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Lantus and night hypos.

Discussion in 'Type 1 Diabetes' started by Catman507, Sep 5, 2020.

  1. Catman507

    Catman507 Type 1 · Member

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    Hello, I am coming to my absolute ends wits at the moment, I am a woman that has had type one for about 11-12 years, I was moved onto lantus and humalog from the novomix 30 5 years ago. So I was able to get my humalog changed to novorapid this year finally due to hypers after eating food from insulin not working fast enough, this has been resolved now. Every single night, the second my lantus kicks in, I am immediately in a hypo that will not go away and this has included severe hypos, I have been dropping the units down and it appears I am still having this problem, I have tried numerous remedies for removing these hypos in the night/sleep slow release carbohydrates, fast release carbohydrates, a mixture of both. The hospital is useless and hates my guts, blames me and won't help me at all, says its my fault. The DN at my GP surgery told the hospital I need my lantus swapped for something else and the hospital refused. I am now taking 8 units so far down from 12units and will be dropping again to 7 units. I feel worried dropping it so much because I am aware it's my background insulin that stays with me throughout the daytime. Has anybody experienced repeated hypos from Lantus, especially at night? And what did you do/recommended? Thank you. Sorry for the long post, I am so fed up because it's left me unable to commit to a job therefore I m currently unemployed due to be unable to adhere to punctuality from passing out sometimes and needing help and I feel like a sack of **** haha.
     
  2. h884

    h884 Type 1 · Well-Known Member

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    Hi Catman507

    I can empathise with your problem. I experienced similar issues earlier this year. I was down to 2 units of Lantus at one point. After much discussion with the the local DSNs I was changed to Levemir. This has helped considerably. I still to drop overnight but not as much.

    Good luck with this. I had to persist till the change was agreed


    Hope this helps
     
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  3. Rokaab

    Rokaab Type 1 · Well-Known Member

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    Can you be referred to a different hospital, or maybe even a different consultant within the same hospital? Did they say why they refused?
    I was having exactly the same issues with Lantus and nighttime hypos, I asked my hospital to change me to Tresiba and they agreed as they could see my hypos on my libre, Tresiba made my nighttime lows less severe by a long way
     
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  4. Catman507

    Catman507 Type 1 · Member

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    Hello, thank you for the response, well the clinician at the hospital got very grumpy with me and dismissed my night time hypo problem, she was unhappy because my a1c was in the 7s rather than a 6, (I was perfectly in the old target we had years ago annoyingly) she actually dismissed my problem and told me I need to inject even more lantus and hired my dose, told me I needed to inject a higher amount at night and in the morning, we ended up having an argument over this because I stated I was having severe night hypos to the extent I have been awoken by paramedics, my a1c was not perfect due to the hypers I was having after my food due to my humalog often not kicking in for a good 45 minutes. I also have the freestyle libre because they were sick of me needing so many testing sticks.
     
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  5. Fairygodmother

    Fairygodmother Type 1 · Well-Known Member

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    A fair few of us have had problems with Lantus, despite it being advertised as a steady release insulin it does seem to have peaks and troughs.
    Could it be that you need to consider the active life of Lantus, and are in fact being subjected to the overlap of your daytime dose when you take your night time dose? If it were me then I might have a go at playing with the daytime dose to reduce the overlap. However, It’s very possible that Levemir would suit you better. There’s no harm in asking the Consultant (nicely) if you could try it and asking your GP to refer you to another Hospital Clinic if the one you go to now can’t help you solve the hypo problem.
     
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  6. Antje77

    Antje77 LADA · Moderator
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    Lantus did this to me once, which was my scariest diabetes diabetes experience to date.
    Thankfully my DN was understanding when I told her I wanted to change to either Tresiba or Levemir.

    I would go back and try again.

    The way Lantus works means it needs to be injected in fatty tissue, hit a small blood vessel and it acts very quick.
     
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  7. Rokaab

    Rokaab Type 1 · Well-Known Member

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    Dismissing nighttime hypos is dangerous and then suggesting upp'ing the basal is even worse, ask for a change of consultant/clinician asap.
     
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  8. Catman507

    Catman507 Type 1 · Member

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    Hello, thank you for the response, I take one shot of lantus a day, a have previously tried taking it in the morning instead, however this resulted in more instability of my life as I was experiencing the hypos during the daytime instead. Thank you for the suggestion however, I will see if there's any possibility of being able to change hospitals, I am not entirely sure how the process works but I will give it a go. I speak to the clinician again in 5 days and I will see how it goes this time and if she's able to accept and understand the problem, my a1c is currently in the range it needs to be in so I am hoping that now my a1c is in the 6s, she will finally be able to actually see the lantus induced hypos rather than a a1c in the 7s and base the whole premise of my appointment on only that issue rather than the overall.
     
  9. Catman507

    Catman507 Type 1 · Member

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    I will definitely consider a shift in hospitals if the appointment next week is unsuccessful. Partner and I have been filling out a full comprehensive food and exercise diary of our own backs for the past few months logging each and every thing with full measurements and trying very hard. This will also be displayed to the hospital if need be to take away the label of 'bad diabetic' after being told by the clinician my problem will be fixed with more basal and lentils.
     
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  10. Antje77

    Antje77 LADA · Moderator
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  11. Fairygodmother

    Fairygodmother Type 1 · Well-Known Member

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    In the meantime, some people find Lantus behaves better if the split the dose, they take some in the morning and some in the evening. It involves a bit of basal testing and adjustment to reach the best split ratio.
     
  12. Catman507

    Catman507 Type 1 · Member

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    Hello, thank you so much for linking this article, this has opened my eyes significantly and made me more aware of what could potentially be causing this problem! I see it states a lot about low body fat, etc well that is quite possibly my issue! I am a lady with a six pack, therefore low body fat therefore potentially incompatible with lantus! I will make sure to raise these concerns with the clinician next week! Thank you so much!
     
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  13. Antje77

    Antje77 LADA · Moderator
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    I'm quite fat, and it still happened once. I honestly thought I was going to die that night, and no-one would've suspected the Lantus.
    It makes sense for it to be more of a problem when thin, but even fat tissue has capillaries you can hit. On the other hand, lots of skinny kids thank their lives to Lantus and use it without problem, so I suppose some bad luck must be involved as well.

    Good luck with your clinic visit next week, I'll cross my fingers for you to get home with a script for Tresiba or Levemir!
     
  14. MarkMunday

    MarkMunday Type 1 · Well-Known Member

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    Useful article. I have also been having problems with Lantus causing hypos. That I used Lantus reasonably successfully for 20 years before starting a pump 6 years ago is odd. I recently restarted Lantus and I am injecting the full dose in the morning. It causes me to go low in the early hours of the next morning, by which time insulin action should be tailing off.
     
  15. Antje77

    Antje77 LADA · Moderator
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    This sounds like a completely different issue, perhaps your basal need is lower in those hours. As far as I understand many of us find their bg lowest in the early hours of the morning.

    I don't think your issue is connected to having sudden sharp drops with severe hypos right after injecting Lantus.
     
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  16. MarkMunday

    MarkMunday Type 1 · Well-Known Member

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    No, but it also highlights how misleading the published action profile for Lantus can be. Variability of action is also an issue not reflected in that action profile.
     
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  17. Circuspony

    Circuspony Type 1 · Well-Known Member

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    I didn't ask about changing Lantus I demanded it! I basically phoned the DN and said I wanted an appointment to sort out an alternative.
     
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  18. MillyBnana

    MillyBnana · Newbie

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    So sorry to hear that, but why do you take your lantus at night?
     
  19. becca59

    becca59 Type 1 · Well-Known Member

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    @MillyBnana I used to take in the morning with exactly the same effects through the night.
     
  20. MillyBnana

    MillyBnana · Newbie

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    I take 32; to 35/units of Lantus at around 2 pm. Anything after 4 pm will give me lows in the early morning the next day. So, I snack on something before I go to bed. Do you snack at night and how much lantus do you take?
     
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