High blood readings

After a spell where I increased my Lantus from 24 units (evening only) to 26 then 28 I had very irregular readings - highs and lows throughout the day. I went back to 24 units and then had a fortnight of almost perfect readings (for me anyway). However, since last Wednesday (16) I've been high or very high most mornings and at around 11 pm. Noon and 6 pm have been fine (after adjustments at breakfast). I recorded yesterday as
16.2 (8.40) 7 (1.30 pm) 8 (6 pm) 14.8 (11 pm) and got up at 3 am to get 13.6 despite having taken +6 Humalog at 11 pm. This morning it was 15.1. I've no idea what's going on but am reluctant to increase the Lantus after my earlier experience.
Any idea/suggestions

I am no professional but will give my thoughts if you dont mind...............

As Lantus is normally only given once a day, you are restricted to one dose which may not be sufficient during some hours of the day, whilst being too much for you at other hours of the day.........

You could try and investigate the exact problem areas on your current dose by having carb free meals or even missing one if you can.........

Another option, which I would ask you speak to the team about, is to split your Lantus dose, one morning, one night..........this will give you much more flexibility with doses during the day and in the evening, REMEMBER that the effect of a change to your Lantus dose takes a few days to settle in...

The next step after that would be Levemir, a much more flexible insulin, but not everyone likes it.................

Whilst you test your background requirements you will just need to compensate with extra QA.............

Have you had any experience with Levemir or discussed splitting your BI dose?

I would definately talk to your diabetes team before considering splitting a lantus dose. The opinion at the DAFNE Collaborative was that Lantus really was a 24 hour insulin that could not be split into 2 doses where as Levemir was not a 24 hour and could be split. This of course may not be the opinion of your specialists, like anything else it is not clear cut. But its always worth checking something like this before you do it in case there is a problem and you need support.

marke said:
I would definately talk to your diabetes team before considering splitting a lantus dose. The opinion at the DAFNE Collaborative was that Lantus really was a 24 hour insulin that could not be split into 2 doses where as Levemir was not a 24 hour and could be split. This of course may not be the opinion of your specialists, like anything else it is not clear cut. But its always worth checking something like this before you do it in case there is a problem and you need support.

I was having a similar problem and ended up having very high ketones as a result, only to find out the cause was a cracked labrusca cartridge! As a precautionary I would change the cartridge if that's what you use!

That was meant to read lantus not labrusca ... Silly iPhone

having similar problems but on Levemir not Lantus. I find my morning readings are high but normalise throughout the day even going hypo at teatime. I am on a lot smaller dosage to you & take my levemir twice a day at 8am & 8pm taking only 3 units at 8am & 4 at 8pm. My diabetes changes because my dosages were the other way round when I finished the course & my lunchtime readings were always high but normalising by teatime, now as I say my breakfast readings are high lunchtime normal & teatime somtimes hypo. I have added problem of having lost hypo awareness at present & am trying to get it back by trying to run my bg a bit higher than normal. My consultant says not to worry about things changing but to work with things day to day. This morning my reading was 11.5 had breakfast & included an adjustment dose of nova rapid of 1.5units & 12 units for food eaten (using ratio of 1.5units of insulin to 1 cp) lunchtime bg was 5.5 so need to watch this afternoon but only use ratio of 1:1 at lunch. Maybe worth mentioning this to your diabetic nurse & see if she can advise you. javascript:emoticon('')

pancreotectomy said:
having similar problems but on Levemir not Lantus. I find my morning readings are high but normalise throughout the day even going hypo at teatime. I am on a lot smaller dosage to you & take my levemir twice a day at 8am & 8pm taking only 3 units at 8am & 4 at 8pm. My diabetes changes because my dosages were the other way round when I finished the course & my lunchtime readings were always high but normalising by teatime, now as I say my breakfast readings are high lunchtime normal & teatime somtimes hypo. I have added problem of having lost hypo awareness at present & am trying to get it back by trying to run my bg a bit higher than normal. My consultant says not to worry about things changing but to work with things day to day. This morning my reading was 11.5 had breakfast & included an adjustment dose of nova rapid of 1.5units & 12 units for food eaten (using ratio of 1.5units of insulin to 1 cp) lunchtime bg was 5.5 so need to watch this afternoon but only use ratio of 1:1 at lunch. Maybe worth mentioning this to your diabetic nurse & see if she can advise you. javascript:emoticon('')

Just to say that I'm taking Lantus twice a day 7 AM and 7 PM although my dose well down from the previous single night time dose of 26 units. I'm now taking 9 units mornings and 7 or 8 units evenings. I'd certainly suggest speaking to your diabetic nurse about split doses as I found it certainly helped me improve my control. Having said that I'm only up at this time because I did a 3 AM test myself. Foolishly didn't allow for high carbs in Branston Pickle with supper last night and BG went through the roof. I hope all settles down with you. Best wishes.

Hi Fifty years on thanks for your post unfortunately my bg is misbehaving today 10.5 before breakfast took 7.5 of nova rapid after breakfast (I always take my insulin after meals as I have a problem with eating & don't always eat what I prepare) & at lunch a shock bg 18.2 checked meter that was ok then took bg again 16.5. I feel ok but keeping an ye on things if still high at dinner time definitely a trip to see the diabetic nurse tomorrow, let's hope things stabilise.