morning levels

[Curleous]

Hi there everyone.
I am having problems with morning levels again and it is really starting to get me down.
I am a type 1 male aged 49 diagnosed four years ago. I have been on Lantus and novorapid since diagnosis and have always had excellent control since diagnosis with hb1ac never over 6.5 percent and most recent 6.2. I have had to increase my lantus dose over the four years from about 14 on diagnosis to about 24 units now. I weigh about 80 kg and my bmi is just in the acceptable limits ..only jus!!!t.
The problem i have is over the last few months my morning sugars are never below 10 when going to bed between 5.5 and 7. I have increased lantus from 24 units up to 34 units which has had no effect at all. I have tested overnight to ensure no night time lows which there arent. I am reluctant to increase lantus anymore as it doesnt seem to be having any effect. I have also missed my lantus dose which i take at 23.00 every night and when i miss it my morning sugars are no different to that when i do take it. I have even missed it on 3 consecutive night in the past and it didnt seem to be making a huge amount of diference. I have tried different batches and injection sites etc .
Please has anyone got any ideas on how to proceed. I know my consultant will not be bothered as he thinks my control is too tight but i am starting to feel quite poorly when i wake up with levels higher than 9 and very poorly when levels are higher than 11 and am having to take correction doses of novorapid on waking which isnt good.

Many Thanks
Andy

 

[LucySW]

Andy,

Look on the Insulin discussion. I've seen posts there about either Lantus or Levemir having no effect on some people. (It's at Diabetes Management / Medication / Insulin.) You should find some experience like yours to compare notes with.

I think people will say, try Levemir (or if that doesn't work, try old-fashioned stuff like 'human' insulin). It seems to be so individual, what works. But huge doses of anything won't help.

On the Insulin discussion there seem to be lots of people saying they have problems with Lantus.

Good luck - your instinct is quite right, those figures aren't working.

(Though if BMI is high, lo-carb and exercise might help too, if you're insulin-resistant.)

 

[iHs]

In the past, Lantus was associated with a certain degree of weight gain and its not uncommon for the doseage to increase over time. My body weight increased as did the Lantus dose. My weight decreased a bit when switching to Levemir twice daily and the hypo feeling was less intense.

As for an a1c of 6.5%...... if it can be achieved with awareness of hypoglycaemia around 3.4mmol then all well and good but usually for most diabetics, a low a1c usually comes with the price tag of awareness being around 2.5 to 3.2mmol and the lower the a1c, the lower the awareness will be.

 

[Daibell]

HI. I wonder whether weight and some insulin resistance is at least a partial cause. If I go on a trip with higher than normal food intake e.g. a recent cruise my insulin control goes out the window and I have to step up the insulin quite a bit beyond what I would have expected. I'm on Levemir and NovoRapid. Are you controlling the carbs as all insulins will result in weight gain if you have too many.