Lantus - what's protocol here?

Hi @mirror and sorry to hear that your daughter is in hospital.

Get the team that is looking after your daughter to contact the hospital diabetes clinic and ask that a DSN or Consultant comes up to the ward to advise.

 

As you know Lantus is mostly a 24 hour long acting insulin to keep the blood sugar at a steady level. But it does have the potential to lower blood sugar too far if too much is given. The half dose morning insulin would have still been in her system when the full evening dose was given.

I inject Lantus in the evening and then with only a difference between injecting 11 or 12 units can have a substantial effect in lowering my morning blood sugar level. If my Blood sugar level is too low in the morning I inject 1 or even 2 units less Lantus in the evening.

@noblehead has given sound advice in post #2.

 

Are the people administering the insulin diabetes qualified.........?

is your daughter able to take control of her own insulin?

 

You may be interested in these guidelines:
https://www.diabetes.org.uk/About_u...ions/Self-management-of-diabetes-in-hospital/
https://www.diabetes.org.uk/About_u...ions/Self-management-of-diabetes-in-hospital/

The second link cites coming off steroids as a risk factor for hypos.

Once she is out of hospital, she should request her notes so a formal complaint can be made, if desired.

 

So the DN wanted to give insulin without checking her BG? Lots to complain about here, I think.

 

12 units of fast? acting insulin for a McD. Way too much IMO. Last week I had a McD Quarter Pounder. I ate half of the bun plus some of my grandsons fries. Total injection 4 units.

 

@SweetLucie I know exactly what Lantus is and how I use it effectively for me...

 

Even if 2 or 3 units too much fast acting insulin are given, low blood sugar will result. You can find the carb value of most food products by googling the product name followed by carb content. Perhaps your daughter's insulin to carb ratio has changed. Some T1s on here have different ratios for different times of the day.

 

That's absolutely ridiculous, millions of type 1s around the world do this every day because it's important, even more so in hospital. These doctors are seriously putting your daughter at risk with not checking her blood sugar beforehand. You need to tell the doctors how important it this is, because the care she's receiving right now is disgraceful. You said the diabetes nurse knows about the situation, is that the one attached to the hospital or one your daughter sees outside of hospital?

 

Try to get hold of her diabetic team outside of hospital, this nurse in the hospital clearly isn't doing her job properly if she did advise the double dose. Hopefully the team outside of the hospital can either scream at them on the phone or do something to get help her out.

 

That sounds like a good idea, I'm not really sure what else you can do other than staying by her all the time making sure that her blood sugar is being checked etc. I hope she does start to feel better soon.

 

Hi the reason the poster queried the use of Lantus with a McDonalds is that it should not be used for mealtime carbs. Lantus is a 24 hr background insulin only. If your daughter should need more insulin for mealtime carbs as well after the steroids have gone right down and her blood sugar needs better control, then additional Rapid insulin such as NovoRapid would be precribed for mealtime use as well. Some people do do two injections of Lantus per day (morning and evening) but the total dose for both is adjusted to be a similar to the amount one single total dose would be.