[nursedude]

Hi:

Greetings from Ontario, Canada

I'm a T2 who has recently changed from oral meds to oral & insulin (metformin and Lantus).

I've been treated for T2 since 1999 so I'm not new to diabetes but am definitely new to this forum.

The switch to Lantus has my sugars higher than I'd like them to be as I'm in the midst of titrating up to an effective dose but I know things will improve.

Cheers!

ND

 

[dkyle]

Welcome Nursedude

I made the switch to insulin this last year, A lot of people do very well on basal insulin alone, for me i really needed basal and bolus, and currently use Lantus and Apidra. Adding the bolus was the final piece of the puzzle for me

In either case Insulin is a great medicine and i am very thankfull for it. If you have trouble controlling your levels on Lantus alone, you may want to think about adding the bolus.

Happy to share my observations with you anytime you would like

 

[TonyC]

Welcome nursedude. Have a look around; you'll be surprised how much you can learn.

 

[onlymep]

welcome Nursedude I'm an insulin dependant type 2 diabetic. I'm similar to Dkyle in that I was placed on insulin in February 2010. Initially I was only placed on basal just to compliment the oral meds... but then my endo ran the diagnostic tests again (C-peptide and GAD) on my insistance and found that I no longer produced enough of my own insulin and so I also needed the bolus (oral meds don't work when you don't have enough of your own insulin). I'm on Lantus and Apidra and I've just had my best HbA1c ever. I started out at 8.2 when diagnosed in 1998... my lowest I ever got to was 7.2.... but I just came in at 6.6. I had oral meds not working on me for years... but docs insisted on trialling everything on me to see what worked. Metformin was not kind to me at all. My stomach has been upset ever since being placed on metformin... and I was recently diagnosed with functional dyspepsia. You can probably understand what I think of metformin... my opinion is that it weakened my stomach... I had a great stomach prior to being placed on it. So for me, insulin is so much better as aside from feeling like a pin cushion... I haven't noticed side effects from it... other than being prone to more hypos. It's just a case of carefully managing your BGLs as best you can. If you haven't had the C-peptide done, it's a good idea. This is a great place for support and info. Keep us posted on how you're doing.

 

[breezeonby]

Hi:

Greetings from Ontario, Canada

I'm a T2 who has recently changed from oral meds to oral & insulin (metformin and Lantus).

I've been treated for T2 since 1999 so I'm not new to diabetes but am definitely new to this forum.

The switch to Lantus has my sugars higher than I'd like them to be as I'm in the midst of titrating up to an effective dose but I know things will improve.

Cheers!

ND

Hello and :welcome: to the forum! There is a wealth of information to be read on here. Read what interests you. If you can't find something, us the white function box on the forum page. I hope that you have the time to visit often and take care.

 

[breezeonby]

Nursedude, how are you titrating your Lantus? Increasing my dose by 2
units every 3 days got me to a decent dose within a month's time. I still have to adjust the dose, it is the hardest of the two insulins that I take. I don't take the same amount of Novolog everyday and you need to have a TDD to help you start building your basal insulin. If anyone knows how to take Lantus on a sliding scale, please let me know.

 

[dkyle]

I dont think it is advisable to try taking Lantus on a sliding scale. Your dose may change over time but it isnt made to cover your daily choices. If that is needed then you need the bolus to do that

I tried adjusting my lantus when that was the only insulin i took and it was a complete failure - I was taking 200+ units per day at times and still not even approximating control.

I now take 50 units per day which fairly consistently returns my BGL to about 100 between meals and I take around 30 units perday of Apidra and am in very good control

I am no expert but i would not recommend Lantus on a sliding scale

 

[breezeonby]

I know that there is not a sliding scale for Lantus,just wish there was. The best combo is basal and bolus. I take Novolog and Lantus.

 

[onlymep]

yeah I started out on 18 units of Lantus, then it's been decreased to 17 units and it seems to work. I'm on total of 30 units for Apidra though. It seems to work mostly for me at the moment.

 

[nursedude]

Hi All:

Thanks for the greetings.

Working with my pharmacist (who is a certified diabetes educator) I've been titrating my Lantus up in increments of 2 units per night if my morning BS were over 10 mmol/L.

When I have 3 consecutive days of morning sugars under 10 we'll increase by 1 unit each night until my am sugars are within the desired parameters (between 4-7 mmol/L)

I'm now up to 23 units daily at bedtime and my morning sugar this am has come down to 8.1 mmol/L which is a nice improvement.

We've reintroduced Gluconorm 2mg with meals and this has helped keep my postprandial sugars in better control.

Regards

ND

 

[Joshua Shorter]

I was always told that once you increased lantus you needed to give it a few days before messing with the doses again. I would increase the units for a few days and see how that corresponds to a fasting number. The same with the other way around.