Late with my lantus

[rachy0121]

Pain In The ar$€

Love that!!!

 

[rachy0121]

Hi @rachy0121, Yes, I have forgotten my doses before breakfast in the past and double dosed myself in the evening - so you are in good company. Besides how else do we learn except from making mistakes?
From my past experience as T1D, not as professional advice or opinion: I have never used Lantus and some have had problems with it regarding absorption, and rarely, from hypos if accidentally injected into a blood vessel.
And even if it it is not lasting 24 hours there is a concern, at least in theory, that if used every 12 hours the overlap could be a problem.
As an example, say the Lantus last 18 hours, if given every 12 hours, there would be an overlap of first and second doses at the 12 to 18 hours mark after the first dose dose. The overlap is called insulin on board or insulin stacking. This term is mainly used where short acting insulin (? what is yours?) overlaps in its action with another dose of short acting and risks hypos occurring. So twice daily Lantus may work if the overlap is not too great and is timed well but otherwise might be a problem.
Consider say the first dose of lantus at 10 pm and the next at say 8 am the next morning, based on a 18 hour action. the overlap is from 8 am the next morning to 4 pm. With the next pm dose of lantus at 10 pm the next night the overlap is from 10 pm til 2am. So hypos might be more likely based on this at say halfway in overlap onwards so ?1pm to 4 pm and 12mn to 2 am.
I and others have also noted that the insulin we take works better, dose for carbs eaten, in the evening compared to the morning. So if more 'umph' is needed say in the morning we might take more short-acting insulin for the number of carbs at breakfast than in the evening. The overlap of lantus in the morning (8am to 4 pm) might helpa little the after breakfast BSL reading to be lower but ? hypo later. Similarly a risk of hypo at 12 to 2 am is not something to wish for !!
So perhaps talk with your DN about what you are doing with your Lantus.
Have you wondered if the high BSLs could be due to something other than the Lantus insulin dosage etc?
Could the highs be due to diet or associated with stressful time of day? And we have already noted that some of us need more short-acting insulin before breakfast. Others also find that their BSL has already started to rise before they wake up.
Also by testing BSLs some find that their short-acting insulin takes longer to 'kick in' than others.
Take Novorapid for example: its peak of action (ability to lower BSLs) is max at say 2 to 3 hours and overall effect may last 5 to ?7 to 8 hours. Lots of variation there. So some of us find that taking Novorapid just before breakfast allows the BSL peak from breakfast to beat the Novorapid peak effect. To better match the rising BSL to the peak in Novorapid effect some delay breakfast for say 3/4 to one hour after the Novorapid is given and obtain a better 2 hours after meal BSL result.
For others the Novorapid taken just before breakfast works fine.
Again some thoughts to share with your DN to help sort things out.
Please keep posting about how things go!!

Do you know what, I’ve read what you’ve put and I completely understand it all. I’ve never had these things explained to me by professionals or suggested to me at any point with either changing insulin’s splitting doses what foods have low GI. I Didn’t even know what GI was until the beginning of this week from someone on a support group so now have completely changed my diet and bought all low GI foods in and got a meal plan for the next few weeks. No ones told me anything and I feel a bit robbed if I’m honest. The only
Thing I’ve had said to me over the last year when visiting is constantly changing my dosage of lantus every time I visit the hospital
Thank you for your advice much appreciated

 

[mike@work]

Love that!!!

Now you made me wonder...

Edited to say: yes, I'm sorry, I know the quality of that one, but I just couldn't resist..

 

[porl69]

Love that!!!

Be careful what you say on hear.....

Do you know what, I’ve read what you’ve put and I completely understand it all. I’ve never had these things explained to me by professionals or suggested to me at any point with either changing insulin’s splitting doses what foods have low GI. I Didn’t even know what GI was until the beginning of this week from someone on a support group so now have completely changed my diet and bought all low GI foods in and got a meal plan for the next few weeks. No ones told me anything and I feel a bit robbed if I’m honest. The only
Thing I’ve had said to me over the last year when visiting is constantly changing my dosage of lantus every time I visit the hospital
Thank you for your advice much appreciated

Consultants do not have to live with it every day whereas we all have to and can give advice which, mostly, works. Just remember we are all different (you will hear that a lot on here) and what works for one may not work for you

 

[SamJB]

I've forgotten loads of times! I have a daily alarm on my phone and even then I still forget!

 

[rachy0121]

Be careful what you say on hear.....


Consultants do not have to live with it every day whereas we all have to and can give advice which, mostly, works. Just remember we are all different (you will hear that a lot on here) and what works for one may not work for you

Exactly my thoughts! And I’m grateful for every bit of advice given!

 

[rachy0121]

I've forgotten loads of times! I have a daily alarm on my phone and even then I still forget!

You sound like me

 

[kitedoc]

Hi @rachy0121, Some doctors are not good communicators. They forget that not everybody has spent years doing a medical course and might assume that you understand diabetes like they do.
I have been known to put questions to doctors like:
"Could you please explain that without those big medical words"?
Or "Doctor, I know a lot about (example: crochet, tourism, badminton, cooking, IT, car maintenance etc etc) but I do not have a medical degree (actually I do!!) so please explain that like I am a five year old."
Or: "Doctor, I wish to make sure I have understood you correctly: (add your question).
If I get the brush off I say: "But I understood that part of your role as a doctor is to communicate with patients so they better understand their condition and what your instructions are"
Occasionally I have got the off putting phrase "Well, it is too complicated for you to understand" in which case the Aussie in me comes out " Well, try me Doctor, see if you can explain it to me" or I say: "Well is there another doctor who can explain it if you cannot"? Perhaps I shall see if one of the nurses can do it better"?
After all you pay taxes for your health services which pay doctors and others to do their part.
In Australia there is a tourism slogan about one of the territories here: "If you never never go, you will never never know"
It is the same with patients and doctors: If the patient never never asks (or persists in asking) the patient may never never know (something important). Best wishes.

 

[mike@work]

I've forgotten loads of times! I have a daily alarm on my phone and even then I still forget!

Have the same problem...

 

[mike@work]

Hi @rachy0121, Some doctors are not good communicators. They forget that not everybody has spent years doing a medical course and might assume that you understand diabetes like they do.
I have been known to put questions to doctors like:
"Could you please explain that without those big medical words"?
Or "Doctor, I know a lot about (example: crochet, tourism, badminton, cooking, IT, car maintenance etc etc) but I do not have a medical degree (actually I do!!) so please explain that like I am a five year old."
Or: "Doctor, I wish to make sure I have understood you correctly: (add your question).
If I get the brush off I say: "But I understood that part of your role as a doctor is to communicate with patients so they better understand their condition and what your instructions are"
Occasionally I have got the off putting phrase "Well, it is too complicated for you to understand" in which case the Aussie in me comes out " Well, try me Doctor, see if you can explain it to me" or I say: "Well is there another doctor who can explain it if you cannot"? Perhaps I shall see if one of the nurses can do it better"?
After all you pay taxes for your health services which pay doctors and others to do their part.
In Australia there is a tourism slogan about one of the territories here: "If you never never go, you will never never know"
It is the same with patients and doctors: If the patient never never asks (or persists in asking) the patient may never never know (something important). Best wishes.

Agree, but now and then you just sit with your jaws open, and all you should have said, comes in mind all too late...

 

[kitedoc]

Agree, but now and then you just sit with your jaws open, and all you should have said, comes in mind all too late...

Yeah, @mike@work, I know the feeling. I try to make a list beforehand. As those questions are being answered I hope I can formulate ones related to what was said!! Sounds in theory but .....