 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / Diseases and Disorders / Diabetes / April 2007Lantus
Let me start this by saying that I know I should ask my doctor, but he just keeps pushing more and more insulin. It peeked last summer when I went unconscious from a low from the Lantus. I have since reduced my Lantus intake from 70 units to 38 units. I also take Humalog with meals. My question is, how do I determine how much Lantus I need? I am at the point now that if I increase it (I take it at night) I go low overnight and then have a high fasting in the morning. By low I mean in the 30's or 40's and with highs in the 200's and 300's. I have tried splitting the dose and tried it in the mornings also, bedtime seems to work best. Some mornings my BS are in the 100's, so it isn't an every morning rise. Just looking for some guidelines as to how to tell what is the correct dosage. This sounds like a cop out, but the correct dosage is whatever is right for you. I take 50 at night and 85 in the morning. I also take regular insulin at 6 12 18 in the morning noon and night. There is no set amount that is right for everybody. Just remember that Lantus is slow acting and regular is fast acting. Get your doctor to give you a range and increase or decrease within that range until you get it right for you. > Let me start this by saying that I know I should ask my doctor, but he just > keeps pushing more and more insulin. It peeked last summer when I went [quoted text clipped - 7 lines] > my BS are in the 100's, so it isn't an every morning rise. Just looking > for some guidelines as to how to tell what is the correct dosage. Regular insulin isn't "fast acting" it's moderately fast acting. Regular starts to work in 30-45mins. It peaks at 2-4hrs and it's usually gone within 5-7hrs. Humalog and/or Novolog is much faster acting Insulin. You must be severely insulin resistant with taking 135u of a Basal Insulin. I would hope you're on a anti-resistant medication to help reduce your severe IR.  SignatureReisa, T1 dx-5/00 asd-7/00 Animas IR1250 pumper Symlin 1u, 30gm meals Daily CHO: 150-175gm TDD: 36-38u Last A1C: coming down. > This sounds like a cop out, but the correct dosage is whatever is right > for you. I take 50 at night and 85 in the morning. I also take regular [quoted text clipped - 15 lines] >> an every morning rise. Just looking for some guidelines as to how to >> tell what is the correct dosage. >Let me start this by saying that I know I should ask my doctor, but he just >keeps pushing more and more insulin. It peeked last summer when I went [quoted text clipped - 7 lines] >my BS are in the 100's, so it isn't an every morning rise. Just looking >for some guidelines as to how to tell what is the correct dosage. I take it you're a Type 2? I'm a Type 1, and my basal dose of Lantus is 26 units a day. Try this experiment: Take your usual Lantus, but eat nothing (or at least no carbohydrates) for a day and omit the Humalog. Test every couple of hours throughout the day. If your Lantus dose is correct, you should be close to your target BG, with no highs or lows. If not, adjust your Lantus dose up or down and do the experiment again. If your only low in this scenario is during the overnight hours, maybe you should have a bedtime snack rather than further reducing the Lantus. Once you have your basal Lantus dose set, only then should you start tinkering with the Humalog doses. > Let me start this by saying that I know I should ask my doctor, but he just > keeps pushing more and more insulin. It peeked last summer when I went [quoted text clipped - 7 lines] > my BS are in the 100's, so it isn't an every morning rise. Just looking > for some guidelines as to how to tell what is the correct dosage. Unfortunately there are no guidelines and it would be inadvisable and wrong for any of us to tell you what dosage to take. I use Lantus but I had a long discussion with my doctor about how to adjust the dosage to fit my particular needs. If you're not satisfied that your doctor is giving you good advice or that he or she has your best interests in mind, then you should find another doctor. You didn't mention if your doctor was an endo, but if they're not you should get one. Lantus is a wonderful drug, but like all drugs it can be very dangerous if used incorrectly. Best of luck. Kurt i had to give up on Lantus and switch to Levemir kate SignatureJoin us in the Diabetic-Talk Chatroom on UnderNet /server irc.undernet.org --- /join #Diabetic-Talk More info: http://www.diabetic-talk.org/ http://www.diabetic-talk.org/freeveggies.htm I have no medical qualifications beyond my own experience. Choose your advisers carefully, because experience can be an expensive teacher. > Let me start this by saying that I know I should ask my doctor, but he just > keeps pushing more and more insulin. It peeked last summer when I went [quoted text clipped - 7 lines] > my BS are in the 100's, so it isn't an every morning rise. Just looking > for some guidelines as to how to tell what is the correct dosage. > Let me start this by saying that I know I should ask my doctor, but he > just keeps pushing more and more insulin. It peeked last summer when I [quoted text clipped - 8 lines] > morning rise. Just looking for some guidelines as to how to tell what > is the correct dosage. Hello.. Yes, you probably should discuss this with your doctor as well... but heres a starter for you. Remember *I* am *NOT* a doctor. <g> I'm a youth Olympic bowling coach and when the kids get frustrated, I tell them to go back to the very basics and start over and 9 times out of 10, they get back in the rythm quickly.. This is the same practice that I've done when I start to have issues with my bg control and my insulin dosages. Pretty much you need to start with a basic starter dose. To do this, calculate 0.5 units/kg/day body weight, this is called TDD/Total Daily Dose). Then I do what Alex said as well, except, I follow what John Walsh (along with my CDE/Endo/GP all recommended) that you only fast until 1pm the first day when testing your basal. Then if you can go from waking until 1pm with steady BG's, your Basal insulin is set correctly. The following day, you fast from 1pm until bedtime and if your BG's remain stable then your afternoon Basal is set correctly. By doing this, I found that I have quite a varied daily insulin need, which prompted my going to a pump instead of staying on MDI. There are some good websites that can walk you through this, one is.... http://www.diabetesnet.com/diabetes_tools/tools_tdd.php which has some very good insulin tools. The site is owned by John Walsh who's written a couple of very good books on how to properly use Insulin. Far better then Bernsquack imho. Walsh's information is up to date, which is most important along with he gives helps on living a normal life while taking insulin and getting the best management. If you want to have a go of it yourself, I found this information at www.aamc.org/patientcare -- Another site you might want to check out is www.insulin-pumpers.org -- The site isn't just for Insulin pumpers, it has some very good information on how to correctly set and check your Basal and Bolus insulins. Just remember to test frequently if you're going to take it into your own hands if you're new and not experienced. And as always, CHECK with your doctor before making any changes. One last thing, you might need to change from Lantus to Levemir. Lantus and Levemir doesn't have a peak per-say. But Type 2's seem to think they notice a peak because of their own Insulin kicking in instead. (what my CDE told me when I asked why T2's see a peak with Lantus/Levemir and T1's don't) HTH. SignatureReisa, T1 dx-5/00 asd-7/00 Animas IR1250 pumper Symlin 1u, 30gm meals Daily CHO: 150-175gm TDD: 36-38u Last A1C: coming down. Levemir has a distinct peak to it based on units/kg of body weight type 2's will notice this peak because they typically take more units/kg of body weight kate SignatureJoin us in the Diabetic-Talk Chatroom on UnderNet /server irc.undernet.org --- /join #Diabetic-Talk More info: http://www.diabetic-talk.org/ http://www.diabetic-talk.org/freeveggies.htm I have no medical qualifications beyond my own experience. Choose your advisers carefully, because experience can be an expensive teacher. But Type 2's seem to think they notice a peak > because of > their own Insulin kicking in instead. (what my CDE told me when I asked why > T2's see > a peak with Lantus/Levemir and T1's don't) > > HTH. Seiously START WRITTING EVERYTHING DOWN!!! When i got pregnant my sugars were all over the shop!!! LIKE really DANGERIOUS! Keep a diary with everything... the time you check your sugars, the times you eat and what you eat (INCLUDING APPROX SIZE AND BE HONEST) how much insulin you take and when!!! also the type of activity you do. then you can see if there are any specific patterns and then your endo can change what your doing and help! you cant get a result from one days sugar levels! give yourself a week of writting it down then go see your doc!!! another thing that helped me was that they told me to pretty much take my weight in units (im 54kls, so i take around 54units a day... on a normal day) Im trying to get this lower so I take a slightly less amount of insulin and exercise and thats one way i get my weight down. Please remember if your not being honest when you write everything down, your only lying to yourself... the docs cant help you if your not honest! DO it for yourself!!! you will appreciate it! Good luck! PS its hard work getting everything under control but my god its worth it!! Sorry just wanted to add, does anyone else find lantus painful??? I find that everytime i inject it im in so much pain! LIKE sharp stabbing.. and i get bad bruises from it??? keep forgetting to ask my doctor about it! > Sorry just wanted to add, does anyone else find lantus painful??? I > find that everytime i inject it im in so much pain! LIKE sharp > stabbing.. and i get bad bruises from it??? keep forgetting to ask my > doctor about it! I find the injections painful at random. I think it's just the needle, not Lantus. I do get the odd bruise, I reckon if I run the needle into the wrong place (vein?) Henry M. > <jen_vander...@hotmail.com> wrote in message > [quoted text clipped - 8 lines] > > Henry M. I have found the same thing, Henry. Also, sometimes there is what I call a slight "burning sensation" as I inject Lantus. It doesn't really hurt but I do notice a different feeling than when I'm injecting Humalog. Show me a person with little black & bruise marks on their belly and I'll show you someone who is my kindred spirit. :) Kurt >><jen_vander...@hotmail.com> wrote in message >> [quoted text clipped - 14 lines] > really hurt but I do notice a different feeling than when I'm > injecting Humalog. Lantus has a higher acid level than most insulins or analogs. Consequently, it does give a burning sensation. Frank > >><jen_vander...@hotmail.com> wrote in message > [quoted text clipped - 17 lines] > Lantus has a higher acid level than most insulins or analogs. > Consequently, it does give a burning sensation. That makes sense. Thanks, Jefferson. Kurt Is it possible to be slightly allergic to it? And it still do its job? Because sometimes im in tears slightly after I give the injection. The needles are fine with every other insulin I've taken! So I doubt it would be because of that! Some nights (because i use it at night) I am getting into bed and the pain in so intense! Especially if i inject into my legs (so i've stopped) and even worse if its cold! Its like a sharp stabbing pain which shoots to where ever the insulin is injected... and around the area! and sometimes i get that sharp stabbing pain for a good 15mins after it. >> <jen_vander...@hotmail.com> wrote in message >> [quoted text clipped - 21 lines] > > Kurt Yes, Kurt!!! That burning sensation really bugs me! About one third of the time I don't feel a thing, another third I feel a needle prick, then there is that burning... As an aside - have you or anyone else here suspected Lantus as being a trigger for headaches? I have suffered from headaches since I was a kid, with an ever increasing array of foods tripping them off. I had a respite from these, but since starting on Lantus, they have redeveloped to the point where I'm getting headaches almost daily. Although I haven't mesaured yet, I do not suspect I'm going too low at night. Henry M. > >> <jen_vander...@hotmail.com> wrote in message > [quoted text clipped - 30 lines] > redeveloped to the point where I'm getting headaches almost daily. Although > I haven't mesaured yet, I do not suspect I'm going too low at night. I've never noticed an increase in headaches associated with Lantus. Headaches are often a sign of a low blood sugar so maybe there are times during the day where you might be dipping low and not aware of it. Just a guess. The cause of headaches are difficult to pinpoint other than low bg so it might be hard to detect if that is the direct cause of yours. Kurt Thank you for some actual information. That is the sort of thing I was looking for. My doctor is an endo, but just tells me to "play with the doses" - not a good thing when he doesn't telll me how to get a basal set. I have been on insulin for over 10 years, so it isn't new to me (I'm type 2), just not sure how to figure out how much of the basal I should be taking. His response to high morning BS is just take more Lantus - which isn't good when it causes me to go low overnight. The rest of my sugars are in good control, it is just the morning ones that are wacky. I do realize that I may just have to live with it too. >> Let me start this by saying that I know I should ask my doctor, but he >> just keeps pushing more and more insulin. It peeked last summer when I [quoted text clipped - 73 lines] > > HTH. OMG find a new endo! wish you could see mine!!! how are you treating your hypo's? If your anything like I use to be at night, you keep eating until you feel better. Control how much your eating. You dont need any more than 5 lollies to get your levels safe for the rest of the night. Then just eat some carbs and go back to bed. Give the sugar time to work before you eat more. Its the lantus peaking that is making you low in the middle of the night but the treatment of the low thats making you high in the morning. START WRITTING EVERYTHING DOWN!!! its a real pain but worth it. How low are your lows in the night??? Once you've got your stable night dose of lantus right DONT CHANGE IT! If your high before bed, give yourself a couple of units of your short acting insulin BUT give it in a seperate injection sight from the lantus. This will help the initial high and wont make you too low during the night. DONT PLAY with your insulin... Remember it can make you very sick and a friend of mine was killed by taking to much and went into a coma and never came out! SO be careful. Start testing lots! when you feel well as well! if your endo sees how much effort you've put in they will be more likely to help you! And if they ever tell you to play with the levels again walk out of there and find a new one! its not as simple as just playing! GOODLUCK > Its the lantus peaking that is > making you low in the middle of the night Lantus doesn't have a noticeable peak. It might seem that way for Type 2's who still produce insulin on their own which might cause a bit of a low. > Thank you for some actual information. You're welcomed. That is the sort of thing I was > looking for. My doctor is an endo, but just tells me to "play with the > doses" - not a good thing when he doesn't telll me how to get a basal > set. Well, unfortunately, playing with the dosage is the best way to learn. Yes, your endo should be working closely with you. Have you tried to adjust your basal and check it over 2-3 days and then inform your endo of the results? You could probably start with a set amount and then begin to adjust up/down from there. For a T1 the starting dose is .5u/kg of body weight, for a T2 it's 1.0u/kg of body weight. You should adjust up 2u. Then wait 3 days before making adjustments to see how you do. If you need to decrease your dose then lower it by 1u. This is pretty much common practice of MDI. > I have been on insulin for over 10 years, so it isn't new to me (I'm type > 2), just not sure how to figure out how much of the basal I should be > taking. See above. His response to high morning BS is just take more Lantus - which > isn't good when it causes me to go low overnight. No, that's not a good way to handle it. You might need to change your Lantus dose to mornings or split it into 2 doses. Another thing might be that you have dawn phenomenon. Since Lantus doesn't have a noticable peak (for most) and you're a T2, you're own insulin is probably causing you to go low at night (since our bodies only need VERY little between 12am-2am) if you're injecting large amounts, then coupled with your own insulin and the small peak from Lantus, yes, I can see you going low in the mid-night. Then DP kicking in and causing a high fasting. Some T2's have found eating a small protein snack before bed helps to trick the liver into not releasing that morning glucose that causes DP. Another thing you might try is to split your insulin into 2 doses and your night dose be half or so of your morning dose. For me, I was on Lantus when it was first released several years back and after 16mons of being on it, I found that I only was getting 19hrs out of my dose. Splitting it for me didn't help either since it takes 2hrs to kick in. I ended up having to suppliment with NPH around 12am to get me through the morning. Basically, you really need to just start experimenting and testing like a fool to see what YOU are actually doing.. I can only give you a few hints where to get started. After you've tried a few things.. you can also post again and talk with your endo and see what they thing with suggestions. Hope you get it sorted out, I know it can be a hell of a trip, but it's worth it once you do get it figured out.. I used to think of it as a game.. and I'd be damned if I'd lose at it. <g> SignatureReisa, T1 dx-5/00 asd-7/00 Animas IR1250 pumper Symlin 1u, 30gm meals Daily CHO: 150-175gm TDD: 36-38u Last A1C: coming down. The rest of my sugars > are in good control, it is just the morning ones that are wacky. I do > realize that I may just have to live with it too. [quoted text clipped - 75 lines] >> >> HTH. > Let me start this by saying that I know I should ask my doctor, but he > just keeps pushing more and more insulin. It peeked last summer when I [quoted text clipped - 8 lines] > Just looking for some guidelines as to how to tell what is the correct > dosage. As Kurt says, it should be discussed with an endo. In my case, having read up on insulin extensively, it took me a few days of experimenting to arrive at the correct dose. For further information you can also go to http://www.lantus.com/ Henry M. |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.