Some advice please

Hi Karen

Thanks for your input. I was taking 30 units Isophane in the evening and 22 12 hrs later (10:30 am and pm}. Total of 52 BI. Do you think splitting it I should take 26 units each time? I have taken my 32 tonight and will see what my BS is tomorrow morning and take it from there.

You may find that as it is a different insulin that you will need different doses anyway and only time will tell.

I have found that splitting 50/50 has worked for me but you will probably have to do a few alterations before you find the dose that is right for you.

My main advice would be to change one thing at a time and then give it about 3/4 days to look at your results and then decide what may need changing next. It took me months to finally get my lantus at the correct levels so don't worry about things not happening over night. When you do get there all the hard work will eventually pay off. It might be worth speaking to your diabetic nurse to discuss what levels of lantus you should start off on after the change from Isophane. Did they not tell you this when they changed you over to lantus?

Karen x

The 50-50 split is always a good place to start if you are going from one dose, usually Lantus, to two doses, usually Levemir or Humulin I.......

But I think its apparent you need more at night that you do during the day, at least that's what it looks like.......Karen makes a good point though, try the dose out for 3 consecutive nights, tweak if needed, then move on to your daytime BI and QA...

And if the DP does cause you problems in the morning, giving your 22 dose when you wake is best...........its not a 12-12 hours split, but Lantus and Levemir last longer than this in the majority of people.....

Look forward to seeing this weeks results..............your doing well..........

Hi

Thanks for your replies.

I was on Lantuis for a few months and only stopped taking it maybe 3 months ago. I am pretty sure I was oin 1 injection of 32 units in the morning so I have taken my 32 this morning and will leave it until tomorrow morning to see the results.

When I was on it before my morning results were good. Stopped taking it because started feeling more tired, depressed, no energy and read sometimes lantus caused those side effects for some people. Been off it for 3 months and feel no different. Still tired and depressed lol.

My BS was 13.7 this morning.

High again, and that was with 32 units at 2230 or there abouts.................

If it was me, I would continue with this dose till Wednesday night, if still high in the mornings, add 2 units at night, repeat the process...........3 am test to confirm its working or not and to avoid hypo........

What were you on before going back to Lantus..........?

Hi

Was on Humilin I for 17 years (since diagnosis) and BS was always high in the mornings. The Hospital put me on Lantus the latter part of last year and the morning BS improved immensely but I started feeling really tired and depressed. Looked up side effects of Lantus and read some people suffered those effects whilst using Lantus.
Asked the hospital to put me on animal insulin because I read some people felt a lot better on animal insulin.. I felt no different so went back onto Humilin I and the high morning BS. Now I have went back onto Lantus.

I used to take 1 injection of Humilin I at dinnertime and just remembered I took the Lantus at the same time. Used to only take a max of 18 units of Isophane because the BI insulins function was never explained to me so I thought the more I took the lower my BS would go. They just told me it was a long acting insulin.

I took 1 32 unit injection of Lantus yesterday at 10:30 and woke this morning with a BS of 13.7 again which makes me think the lantus has run out by morning so will take my injection at dinnertime and hopefully it should last until breakfast time.

Just noticed you don't have to keep adding a new diary to posts. It automatically updates, cool. (small minds are easily amused, lol)

So are you saying you are going to take your 32 units of evening Lantus earlier than 22:30pm?

This would mean your 32 units would need to last longer, if in fact this is actually the issue.

If it wasn't lasting as long as you want, then injecting as close to the morning as possible is best, so in your case, immediately before bed.

If you are going ahead with this change, remember to do 3 am blood tests, each time you change the time or amount of your BI dose...

Do you understand my point about timing............?

Its interesting what you say about Humilin, at the DAFNE collaborative it was suggested that it is probably more effective as a 4 times a day injection but they felt people would not be prepared to do this. My view was a few more injections wouldn't make much difference either way. Apparently 4 times give optimum control becasue of the 'duration' of Humilin, originally it was used as a 'long' lasting once a day insulin but it is not as effective if used only once a day. This is the kind of information that is lacking about Lantus/Levemir becasue there is not the body of evidence built up over time.
With regard to high BS in the morning the opininon was as per Novarapidboi i.e inject as close to bedtime as possible to get the best effect on morning BS. Although they still insist that Lantus IS a 24 hour insulin and care should be taken if you overlap a split dose. I can't comment on that as I'm on Levemir.
I'm not sure about the 3am testing though, I thought that was a DAFNE Myth

I seen that alleged myth in the myth slideshow, but I believe its valid to test at this time.................especially if the dawn phenomenon is at work as anytime after this is when the glucagon release will start........so the 3am test will confirm if that dose of BI is right, or would have been right without the DP.......

I think it was a misconception actually, so purely a misunderstanding of an existing principal................oh yeah....

Hi

I am not sure I believe in the 3am testing as can be seen by this diary. Bed was 7, 3 am test 5 and then 14 at breakfast.That was with 30 units of Isophane at 22:30.

When I was diagnosed I was on a Hunilin S (soluble) and Humilin I mix twice a day. Then they moved me onto Humalog and told me to only take the isophane at dinnertime.

The reason for moving my lantus onto dinnertime was that was what worked in the past for me. I am used to having no BI during the day. Thought that was normal and the QA covered you anyway. As I said the BI function was never explained to me.

I was taking the BI at bedtime and because of my bedtime being all different times the HCP told me I needed to be more regular? take it the same time every night and that is where the 10:30 and 22:30 comes in.

Having lived with high morning BS, over 15, for the past 17 years and starting to see an improvement in the last 2 months I am happy I will get there eventually.