How Do We Decide HOW Much Lantus to Use?

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How Do We Decide HOW Much Lantus to Use?


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Old 03-07-2011, 06:26   #1
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Question How Do We Decide HOW Much Lantus to Use?

How Do We Decide How Much Lantus to Use?

I am tired of trying to find a comfortable level of Lantus. At this point, I am taking 62 units at bedtime. Endo/doctor will not allow me to take more than one injection per day, and prefers bedtime.

So, what's the problem? Most of the time, my three hour peak (following a meal) is between 130-160. However, there are times like today, where my BG spiked to 240 at the three hour point. This shouldn't be, because I eat the same thing for breakfast, every day. The amount is no more, or no less. It is a healthy mix of ground flax seed, wheat bran, oat bran, Quaker Oats oatmeal, and seven canned peach slices, diced and mixed in the cereal.

This is not the first time, since I went to 62 units, that I have spiked at over 200, and it must mean that I am either counting the carbs wrong (today I added an extra 4 unit of insulin to compensate for any errors), or I need more Lantus.

My Endo and his nurse/nutritionist will not give me a scale. They simply started me at 54 units last year, and told me to adjust accordingly.

Well, the accordingly is driving me crazy, because I can't seem to find a happy medium (and I'm not referring to a joyful Palm Reader - LOL).

Does anyone have a suggestion that I can use to find a level of Lantus that will wipe out the sporadic spikes? Alternatively, are the sporadic spikes something to be expected?

Thanks for any feedback,

Pastor Paul

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Old 03-07-2011, 07:03   #2
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Originally Posted by righteousdude2 View Post
How Do We Decide How Much Lantus to Use?

I am tired of trying to find a comfortable level of Lantus. At this point, I am taking 62 units at bedtime. Endo/doctor will not allow me to take more than one injection per day, and prefers bedtime.

So, what's the problem? Most of the time, my three hour peak (following a meal) is between 130-160. However, there are times like today, where my BG spiked to 240 at the three hour point. This shouldn't be, because I eat the same thing for breakfast, every day. The amount is no more, or no less. It is a healthy mix of ground flax seed, wheat bran, oat bran, Quaker Oats oatmeal, and seven canned peach slices, diced and mixed in the cereal.

This is not the first time, since I went to 62 units, that I have spiked at over 200, and it must mean that I am either counting the carbs wrong (today I added an extra 4 unit of insulin to compensate for any errors), or I need more Lantus.

My Endo and his nurse/nutritionist will not give me a scale. They simply started me at 54 units last year, and told me to adjust accordingly.

Well, the accordingly is driving me crazy, because I can't seem to find a happy medium (and I'm not referring to a joyful Palm Reader - LOL).

Does anyone have a suggestion that I can use to find a level of Lantus that will wipe out the sporadic spikes? Alternatively, are the sporadic spikes something to be expected?

Thanks for any feedback,

Pastor Paul
Are you taking a rapid acting insulin at meal times?

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Old 03-07-2011, 14:43   #3
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Sounds to me more like a problem with the rapid acting insulin you are taking with your meals. Do you use a insulin:carb ratio to take your fast acting?
How many carbs are you calculating all that oatmeal and peaches to be? maybe you are off a bit. I know I love oatmeal but I have to be pretty careful how much of it I eat and in what combinations of stuff I eat it with.

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Old 03-07-2011, 23:53   #4
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Are you taking a rapid acting insulin at meal times?
I'm sorry if I left that out. Yes, I take novolg, the units are based on my carb count.

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Old 03-07-2011, 23:55   #5
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Sounds to me more like a problem with the rapid acting insulin you are taking with your meals. Do you use a insulin:carb ratio to take your fast acting?
How many carbs are you calculating all that oatmeal and peaches to be? maybe you are off a bit. I know I love oatmeal but I have to be pretty careful how much of it I eat and in what combinations of stuff I eat it with.
I figure the total carbs at 50. The fiber is so important to fighting cholestrol, and it has been working.

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Old 03-08-2011, 04:46   #6
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I'm sorry if I left that out. Yes, I take novolg, the units are based on my carb count.
OK. I am not sure that a doctor will give you a sliding scale for your basal insulin Lantus. I have wrestled with the same situation often and I just change my units used, my doctor lets me adjust up or down as long as I do my adjustments in small increments. I am usually low on my fasting reading but am good for the rest of the day and I can't seem to tweak the right amount of units. Since I don't eat at the same time day and eat every meal, I think that does affect the way my Lantus works for me. I am taking a large dose of Lantus every night at 9PM. It lasts for 24 hours for me. You can test your basal dose, let me know and I will get the information up for you. I hope that you can play around with it a little bit and get a dose that works well for you.

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Old 03-08-2011, 05:02   #7
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if your pre=meal reading is good and it is your post meal that is high, then maybe the issue is with your fast acting and not your Lantus

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A1c in March 2010 12.6%
current A1c 6.3%

Currently taking:

Metformin 1000mg twice a day
Neurontin 300mg three times a day
Cymbalta 30mg a day
Symlin injections 60 mcg before meals
pumping with the minimed Revel and novalog
Milk Thistle twice a day
Fish oil twice a day
Nexium once a day
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Old 03-09-2011, 00:45   #8
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My amount of Lantus stays stable. I take a split dose 12 hours apart. For some people Lantus does not work a full 24 hours.
I have had to go on a rapid release insulin also, Humulog. That is the insulin which I adjust. It works so differently from the Lantus.
Lantus work quietly in the background to help stabilize your BS.
One Dr. told me I could up it 4 units if I had to.

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