Lantus at 5am Vs Lantus 7am.

[DanGoku]

So I have been diabetic since October 2022 and I'm 37 years old. So recently my Lantus keeps increasing from the recommendation from the diabetic nurse to the diabetic consultant in one of the hospitals in Kent where I go to.


My Lantus went from 16 to 18 to 20 and now its increased to 22.

I take my diabetes seriously but according to the data on my Freestyle Libre 2 the hospital in Kent are not satisfied with my overall result. My results are 44% which they are concerned of.


So I work nights in my local supermarket job and when I was speaking to the person from the hospital telephone consultation I explained that my blood improves at work. But when I have a day off and I have to switch my body clock around for example I got to bed at 10am and wake up at 7am, my blood sky rockets to 20mmml/L or even 23mmml/L.


I took my lantus 7am at the same time. Sometimes my blood improves throughout the day and sometimes randomly it decides not to.

So I thought what happens if I took my lantus at 5am. I tried this for about 2 weeks and I did notice my blood was getting better. So my blood at 5am would be 19mmm/L, took Lantus at 5am.

By 7am it would be 12mmm/L. And through out the day I took Novorapid for my breakfast at 7am blood improves at 8mmm/L by 12pm and by 1pm I have my Novorapid by lunch.

My blood would spike at 4pm by 15 and I have a snack with Novorapid. Dinner at 7pm and so on. At 8pm blood would be 6.


Well the telephone consultation nurse didn't agree with me at all when I took Lantus at 5am because she didn't like the idea of my when my blood would drop from 20 at 5am to 12 at 7am because after 7am I took Novorapid and had my breakfast.


So by listening to her advice today I took my Lantus at 7am and throughout the day my blood has been hight as 23 at 7am - 15 by 6pm knowing I have to go to work on my first night and change my body clock around. I did the telephone consultation nurse that I work nights but they just seem to brush it under the carpet and completely just not take my perspective of my working life.


So if I'm wrong taking my Lantus at 5am on my days off please could you guys give me feedback.

 

[EllieM]

Hi @DanGoku and welcome to the DCUK forums.

I can't tell you what to do. (Forum rules don;t allow us to give medical advice and I genuinely don't know the answer.) But here are some comments.

1) Lantus often doesn't last 24 hours so some people (eg me when I was on it) split the dose morning and night to get a more even distribution.
2) Some people's basal needs vary drastically throughout the day/night. I'm wondering if you would be a good candidate for an insulin pump. Then you would be able to set different regimes for your night and day shifts.
3) Maybe you need to do some more basal rate testing to see if you've got the right dose of lantus yet. (Some people can continue producing some insulin for several years after diagnosis so it might make sense that your needs increase.) There are also shorter and longer lasting basals (levemir and tresiba) which might be worth considering.

Good luck.

(edited to add a welcome)

 

[DanGoku]

The telephone consultation lady did say levemir. I mean maybe in the near future with the insulin pump but what made me confused is she said the lantus is 24 hours and yet she said the time when my blood spikes when I have a day off she said 'The lantus insulin has run out in your body at a certain time during the night'. So I'm thinking then it can't possibly be 24 hours and I'm glad you mentioned that.

The thing is I honestly don't think I'm getting much help they just tell me do this and notch up my Lantus. It's not something I wanted to hear where she said 'You may have complications along the way'. I said to the lady and made it very clear that my blood does improve at times on night shift. It just seems when I give confident information they don't really take into my consideration that switching my body clock is stressful in itself.

I fee when my blood is 20 I feel quite hot when I wake up. I just feel taking Latus at 5am on my days off was better as I was more at ease with myself. Maintaining diabetes is challenging for all types.

 

[EllieM]

Do you know how to give correction doses of bolus? If I wake high I give a correction dose... But honestly, in your position I would seriously consider asking your DN about splitting the dose.

Levemir typically lasts 12 hours so it might be better if you want to give different doses on days and nights.

I always found lantus a bit erratic, though it improved when I decided to try splitting it. Eventually my team offered me a pump...

 

[DanGoku]

Its interesting when you said splitting the dose because I said to the nurse over the phone can I split the Lantus and she said 'Oh no use it at 7am'. In my opinion I honestly don't think it's a good idea. So when i first took Lantus at 7am from October 2022 usually and sometimes this happens and this was yesterday. I knew having my Lantus at 5am would suit me better because my blood eases at 12mmml/L. But here is a prime example when i took my Lantus at 7am. I forgot to scan it at 7am but it was 23. At 13:34 pm I went to bed to turn body clock because at 1pm I had Novorapid with lunch.

 

[Jaylee]

Hi @DanGoku ,

Welcome to the forum.

On the whole Lantus don’t last a full 24 hours closer to 20? For me.

I kinda work nights playing in an energetic band & find when my Lantus is tailing off on a gig night I can happily delay my dosage up to 4 hours, (cruising still in the low 5s.) i normally inject at 10PM.

A few years back I was doing night shift work leading up to Christmas in a massive pet food warehouse.
I had hell of a time with hypos, eventually waiting till I finished my shift to inject?
I started lowering my dose to start with at the usual time but had to keep snacking…

I put it down to possible insulin sensitivity at night & nocturnal exercise?

What are your numbers like during a shift?

 

[DanGoku]

Hi @DanGoku ,

Welcome to the forum.

On the whole Lantus don’t last a full 24 hours closer to 20? For me.

I kinda work nights playing in an energetic band & find when my Lantus is tailing off on a gig night I can happily delay my dosage up to 4 hours, (cruising still in the low 5s.) i normally inject at 10PM.

A few years back I was doing night shift work leading up to Christmas in a massive pet food warehouse.
I had hell of a time with hypos, eventually waiting till I finished my shift to inject?
I started lowering my dose to start with at the usual time but had to keep snacking…

I put it down to possible insulin sensitivity at night & nocturnal exercise?

What are your numbers like during a shift?

I think I may have to do exercising on a day off before Bed, my numbers can vary during a night shift. There are times where it does dip into hypos but not that often, I have jelly babie sweets at all times. I'm a fast worker at work and get things done and all that. I work in my local supermarket full time. When it's my last night I having breakfast at home of course the medication. Go to bed at 9am get up at 4pm so my levels dip a little bit, have lunch then dinner later on then I go to bed at 10pm but that's when my blood goes up let's say 5am to 20mmml/L.

 

[Jaylee]

I think I may have to do exercising on a day off before Bed, my numbers can vary during a night shift. There are times where it does dip into hypos but not that often, I have jelly babie sweets at all times. I'm a fast worker at work and get things done and all that. I work in my local supermarket full time. When it's my last night I having breakfast at home of course the medication. Go to bed at 9am get up at 4pm so my levels dip a little bit, have lunch then dinner later on then I go to bed at 10pm but that's when my blood goes up let's say 5am to 20mmml/L.

Maybe a blind spot with little or no basal coverage in the early morning hours?
Take a look at this. It’s a method to work out how the Lantus is performing. (Any basal really.)

How To Successfully Test Your Basal Rate

Are you looking for basal rate information and testing instructions? Perfect! You're in the right place!

www.mysugr.com

Do you only speak to a nurse, or do you also get appointments with a specialist?