Lantus

I know they say to make changes to lantus every three or four days or a week, but due to me having night hypos or waking to them I'm going to try reducing it each night. So if I have a night hypo or wake in the low 4s I'll reduce it again the next night until I'm OK.

What would you do in my situation:
1. do as I'm going to do
or
2. leave it for every three or four days or a week
or
3. do it a bit sooner than three/four days/1 week

Thanks in advance for any replies

If your having constant hypos in the middle of the night then keep reducing until you don't have them, then you can fine tune it with the 3 day rule.......

your priority at the moment is being safe and hypo free, the 3 day rule is in place so you can get accurate dose adjustment......

novorapidboi26 said:
If your having constant hypos in the middle of the night then keep reducing until you don't have them, then you can fine tune it with the 3 day rule.......

your priority at the moment is being safe and hypo free, the 3 day rule is in place so you can get accurate dose adjustment......

Some input from me - I would go for 2 day wait between Lantus changes. But your issue I recall from other threads you posted is the level of lantus reduction. 10% to 20% reduction I believe gave 4 to 7 units in your case so if I was you I would leave the delay of 2 days minimum between changes but be more aggressive for how much you reduce the Lantus by. Not 2 units at a time but 4 units whilst 10% - 20% remains to be much more than 1 or 2 units.

simon

the 3 day rule is just that you need to wait that long, sometimes less, to see the effect of a Lantus change....

So I would get the risk of night time hypo away first, then think about fine tuning the dose...

Simon makes a good point, take more off the dose in the first instance, then you can always add on some more.....

BI/lantus last reduced on Friday evening by 2u from 32u to 30u so it's been three days so I'm going to reduce it tonight by maybe 4u.

Ps - I know there are some things missing from my diary so please ask away for any further info.

You can see that the Lantus is making a big impact 11 hours after. DAFNE rules say you can reduce BI by 10%-20% so for you that would be 3u-6u. BG 2.4 is far too low to wake up to. At 00:08 assuming this was sleep time, with BG at 4.3 you should have taken some CPs. A toast ? Did you do anything about it? Bedtime BG should be between 6 and 8. For me I try to be at the top end of this target.

Go with minimum of 4u drop for Lantus. You can afford to drop more. You could always bring it up again later on once the hypos are eliminated and you find you need to do that. How did you establish you needed so much BI ? Apologise if you explained it elsewhere, Once the right level of BI has been established and settled down you may find you need higher QA:CP ratios but leave that tinkering till later and in the interim just have QA corrections when you find you need it.

Simon