LANTUS Questions and Confusions !!

Blackadder

Well-Known Member
Messages
61
I am on lantus and finding it really difficult to get right.

I seem to be injecting Novorapid several times a day to correct rising fasting blood sugars that the Lantus seems to do nothing with. I can goto bed on 4.x and wake up on 7.x with nothing in between, other days I'll wake up with the same figure as going to bed. I can have dinner put the kiddies to bed and sit down stairs on 3.8 and at bed time it can be 7 with 2 cups of tea, little milk and no sugar in between. Same during mid morning.

I started low carbing on 2 inj a day Hypurin Porcine last year and lost 2 stone in weight. I have not changed my diet but since starting Lantus and Novorapid I have put on 4 pounds in 3 months and if anything I am eating less and I exercise the same. Totally baffled. My overall controll is generally pretty good and I am testing every 2-3 hours and my average is currently 5.4, no major swings but I am still not convinced Lantus is working properly for me.

I started on 20 units at night, changed that cos it didn't work for me to 10 in the morning and 10 at night, changed that eventually after upping it gradually to 14 at 10pm 14 at 12noon. This seemed ok but too many lows, so it's reduced to 12 and 12 but changed to 12 with evening meal and 12 with breakfast. This seems to be causing fasting rises in the evening and in the mornings or late mornings. My shoulders, left mainly seem to ache a lot ever since I started Lantus and the injections sting sometimes beyond belief and I can take pain.

The weight gain is a big concern for me as there is no reason for it diet wise so it has to be something to do with Lantus. I am about to ask the dr to change to levimir but this will be my 4th change in less than a year and I am getting fed up with it now.

Any thoughts?
 

timo2

Well-Known Member
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613
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Glycemic excursions
Hello Blackadder,

If you wish to persevere with Lantus, it may be a good idea to get hold of a single unit Autopen,
to give finer dose adjustments. Also, your AM/PM doses will not necessarily be equal, you may be needing less AM and more PM or the perhaps the complete reverse (for instance, I use 9 units AM and 7 units PM).

Levemir is a good alternative to Lantus, although, many find they need a higher dose of Levemir compared to Lantus (usually around 20% extra). There's also the option of an insulin pump.

Good luck,
Tim.
 

Blackadder

Well-Known Member
Messages
61
Tim,

I have an Autopen with 1 unit doseages. The difficulty for me is I just don't know if its actually working properly. When do most people actually inject their Lantus, what times of the day if on two doses? I found out imediately that 1 inj a day was not lasting anywhere near long enough. But two doesn't seem to be doing a lot better.

20+ units a day seems a lot and I am now convinced that the more Lantus I inject the more weight I am going to put on.

I keep my control pretty good to be honest but it's mainly due to corrective doses of novorapid when I know my basal just starts to raise without eating.
 

timo2

Well-Known Member
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613
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Glycemic excursions
Hi Blackadder,

Sorry, I saw your 10/12/14 adjustments and assumed you were using a 2 unit pen.

What condition are your injection sites in?
Are you using the same injection sites for both Lantus and Novorapid?
 

Blackadder

Well-Known Member
Messages
61
NO I don't use the same site for both.

Well I started using my stomach when I changed 3 months ago and in the 33 years of being a type 1 I have never really used my tummy. I use Lantus one side and novorapid the other side of the abdomen until recently when I changed to leg / tummy or leg / arm.

My legs havent been used for about 9 months now to a year but my legs and arms have taken the hits alternately over the whole of the diagnosed 33+ years. I find the legs a little slower to work but I have had little difference in them from my tummy.
 

timo2

Well-Known Member
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613
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Glycemic excursions
THAT'S OK! :D

Do you eat much protein? If you're not covering the rise in blood sugars from protein, which peaks
at around 3-4 hours after a meal, then this could be causing your gradual rise, rather than any
problem with the Lantus.
 

Blackadder

Well-Known Member
Messages
61
Thanks for your help Timo, I appreciate it.

Ahhh I eat lots of protein with every meal. Can that cause weight gain too?

I had forgotten to include that after reading Dr Bernsteins book. How do you determine the amount of protein turns to carb? Is it 40%.

It's often about 3 to 4 hours after actually maybe 5 that the increase occurs. So how does one calculate what to inject at say 5pm for dinner if the bulk of the rise is going to be 4+ hours later? Or can control only be achieved by corrective doses 4 hours later when it starts to raise.

I eat little carbs but have a lot of chicken, turkey, fish, sausages pork, beef and dairy but mostly my problem is cheese.

So when do most people taking 2 shots of Lantus take their jabs?
 

timo2

Well-Known Member
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613
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Glycemic excursions
Hi Blackadder,

I inject my Lantus at around 8AM and around 8PM.

The protein side of things is a little bit of trial and error. It will help to stick to more carefully measured amounts.
You could give a preemptive dose of Novorapid at around the 2+ hour mark (either subtracted
from or in addition to your pre-meal dose). You may want to consider using a slower acting
bolus insulin, such as Humulin S or Actrapid. These have a slower onset but longer action,
better suited to the long slow rise from protein.

Regards,
timo.
 

janabelle

Well-Known Member
Messages
816
Dislikes
Lack of choice of insulin for newly diagnosed patients.
Dog owners who let their dogs poop in the street-a hazard for most, but worse if you're visually impaired!
Having RP
Hi, the 'Lantus not working' is becoming a familiar topic on this forum. I had 4 1/2 miserable years on the muck, and my control varied almost daily between 21 and 2, although my consultant had the usual get-out clause HBA1c test, to say 'don't worry about the highs', as the HBA1c test was within acceptable rangeI!!
Having been on different 'human' synthetic insulins for 15 years prior to Lantus, my control was always brittle, but with Lantus I had no consistency day to day- told 3 consultants and countless GPs and so-called Diabetes Nurses over the 4 1/2 years-no one helped! Contacted the IDDT last April.
They day I stopped Lantus(1 year ago), I felt like a different person-human again, not a zombie- and my control has been stable since. LANTUS DOES NOT WORK (!!), and causes many side effects-want more info please PM me, as I'm in danger of sounding like a broken CD on this forum! :D
Purified Animal insulin is REAL insulin- tried, tested and safe, and the only insulin that is!
As for the weight, get back onto pork and watch it fall off. Real insulin does much more than lower your blood sugar, synthetics are designed ONLY to lower your blood sugar(apparently!! :cry: ).
Best of luck and hope things improve for you.
Jus
 

susan1968

Member
Messages
21
Hello blackadder, I was told that lantus should be injected on your bottom :lol: In fact that is where I inject it. Novorapid I inject in different areas, depending on how high my glucose is. If it´s very high, in the abdomen, if it´s okay and I´m going to eat lentils, on my arm. My endocrine was quite persistent in telling me that lantus on the bottom.
 

Blackadder

Well-Known Member
Messages
61
Yes it stings like hell sometimes, thats normal.

I have just changed to Levimir and that doesn't sting nearly as much if at all.
 

Blackadder

Well-Known Member
Messages
61
susan1968 said:
Hello blackadder, I was told that lantus should be injected on your bottom :lol: In fact that is where I inject it. Novorapid I inject in different areas, depending on how high my glucose is. If it´s very high, in the abdomen, if it´s okay and I´m going to eat lentils, on my arm. My endocrine was quite persistent in telling me that lantus on the bottom.

Blimey, never heard that before. Maybe he just liked the vision in his mind of you doing it there? :D

I have now changed to levemir which seems to not cause that unexplained drop in b/s for no apparant reason, still getting the dawn phenomenen but no where near as bad.
 

Roboticg Gerg

Newbie
Messages
2
timo2 said:
Hello Blackadder,

If you wish to persevere with Lantus, it may be a good idea to get hold of a single unit Autopen,
to give finer dose adjustments. Also, your AM/PM doses will not necessarily be equal, you may be needing less AM and more PM or the perhaps the complete reverse (for instance, I use 9 units AM and 7 units PM).

Levemir is a good alternative to Lantus, although, many find they need a higher dose of Levemir compared to Lantus (usually around 20% extra). There's also the option of an insulin pump.

Good luck,
Tim.
im a type 1 diabetic and i got diagnosed on april 2 2008 and im also 14 yrs old so ive had quite a few mental implosions because it usually takes me a good while to realize that i have diabetes and when i realize it i go absolutely nuts, i start crying for hours on end i think about killing myself etc. but for right now i inject myself with humulog and lantus in the stomach area with a simple hypo
 

Marky74

Well-Known Member
Messages
69
Blackadder said:
Yes it stings like hell sometimes, thats normal.

I have just changed to Levimir and that doesn't sting nearly as much if at all.

That is good to know that it stings with people.. I don't feel too odd now.
 

janabelle

Well-Known Member
Messages
816
Dislikes
Lack of choice of insulin for newly diagnosed patients.
Dog owners who let their dogs poop in the street-a hazard for most, but worse if you're visually impaired!
Having RP
Hi roboticg gerg,
I really feel for you, you're so young and it must be a huge shock for you. I've always felt lucky that I wasn't as young when I was diagnosed- I was 19, just moved to London and started a new job. It was still a shock, especially the realisation that it wasn't something that would go away-I got very depressed and imagined myself blind and limbless by the time I was 40. How the years have flown :? -turned 40 this year, still got my arms and legs and eyes! Try not to feel too gloomy, it's a manageable condition, but it does somewhat dictate your daily life, but not your whole life.
On this forum I've continually expressed my concern over synthetic,particularly analogue, insulins. I was on Lantus for 4 1/2 years and had lousy control and felt like **** with many side-effects which have disappeared since coming off it. Side effects were, joint/muscle pain, anxiety,debilitating exhaustion(sometimes sudden in onset), zombie-like 'in a cloud' feeling, depression(understandable :cry: ),inability to think clearly, and unexplained hypos and hypers.
I speak to many people who have had probs on synthetic insulin, and report better control and health since changing to animal insulin. May not be the answer for everyone but it certainly is for a very significant number of people.
Jus