuff72 Type 1 · Well-Known Member

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    I had a hypo on Wednesday afternoon. 1.8 and I passed out on my living room floor. I was petrified. I only take lantus at 7am every morning as my pancreas is still spurting it out now and again. I recently increased my lantus to 10 and and suffered 4 hypos in one day I decreased it back to 8 and still I'm having hypos but it's at 4am and I wake up paralysed and often can't breathe and covered in what seems a few bucket fulls of water but it's actually cold sweat. I've spoken to my DN and she wasn't much help. I'm a dispenser and know about stuff and my brother has type 1 and my father in law. I'm 8st 3 and 5ft 7. Xx
     
  20. jack412

    jack412 Type 2 · Expert

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    Peachypuff72 change DN, they have to take it seriously, I'm a T2 pleb so I'm asking for myself and not giving advice, but wouldn't you need to back off the basal till you don't hypo overnight? Then a correction dose for any premeal peaks with bolus for when your pancreas is having a quiet day. the experts will be along to tell you what would be best, but I would guess the first priority is to treat the low.
    have you got the books that are talked about here like, think like a pancreas?

    I've been reading up on workbooks for if/when I finish up on insulin, even they are of varying quality, see if you can find a better one than you have
    https://www.google.com.au/#q=bolus basal workbook
     
    #20 jack412, Jun 7, 2014 at 5:12 AM
    Last edited by a moderator: Jun 7, 2014
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