Don't give up. 
It is indeed frustrating as there are so many things to get your head around even as a 'normal' diabetic. Most Doctors make you feel guilty as though you are not trying, but it is usually that they themselves have so few patients that are 'real' brittle patients, and would never admit that they do not know why something is happening weird. That website has Doctors who see this themselves and explain that some people (like me) have this horrid problem with Diabetes and even more of their colleagues that are just ignorant.
No two people are the same but most fall into a 'normal' 1 or 2 category. The reason your Lantus (aka Glargine) is an issue is that Lantus starts working and levels off after 2-4 hours, and no two people have the same time frame. Also this 'leveling off' is not always a straight line and deviates slightly over the hours as your Liver and pancreas have a natural rhythm and your body is always trying to optimize what it finds. It wants to self correct, and for some it works better than for others. I start my pump shortly and will let you know how I get on. I also try to make sense of the Lantus and have done the very same thing and found it just changes from time to time. So when I have a low AM maybe for a day or two I drop a few units. I take 18 at 11 PM but if I am poorly then sometimes down to 15 or 16 for a day or two then I know I wont have hypo issues, then 2 or 3 days later go back to 18.
If you had a beer (or wine) earlier tonight then when 10 PM rolls around tonight then I would drop down to like 10 or 12 and see what your levels are in the AM then maybe you wont have that horrid crash again.
Remember the Lantus is considered a peak-less profile. In that it levels off and remains the same after 2-4 hours, as opposed to short acting where they shoot up quick and trail off after just 1.5 - 3 hours.. Since Lantus builds up and remains at the same level the problem is finding when your body has used it up. Meaning that for some people that can be 18 hours and others a dose can last 26 or 28 hours, so if your really unlucky they can over lap. I would suggest to err on the side of lighter Lantus and if your sugar levels go a bit hi in the AM (usual for all peoples body clock) then you can always give a very small dose of short acting insulin to bring it down. Most people forget that we are all different and our metabolisms work different and indeed YOU are going to be your best Doctor in the future because YOU can learn about YOUR body and how it reacts.
I guess I will see if a brittle is really helped as I am about to start a new adventure with this pump and using only short acting insulin feels a bit uncertain, but after reading about others experiences it seems they feel much more control when they have sorted the pump out.. Fingers Crossed
PS maybe ask about doing your Lantus in the AM, the only bad thing is you could go high in your sleep and wake up higher. Your Latus should be at full throttle if you are at 10 PM. Another thing is that remember that your Novo can stack. So though its peak is 1.5 to 3 hours it still take about 3 to 7 hours to completely wear off. Should you have an extra dose late at nite, and you had already had some earlier this can be a source of issues http://www.lantus.com/hcp/dosing-titration/dosing-calculator.aspx for Lantus dosage info.. Might also help if you start going to sites reading about pumps and how they work only with short actiing insuline, this would help you to better know how to self adjust in the future when you think there is a possibility of a change
It is indeed frustrating as there are so many things to get your head around even as a 'normal' diabetic. Most Doctors make you feel guilty as though you are not trying, but it is usually that they themselves have so few patients that are 'real' brittle patients, and would never admit that they do not know why something is happening weird. That website has Doctors who see this themselves and explain that some people (like me) have this horrid problem with Diabetes and even more of their colleagues that are just ignorant.No two people are the same but most fall into a 'normal' 1 or 2 category. The reason your Lantus (aka Glargine) is an issue is that Lantus starts working and levels off after 2-4 hours, and no two people have the same time frame. Also this 'leveling off' is not always a straight line and deviates slightly over the hours as your Liver and pancreas have a natural rhythm and your body is always trying to optimize what it finds. It wants to self correct, and for some it works better than for others. I start my pump shortly and will let you know how I get on. I also try to make sense of the Lantus and have done the very same thing and found it just changes from time to time. So when I have a low AM maybe for a day or two I drop a few units. I take 18 at 11 PM but if I am poorly then sometimes down to 15 or 16 for a day or two then I know I wont have hypo issues, then 2 or 3 days later go back to 18.
If you had a beer (or wine) earlier tonight then when 10 PM rolls around tonight then I would drop down to like 10 or 12 and see what your levels are in the AM then maybe you wont have that horrid crash again.
Remember the Lantus is considered a peak-less profile. In that it levels off and remains the same after 2-4 hours, as opposed to short acting where they shoot up quick and trail off after just 1.5 - 3 hours.. Since Lantus builds up and remains at the same level the problem is finding when your body has used it up. Meaning that for some people that can be 18 hours and others a dose can last 26 or 28 hours, so if your really unlucky they can over lap. I would suggest to err on the side of lighter Lantus and if your sugar levels go a bit hi in the AM (usual for all peoples body clock) then you can always give a very small dose of short acting insulin to bring it down. Most people forget that we are all different and our metabolisms work different and indeed YOU are going to be your best Doctor in the future because YOU can learn about YOUR body and how it reacts.
I guess I will see if a brittle is really helped as I am about to start a new adventure with this pump and using only short acting insulin feels a bit uncertain, but after reading about others experiences it seems they feel much more control when they have sorted the pump out.. Fingers Crossed
PS maybe ask about doing your Lantus in the AM, the only bad thing is you could go high in your sleep and wake up higher. Your Latus should be at full throttle if you are at 10 PM. Another thing is that remember that your Novo can stack. So though its peak is 1.5 to 3 hours it still take about 3 to 7 hours to completely wear off. Should you have an extra dose late at nite, and you had already had some earlier this can be a source of issues http://www.lantus.com/hcp/dosing-titration/dosing-calculator.aspx for Lantus dosage info.. Might also help if you start going to sites reading about pumps and how they work only with short actiing insuline, this would help you to better know how to self adjust in the future when you think there is a possibility of a change
