Author Topic: Lantus  (Read 640 times)

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Offline Blueduck

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Lantus
« on: 06 October 2017, 08:24:30 AM »
Sorry all, life has been hectic. Not been on for a while. Started on lantus today, Bs had been crazy over the holiday, but time differences seem to have a big impact on me. I know it will take a while to get dosage right, but am feeling positive about the change.  :)
Cheryl

Spelling is not everything!
Humalog and  Lantus. 4 metformin a day
Diagnosed T2 2010 Now find I am T1 2017

Offline sedge

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Re: Lantus
« Reply #1 on: 06 October 2017, 12:10:54 PM »
Good Cheryl - a far more sensible basal insulin!

Don't forget when adjusting doses, it takes three days to see the full effect - so unfortunately it's a slow process.
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Pattidevans

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Re: Lantus
« Reply #2 on: 06 October 2017, 05:17:45 PM »
Hi Cheryl

YAAAY... way to go.  You should find Lantus much easier than Humalin.  As Sedge says, at each tweak give it 3 days to settle into a pattern before tweaking again.  BTW you now need to alter your signature to reflect the change in insulin.  :)


Do let us know how you get on!
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Venomous

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Re: Lantus
« Reply #3 on: 06 October 2017, 09:00:11 PM »
So glad you are feeling positive. :) :) :)
T2 and PCOS. Just had large serous adenofibroma removed with ovary and fallopian tube. Bp is now normal!

Novorapid, levemir, trulicity, metformin.

Offline himtoo

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Re: Lantus
« Reply #4 on: 07 October 2017, 09:31:03 PM »
the lantus should help with your control== do be aware that you can adjust the timing of your dose to suit you -- IE   6pm or 10 pm or 8am -- etc may work best for you--- talk toy your diabetic nurse to discuss any changes !!
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014

Offline Blueduck

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Re: Lantus
« Reply #5 on: 12 October 2017, 07:38:42 AM »
Thank you. Seems to be going ok, taking your advice and waited 3 days before changing dose,  will need to see how it goes but already levels are looking more stable, if not yet quite what I would like. :D
Cheryl

Spelling is not everything!
Humalog and  Lantus. 4 metformin a day
Diagnosed T2 2010 Now find I am T1 2017

Offline Pattidevans

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Re: Lantus
« Reply #6 on: 12 October 2017, 08:55:13 AM »
Hi Cheryl


 So what are your levels now?  Have they dropped much?
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Blueduck

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Re: Lantus
« Reply #7 on: 17 October 2017, 09:42:22 AM »
In general, over the day my bs ranges from 5 - 8. I've had a couple of hypos but I think I need to be very accurate with my meal time carb counting and the 2 hypos  were when I mis calculated, and then went on long dog walk, so looking back I could see why.( then panics and eat too much and end up high) Also a few 10's and an 11, again not good carb counting, so I can see why I was wrong. I know it's about the patterns.

The only thing I am struggling with, and I am hoping someone can help, is that I like a snack at 9.30am and My stomach is so used to it that I feel very very hungry by lunch if I don't have one, but if I have a snack at 9.30 it is putting my bs up a bit high before lunch. In the 8-9 Then will be 9-10 after 2 hours, dropping down by 4.30/5pm, to 4-5. (Snack is usually half a cerial bar 5 carbs)

Lunch is usually salad, half an avocado, 2 ryvita small portion of fruit and yogurt - carbs 26 - 28 - 3 units humalin

I am injecting the lantus at 7.30am, ( 5 units)  so it's 9 hours after that, that bs is lowest, So I thought I could try moving the lantus by 9 hours but that's makes it 1/2 past midnight, and I don't want to get up to do it. So any ideas would be really helpful.  Or am I doing something completely wrong, and probably need to change the lantus ? But worried if I up the lantus without changing the time, by 4.30 pm I will be too low. Been on lantus now for 11 days. Probably need to do the basal test, but hunger is such an issue for me. Could I do it and eat eggs?
Cheryl

Spelling is not everything!
Humalog and  Lantus. 4 metformin a day
Diagnosed T2 2010 Now find I am T1 2017

Offline himtoo

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Re: Lantus
« Reply #8 on: 17 October 2017, 11:02:21 AM »
I think you should start by being kind to yourself -- all of the numbers you have provided look pretty good -- especially as you have not been taking the lantus for very long.

making adjustments does take time because you can only do the adjustments in "real time" - it's just not possible to go any faster.

Definitely you should visit basal testing -- that is a cornerstone of good diabetes management.
I would also recommend you use your DSN as a help as well -- that is what she gets paid to do and she is trained to look at patterns in BG , food , exercise etc.

T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014

Offline nytquill17

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Re: Lantus
« Reply #9 on: 17 October 2017, 12:28:24 PM »
Agree with Paul, your numbers look good overall esp. considering you just started! As regards basal testing you can be kind to yourself there as well - like changing lancets, I think none of us do it as often as we should because it is kind of a pain to do! Some info to get you started can be found here http://www.diabetes-support.org.uk/info/?page_id=120 on the bottom 3rd or so of the page. You can definitely do it on protein-only, the results might not be the same for some people but if it's a question of doing protein-only or not doing it at all then this is a case where idealism/perfectionism would do more harm than good.

Lantus is a lot "smoother" than older stuff like insulatard, but it does still have its own peak. Most people report something like 4-5 hours after injection; when I was taking it, it was 7 hours like clockwork! And often before it peaks it can be a bit "weak", especially in the first few hours after you take it, and/or if it doesn't quite last 24 hours. So it might be a combination of Lantus being weak in the morning hours, when BGs tend to rise naturally, and then peaking in the afternoon hours. Or not! You'll start to see when you basal test!

But you know, it took me a few months to figure out how Lantus worked for me, the timing of it and everything, once I started "investigating" (i.e. basal testing). So it's not like you "should" already have known what Lantus does for you personally or like you "should" know it tomorrow if you do a basal test today! Think of it as a long-term project.

Meantime, I know your morning snack isn't very big, only 5g carbs, but what happens when you have a protein-only snack, no carbs at all? Does the same thing happen? What about when you have a lower-carb lunch, what happens then? Everything is an experiment when you're on insulin! ;)
T1 DX 1995
Levemir + Novorapid
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline Pattidevans

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Re: Lantus
« Reply #10 on: 17 October 2017, 08:07:53 PM »
Hi Cheryl

Quote
In general, over the day my bs ranges from 5 - 8. I've had a couple of hypos but I think I need to be very accurate with my meal time carb counting and the 2 hypos  were when I mis calculated, and then went on long dog walk, so looking back I could see why.( then panics and eat too much and end up high) Also a few 10's and an 11, again not good carb counting, so I can see why I was wrong. I know it's about the patterns.

Those figures look excellent to me and if they were mine I would not be worrying at all.  You can be as accurate as you like with carb counting, but you still cannot account for a large number of other factors which will also impact on your BGs.  It might be a simple extra bit of exercise you had earlier in the day that you never even thought about, like going upstairs a couple of times more than usual, which will lower BGs.  Or maybe some other factor that's pushing them up slightly more than expected and you absolutely cannot account for all those factors when carb counting and dosing.  Sometimes you can realise in retrospect and that is how we all learn, but so many times we just don't know.  Do not beat yourself up about it!

Some people can do basal testing by eating protein... any protein shows in my BGs so I do have to fast, but I split the days up to do it.  Your mileage may vary... especially since you are on such small doses you may get away with eating a bit of protein.

At the moment I'd say that you do not know whether the fact that you end up at 8 - 9 before lunch is due to eating a 5g snack of carb, or whether you are having a natural rise during that time.  I always have a rise in the mornings.  I have a rising basal from about 7am and even that does not always deal with it.. and I am on a pump and can do that and you cannot with a fixed dose of Lantus, so it could be that taking a little tiny dose e.g. 0.5u insulin with your snack would smooth that rise out.. but you won't know without basal testing and you cannot address it with Lantus.  Also you would need a half unit pen for your Humalog. However, as everyone has already said... your numbers are fine, nothing to worry about!  We are T1s and we do not have working pancreases and with all the best will in the world we cannot mimic a working pancreas with the blunt tools we have.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Blueduck

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Re: Lantus
« Reply #11 on: 18 October 2017, 04:59:16 PM »
Thank you nytquill, that’s all really positive and helpful. I suppose I am hoping to run before I can walk, and I did not think the numbers were too good, but feel now, maybe I am not doing to bad in a short time. I’ll definatel try a protein snack and see how that works, and as soon as I have to chance I will start on the basal testing. Depending on Work and grandchildren duties, some days are not so easy as others.

That’s really interesting about the times frames, and quite obvious when the lantus is peaking for me.  At least I have had nearly 2 weeks of not too many hypos and no 13 or14’s so that’s positive.  Thank you.
Cheryl

Spelling is not everything!
Humalog and  Lantus. 4 metformin a day
Diagnosed T2 2010 Now find I am T1 2017

Offline Blueduck

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Re: Lantus
« Reply #12 on: 18 October 2017, 05:13:25 PM »
Thank you Patti, it is so helpful know what happens to others, and puts things in perspective.

I gone a couple of days now, starving (not really but feels like it) and found that if I have no snack in the morning, first my levels go down, then they go up before lunch.

Getting up      10 o’clock.    12.00
7.2.                    6.2.           7.4
9.3.                    8.4.          10.4

So basal testing will be interesting, and I think maybe moving the time of the lantus injection will help, but won’t rush into that.  See DN in November so see how it goes.

Thank you for the detailed replies, the suggestions and support really helps :D
Cheryl

Spelling is not everything!
Humalog and  Lantus. 4 metformin a day
Diagnosed T2 2010 Now find I am T1 2017

Offline Blueduck

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Re: Lantus
« Reply #13 on: 18 October 2017, 06:00:23 PM »
Himtoo,

Thank you, maybe I am being hard on myself and maybe unrealistic in my expectations. I will try to relax a bit and cut back on the testing.......it’s hard. Comments from you all help me, as I like to be in control and I know there is a limit to that control. I want it to be perfect and I know it really can’t be :eek:
Cheryl

Spelling is not everything!
Humalog and  Lantus. 4 metformin a day
Diagnosed T2 2010 Now find I am T1 2017

Offline Pattidevans

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Re: Lantus
« Reply #14 on: 18 October 2017, 07:27:58 PM »
Quote
Getting up      10 o’clock.    12.00
7.2.                    6.2.           7.4
9.3.                    8.4.          10.4

Not sure what conclusion I would draw from that.  There's little differential in real terms bearing in mind that meters are only +/- 10 - 15% in accuracy.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans