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Lantus - what's protocol here?

mirror said:
Conrad - happy to tell you via pm the med if you are interested
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Sounds good; my brother in law is a bio-chemist doctor who works in research - I'll ask him for the low-down on it.
 
mirror said:
Just quickly googled
C peptide test needs no food / drink for 8-12 hours ( she'd be hypo)
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Ideally - I'd do the test anyway just for laughs.
Tell the consultant he or she could win a Nobel prize if this pans out a certain way...
 
ConradJ said:
This situation is utterly perplexing, more so because the BG results are low overnight and until early pm, whence they rise until night-time again.
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Maybe she has a vampire pancreas - can't be killed but only rises at night.
 
Your first post said she is 20 and another that she's had type 1 for 20 years. Has one of the rare monogenic diabetes ever been looked in to? (usually diagnosed before 6 months)
 
There were some studies in mice that showed if glucagon activity could be repressed (ie the liver stops pushing glucose into blood) then Glut4 receptors in the muscles could more than adequately deal with blood glucose without the need for extra insulin. I wonder if this is what is happening in your case?
 
Interesting. Sounds plausible Tim. The off label meds are seriously hepatotoxic so stopping the glycogen response, rather than the glucagon stimulus, would be the presumed mechanism in this case.
 
Spiker said:
Interesting. Sounds plausible Tim. The off label meds are seriously hepatotoxic so stopping the glycogen response, rather than the glucagon stimulus, would be the presumed mechanism in this case.
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I'm starting to suspect that even if this med has had a beneficial effect on her blood glucose control, it probably has side effects and risks that make it unsuitable as a treatment for T1. But if it demonstrates an effect that has not been seen before, it could lead to new discoveries and a different drug to try for T1.

It's possible that this med has not been tried in a person with T1 who is on the other meds. Perhaps when all the dust has settled, her specialists should publish a case study so that other doctors are aware of the effect this combination can have on blood glucose in T1s.
 
Been away for a bit, just been catching up...........wow! amazing reading this thread, Mirror you're doing stonkingly well to manage the situation.

So we think the off license med has stopped her liver dumping, and she maybe producing some insulin? I'm not sure on that, I think the drop in blood sugar is kidney function (doing as they should - cleaning the blood) the drops aren't massive, insulin like drops. But at the same time small injected doseages of insulin cause a big drop so highly sensitive to the stuff!

Is she drinking and going to the loo a fair bit now it appears she's not had a hypo for a while? (especially that evening when she had the MaccyD)
 
ok, so since 6pm yesterday (if anyone is still interested?)
8pm bm 4.7
10.17pm 5.6bm
12.06 am bm 5.7
12.40am 3.7 bm (i woke up and did it here, unaware her dad had done it only half an hour previously but a wierd drop - its possible i didnt have quite enough blood on though if that makes a difference). i did make her have 200ml lucozade and about 20g worth of milkshake, and 25g biscuits.
also somewhere between 10 and 12.40 she ate half a wrap - as dad put it there at 10 and half was gone when i went up at 12.40 - 25 g carbs
1st sept
2.30 am - 5.2 bm
4.30 am - 5.9 bm
7 am - 6.7 bm
09.23 am - 8.6 bm
12pm - 15.1 bm 0.1 ketones 30 g carbs (small wrap)
2pm - 21.3 bm lo ketones (humming and harring about if to give novo - none given)
2.55pm 16.6 bm
5pm 11.4 bm
6.25 pm 9.2 bm

had a pre-diabetic appt blood test and asked for liver function (appt friday)
said cant do c peptide unless in hospital

theoretcially got next infusion monday. apparently they always do a liver function test pre infusion and it was fine 10 august (as it would be as it was first dose of the meds)
 
slip said:
Been away for a bit, just been catching up...........wow! amazing reading this thread, Mirror you're doing stonkingly well to manage the situation.
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thanks a lot - its stressy but with no ketones, and bms reasonable i really dont want her in hospital - shes doing stuff at home, and after being in hospital 4 months before it led to very low mood, self harm (cutting) etc - so deffo want to keep her out
(and shes not yellow)
 
So from at least 6pm yesterday she's had no insulin lantus or novorapid?
 
But she is getting ketones when high and then slowly dropping - I would give her 1 unit of novorapid when above 16mmol and see what happens if it does take her down 11 as already stated at least she shouldn't go too low especial as she's not having any lantus at the mo.

Keep posting the detailed logs, if anything it'll help you keep track of things. I guess she's not doing much physical activity at the mo?
 
mirror said:
ok, so since 6pm yesterday (if anyone is still interested?)
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Yes we are still interested Out of concern for her and curiosity about her medical condition.

You are doing amazingly... you and your partner are working so hard and you seem to really know your stuff.
 
Don't know our stuff..
Just moderately intelligent and desperately need to keep her out of hospital whilst completely up for taking her in if necessary
Keeping in touch with DSN and other professionals
 
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