Levemir versus Lantus - DAFNE Online

May 18, 2011 16:41

MelissaF DAFNE Graduate
South West Essex PCT 56 posts

Ah well then it's early days and I think that you need to expect a fair amount of disruption when you change insulins.

Definitely try the 3am tests first. It's a pain in the a*se but it will give you a much better idea of why this is happening and then help you to track results when you start to correct. At least with the Levemir you should see an effect from dosage adjustments more quickly than you would have done on the Lantus (if that's what you were on before?)

May 18, 2011 17:55

saxman DAFNE Graduate
The Rotherham NHS Foundation Trust 28 posts

MelissaF said:
Ah well then it's early days and I think that you need to expect a fair amount of disruption when you change insulins.

Definitely try the 3am tests first. It's a pain in the a*se but it will give you a much better idea of why this is happening and then help you to track results when you start to correct. At least with the Levemir you should see an effect from dosage adjustments more quickly than you would have done on the Lantus (if that's what you were on before?)

Thanks for the advise I will let you know how im getting on

May 18, 2011 21:20

ClaireH DAFNE Graduate
Mid Yorkshire Hospitals 14 posts

HI

Im new here lol

I have been put on a split dose of lantus now and am still have a nightmare getting the doses right

Im having high in morning with normal BGs at 3am and if my 3 am test is high i correct then too and yet im still high!! Most frustrating to say the least

Anyone else on split lantus?

Claire
x

May 18, 2011 22:09

saxman DAFNE Graduate
The Rotherham NHS Foundation Trust 28 posts

ClaireH said:
HI

Im new here lol

I have been put on a split dose of lantus now and am still have a nightmare getting the doses right

Im having high in morning with normal BGs at 3am and if my 3 am test is high i correct then too and yet im still high!! Most frustrating to say the leastHi claireH,If it was me i would speak to my specialist nurse cos i think there are better options regarding lantus when you want to split the dose

Anyone else on split lantus?

Claire
x

May 19, 2011 08:05

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

ClaireH said:
HI

Im new here lol

I have been put on a split dose of lantus now and am still have a nightmare getting the doses right

Im having high in morning with normal BGs at 3am and if my 3 am test is high i correct then too and yet im still high!! Most frustrating to say the least

Anyone else on split lantus?

Claire
x

Definitely sound like the Dawn Phenomenon, just after 3 am you body clock knows you will be getting up in a few hours so starts to release a cocktail of hormones, one of which is from the alpha cells of the pancreas, Glucagon, this increases resistance and also carry's a message to the liver that instructs it to release glucose from its stores in preparation for increased energy requirements when starting the day..........

Correcting at this time is fine, but having QA insulin on board may make the interpretation of your results harder to follow.........just keep increasing your evening Lantus dose, the only downside is Lantus dose changes take a few days to get going, so effectively, 3 days to get going, 3 days to confirm the doses effect, so time consuming.......

As far as the correction goes, at higher levels you may experience higher resistance to insulin, so 1 unit may not drop your blood sugar by 2.5mmol/l, this may be the contributing to your even higher result when you wake as the correction has not been sufficient together with the effects of the Dawn Phenomenon.......

May 19, 2011 08:09

AK 16 posts

Thanks for your pump info, Novorapidboi.

May 19, 2011 08:22

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

AK said:
Thanks for your pump info, Novorapidboi.

No problem..........

Are you thinking of getting/asking for one......?

Is there a specific issue to be dealt with or is it general control....?

May 19, 2011 12:03

AK 16 posts

My local Trust is expert on them and they asked whether I wanted one. For the general control aspect, I was tempted but for lifestyle generally I want to forget about injections from time to time, which would be difficult with a pump attached to you.

May 19, 2011 12:14

novorapidboi26 DAFNE Graduate
NHS Lanarkshire 1,819 posts

AK said:
My local Trust is expert on them and they asked whether I wanted one. For the general control aspect, I was tempted but for lifestyle generally I want to forget about injections from time to time, which would be difficult with a pump attached to you.

Everyone may feel different, but you would get used to the pump being there, and injections would be a thing of the past, no need to dial up, pull the cap off etc ,you just push a button and hey presto..............you can also get Bluetooth handsets that can tell the pump to deliver wirelessly, in case it was in an awkward position and you were eating out...........

A just a case of weighing out the benefits to the hassle.......and workload..........

May 19, 2011 15:57

ClaireH DAFNE Graduate
Mid Yorkshire Hospitals 14 posts

novorapidboi26 said:
ClaireH said:
HI

Im new here lol

I have been put on a split dose of lantus now and am still have a nightmare getting the doses right

Im having high in morning with normal BGs at 3am and if my 3 am test is high i correct then too and yet im still high!! Most frustrating to say the least

Anyone else on split lantus?

Claire
x

Definitely sound like the Dawn Phenomenon, just after 3 am you body clock knows you will be getting up in a few hours so starts to release a cocktail of hormones, one of which is from the alpha cells of the pancreas, Glucagon, this increases resistance and also carry's a message to the liver that instructs it to release glucose from its stores in preparation for increased energy requirements when starting the day..........

Correcting at this time is fine, but having QA insulin on board may make the interpretation of your results harder to follow.........just keep increasing your evening Lantus dose, the only downside is Lantus dose changes take a few days to get going, so effectively, 3 days to get going, 3 days to confirm the doses effect, so time consuming.......

As far as the correction goes, at higher levels you may experience higher resistance to insulin, so 1 unit may not drop your blood sugar by 2.5mmol/l, this may be the contributing to your even higher result when you wake as the correction has not been sufficient together with the effects of the Dawn Phenomenon.......

Thing is I have done DAFNE and established 10 lantus was too high on a night and I walways hypo'd. SO we dropped to 6 and I've steadily built back up to 8 or 9. 8 gives me morning highs and 9 gives me a 1am hypo .... I am a tad demoralised Sad

May 18, 2011 16:41 MelissaF DAFNE Graduate South West Essex PCT 56 posts	Ah well then it's early days and I think that you need to expect a fair amount of disruption when you change insulins. Definitely try the 3am tests first. It's a pain in the a*se but it will give you a much better idea of why this is happening and then help you to track results when you start to correct. At least with the Levemir you should see an effect from dosage adjustments more quickly than you would have done on the Lantus (if that's what you were on before?)
May 18, 2011 17:55 saxman DAFNE Graduate The Rotherham NHS Foundation Trust 28 posts	MelissaF said: Ah well then it's early days and I think that you need to expect a fair amount of disruption when you change insulins. Definitely try the 3am tests first. It's a pain in the a*se but it will give you a much better idea of why this is happening and then help you to track results when you start to correct. At least with the Levemir you should see an effect from dosage adjustments more quickly than you would have done on the Lantus (if that's what you were on before?) Thanks for the advise I will let you know how im getting on
May 18, 2011 21:20 ClaireH DAFNE Graduate Mid Yorkshire Hospitals 14 posts	HI Im new here lol I have been put on a split dose of lantus now and am still have a nightmare getting the doses right Im having high in morning with normal BGs at 3am and if my 3 am test is high i correct then too and yet im still high!! Most frustrating to say the least Anyone else on split lantus? Claire x
May 18, 2011 22:09 saxman DAFNE Graduate The Rotherham NHS Foundation Trust 28 posts	ClaireH said: HI Im new here lol I have been put on a split dose of lantus now and am still have a nightmare getting the doses right Im having high in morning with normal BGs at 3am and if my 3 am test is high i correct then too and yet im still high!! Most frustrating to say the leastHi claireH,If it was me i would speak to my specialist nurse cos i think there are better options regarding lantus when you want to split the dose Anyone else on split lantus? Claire x
May 19, 2011 08:05 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	ClaireH said: HI Im new here lol I have been put on a split dose of lantus now and am still have a nightmare getting the doses right Im having high in morning with normal BGs at 3am and if my 3 am test is high i correct then too and yet im still high!! Most frustrating to say the least Anyone else on split lantus? Claire x Definitely sound like the Dawn Phenomenon, just after 3 am you body clock knows you will be getting up in a few hours so starts to release a cocktail of hormones, one of which is from the alpha cells of the pancreas, Glucagon, this increases resistance and also carry's a message to the liver that instructs it to release glucose from its stores in preparation for increased energy requirements when starting the day.......... Correcting at this time is fine, but having QA insulin on board may make the interpretation of your results harder to follow.........just keep increasing your evening Lantus dose, the only downside is Lantus dose changes take a few days to get going, so effectively, 3 days to get going, 3 days to confirm the doses effect, so time consuming....... As far as the correction goes, at higher levels you may experience higher resistance to insulin, so 1 unit may not drop your blood sugar by 2.5mmol/l, this may be the contributing to your even higher result when you wake as the correction has not been sufficient together with the effects of the Dawn Phenomenon.......
May 19, 2011 08:09 AK 16 posts	Thanks for your pump info, Novorapidboi.
May 19, 2011 08:22 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	AK said: Thanks for your pump info, Novorapidboi. No problem.......... Are you thinking of getting/asking for one......? Is there a specific issue to be dealt with or is it general control....?
May 19, 2011 12:03 AK 16 posts	My local Trust is expert on them and they asked whether I wanted one. For the general control aspect, I was tempted but for lifestyle generally I want to forget about injections from time to time, which would be difficult with a pump attached to you.
May 19, 2011 12:14 novorapidboi26 DAFNE Graduate NHS Lanarkshire 1,819 posts	AK said: My local Trust is expert on them and they asked whether I wanted one. For the general control aspect, I was tempted but for lifestyle generally I want to forget about injections from time to time, which would be difficult with a pump attached to you. Everyone may feel different, but you would get used to the pump being there, and injections would be a thing of the past, no need to dial up, pull the cap off etc ,you just push a button and hey presto..............you can also get Bluetooth handsets that can tell the pump to deliver wirelessly, in case it was in an awkward position and you were eating out........... A just a case of weighing out the benefits to the hassle.......and workload..........
May 19, 2011 15:57 ClaireH DAFNE Graduate Mid Yorkshire Hospitals 14 posts	novorapidboi26 said: ClaireH said: HI Im new here lol I have been put on a split dose of lantus now and am still have a nightmare getting the doses right Im having high in morning with normal BGs at 3am and if my 3 am test is high i correct then too and yet im still high!! Most frustrating to say the least Anyone else on split lantus? Claire x Definitely sound like the Dawn Phenomenon, just after 3 am you body clock knows you will be getting up in a few hours so starts to release a cocktail of hormones, one of which is from the alpha cells of the pancreas, Glucagon, this increases resistance and also carry's a message to the liver that instructs it to release glucose from its stores in preparation for increased energy requirements when starting the day.......... Correcting at this time is fine, but having QA insulin on board may make the interpretation of your results harder to follow.........just keep increasing your evening Lantus dose, the only downside is Lantus dose changes take a few days to get going, so effectively, 3 days to get going, 3 days to confirm the doses effect, so time consuming....... As far as the correction goes, at higher levels you may experience higher resistance to insulin, so 1 unit may not drop your blood sugar by 2.5mmol/l, this may be the contributing to your even higher result when you wake as the correction has not been sufficient together with the effects of the Dawn Phenomenon....... Thing is I have done DAFNE and established 10 lantus was too high on a night and I walways hypo'd. SO we dropped to 6 and I've steadily built back up to 8 or 9. 8 gives me morning highs and 9 gives me a 1am hypo .... I am a tad demoralised