Novorapid Lantus help

Hi Vicky,
The best way to figure out if your Lantus is correct is by comparing bedtime and before breakfast readings. You need to make sure that you haven't eaten or injected a few hours before the bedtime reading as this may skew the results. If you have a change of more than 1.6 mmol/l then you need to adjust your Lantus by 10%. This is the technique from Gary Scheiner's Think Like a Pancreas book and it works very well for me.

Another sign that your Lantus needs adjusting is changes is your levels between meals, although this is more subtle.

Also in Scheiner's book, he talks about changing your insulin when you exercise. This has been invaluable to me as I'd frequently have hypos after exercise because I was giving myself fixed insulin doses. When you exercise your body produces hormones that make your muscle cells more absorbent, this makes insulin work more efficiently, which is why you have hypos after exercise. After I've done some high intensity exercise (enough to be out of breath for 10 mins or so) I need to drop my next Novorapid dose by 1 unit (as I normally have a meal after exercise). I also need to drop my Lantus by 10%. Scheiner says this lasts for 48 hours, so after 48 hours I put my Lantus back to what it was.

Sometimes I need to give myself insulin when I exercise to stop myself going high. When I play rugby I'll need insulin, but when I go for a run I'll need sugar. I think the intensity and stress of a game of rugby means that I'm producing glucogen.

Being dynamic with my insulin after exercise has been one of the best things I've done with my diabetes. It's stopped the hypos and highs. It's all about intelligent testing and figuring out what your body needs. If you spot patterns of highs or lows, then take action next time you do a given activity.

Hello,
I've had similar problems to what you have been describing. I'm on levermir and humalog with meals. I've had to increase my levermir in both the morning and night. I'm on quite large doses now but my blood sugar readings have now come down to single figures. It was a lot of perseverance and took a bit of time. But good luck with it


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I'm on lantus and novorapid too. I don't think there would be much point in splitting the lantus dose as it provides a steady dose throughout the day, with no peaks. I'm having similar troubles to you as my pancreas is still getting worse, so I'm constantly having to adjust. My diabetes nurse recommends changing the lantus two units at a time and then waiting a day or two to see what the effect is. I put mine up a couple of points last week as my novorapid doses were creeping up. I then started having a hypo every afternoon, so I've put it down by one, we'll see what happens next! :smile:

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As it appears to be happening in the evening mainly does that mean lower Novo for evening meal and maybe drop lantus?

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Is this after you exercise? If so then yes I'd drop the Novorapid by a unit. I don't normally need to change my next-meal-Novorapid or Lantus dose if I do weights, but do if I do cardio. So if I were in your shoes, I'd drop my Novorapid to avoid the hypos and if there's a significant change in overnight levels (>1.6 mmol/l - see the Scheiner rule in my earlier post) then I'd drop my Lantus by an appropriate amount too.

As you said it's trial and error, the best way to find out is to test!