Ooh, it’s a tricky one. I often only eat one meal a day, but I’m on a pump and have done fairly extensive basal rate testing to get my levels right so I can do that. Lantus is a tricky one, because it has quite a peak and a tail off, and doesn’t often last the full 24 hours. A couple of questions...
What is your Lantus regime - are you taking it once a day (when?) or splitting it?
Are you using a glucose sensor or finger pricks?
The rise in the morning sounds awfully like dawn phenomenon - I never noticed it until I went LC, I think the carbs in my diet masked the effect before. Your liver dumps glucose and cortisol into your bloodstream to get you going for the day - people with pancreases just deal with that by releasing some insulin, but we have to do it ourselves. I’ve got my pump pretty well timed to squash that, but had to wake up at sparrow-fart o’clock to inject a unit or two in an attempt to head it off at the pass when I was on injections.
Congrats on the weight loss, and the amazing Hba1c btw!
Thank you for your reply Mel dcP. I’ve taken Lantus for years but over the past six months I have found it more and more difficult to control my bs and I really think I need to change to something else.
I used to take Lantus before bed. Then I found it wasn’t covering me late evening and I had to take a small correction dose of short acting. After reading on the forum about split doses and some finding this worked with Lantus, I decided to give it a try. So I changed to taking it at 8a.m. and 7-8p.m. That got me into all sorts of trouble, but the worst was going low overnight. I kept reducing the p.m dose down and down and although things improved I was still getting overnight lows. Stopped the p.m dose completely and am still getting lows. Don’t understand that as my a.m. dose can’t possibly still be working - could it? So now I take 9 units at 7 or 8a.m. which normally keeps me stable throughout the day and evening.
However I am definitely getting DP, presumably because no basal cover by that time. I also take Metformin a.m and p.m; without it I have much higher readings. I take this immediately I wake to try and halt the DP but sometimes it’s too late, so then up my short acting a little to get back to normal after breakfast. Whilst trying to fast in the mornings I have been taking the Metformin immediately plus 4 units of Humalog. Sometimes that keeps me in the normal range, sometimes not. This morning I was ok until 11.30 a.m when my bs rose to 9.
I couldn’t live without my Libre!! That’s how I know I’m going low during the night. The lows start early, about 2a.m until the DP begins and that can vary from 5a.m to 7a.m. I also finger prick with Abbot strips on the Libre to ensure the blood tests and sensor readings haven’t drifted too far apart, usually once a day. Some sensors haven’t been too good and I’ve had them replaced, but overall it’s been an amazing aid.
I’m seeing my DN next month and will discuss the problem and ask for a change of basal.
Thank you, re the weight loss and results. I couldn’t have done it without this forum and my Libre.
Any thoughts on the above and whether there is any point in fasting, would be greatly appreciated.