[breezeonby]

On Monday I went to sleep and didn't wake up until the medic gave me some dextrose through an IV. I was following all of my doctor's orders,but my diabetes had a mind of its own. I went to sleep at 11:30PM and it was 5:30PM the next day that I woke up. My doctor changed the way that I took my Lantus. Take 1/2 of my units in the morning and the other half in 12 hours later. My blood sugar had dropped in the teens and I couldn't wake up. I am scared to take my Lantus. Please help if you know why my Lantus isn't working this way either. I was scared to take any Lantus and last night I took my BG and it was 411. I am scared and don't want to take any insulin. I know that I am just going to get sick with high blood sugar. HELP!!!:noidea:

 

[foxl]

Oh, Breeze --can you get someone to stay with you, perhaps, or stay with someone at their place, until you feel safe taking your Lantus again?

If not, what if you took at least a half dose?

I am so sorry this happened -- of course all insulin users live in fear of this.

 

[fgummett]

Which Lantus is the new one.. the night or morning dose?

What prompted the change to a split dose?

I can see how this would affect your confidence but I agree with Linda that maybe a smaller dose may be in order -- I'd be tempted to start over with a minimal dose and every few days slowly increase until control is re-established... even then you may find you can back the dose off a bit.

 

[breezeonby]

Oh, Breeze --can you get someone to stay with you, perhaps, or stay with someone at their place, until you feel safe taking your Lantus again?

If not, what if you took at least a half dose?

I am so sorry this happened -- of course all insulin users live in fear of this.

Will taking 1/2 a dose help?

I live with my Mom, but she just lets me sleep and then I go hypo and need the medic to give me dextrose. The local fire department doesn't give out glucagon, because of the expense. But they aren't careful when jamming the IV needle in my hand, the needle is very heavy thick and causes problems. I really don't know what I am going to do.

 

[foxl]

I would think taking 1/2 would be a good start, perhaps keep you out of DKA ... and permit you to then step up your doses gradually, too.

 

[breezeonby]

Which Lantus is the new one.. the night or morning dose?

What prompted the change to a split dose?

I can see how this would affect your confidence but I agree with Linda that maybe a smaller dose may be in order -- I'd be tempted to start over with a minimal dose and every few days slowly increase until control is re-established... even then you may find you can back the dose off a bit.

I was on Lantus at night and on Novolog with meals. I wasn't eating enough and I was sleeping 15 through 17 hours and needed the medic to give me dextrose in order for me to wake up. My doctor decided it was time for me to go to split dosing and then things would change. I thought this would change, but I guess not.

 

[breezeonby]

I would think taking 1/2 would be a good start, perhaps keep you out of DKA ... and permit you to then step up your doses gradually, too.

What numbers will put you in DKA?

 

[foxl]

What numbers will put you in DKA?

400 - 500's ...

This says 250!?!

How can I prevent DKA?
When you are sick, you need to watch your blood sugar level very closely so that it doesn't get too high or too low. Ask your doctor what your critical blood sugar level is. Most patients should watch their glucose levels closely when they are more than 250 mg per dL.

When you're sick or stressed, you should check your blood sugar level more often than normal (sometimes every 3 to 4 hours). If your blood sugar reaches a critical level, check it every 1 to 2 hours. Ask your doctor if you should test your blood sugar level during the night.

You should also test your urine for ketones every few hours if you're sick, stressed or if your blood sugar level is more than 250 mg per dL.

 

[fgummett]

So the hypo has happened more than once?

Sounds like too much Lantus -- how much do you take? Did you start off with a set dose from the Doctor or did you gradually build up until you found the sweet spot?

 

[Jeremymc1]

How much Lantus did you take in your split dose? As in, how many units? It almost sounds like you took your Novolog instead of your Lantus by mistake.

Cheers,

Jeremy

 

[fgummett]

Linda, the OP is a Type 2 so the insulin may be more a question of overcoming IR than absolute insulin requirement as may be seen in Type 1 or 1.5 -- I'm not sure to what extent DKA is an issue?

I'm wondering if you can get advice from a Doctor who knows what they are doing? This all sounds kinda dodgy to me... I would think that the response to repeated hypos is not to split the dose but rather reduce it. Are you not eating as you did previously or as the Doctor expects?

 

[breezeonby]

So the hypo has happened more than once?

Sounds like to much Lantus -- how much do you take? Did you start off with a set dose from the Doctor or did you gradually build up until you found the sweet spot?

Yes, I have needed the medic about 5x now to give me dextrose. 100 units of Lantus per day. I started off taking 60 units and found out that 100 units kept my morning from being high and kept my blood sugar very smooth during the day.

 

[foxl]

You might want to try Levemir if you are modifying your dosage for DP -- it has a mild peak and you can time it to cover ...

Frank, I was dx'd in DKA and my C-peptide was mid-range, 15 mos later -- so despite the remarks I have heard that T2's "can't" go DKA -- it is a concern!

 

[fgummett]

Are you confident to change your dose yourself or do you need to see your Doctor?

100u of Lantus per day (as basal) sounds like you have significant Insulin Resistance to overcome. If it were me (and I am NOT a Doctor) I would try injecting 25u Lantus twice a day ( for a total of 50u per day) and still bolus with Novolog for meals as necessary. There should be little fear of DKA so long as you have insulin on board BUT by testing BGs frequently you could check for rising BGs and if need be correct with some Novolog -- if you are confident to handle that yourself? If not then I'd suggest you need to see a diabetes specialist.

---

Edited to add...

If your Fasting BGs are not where you want them in three days try raising the nighttime Lantus by 2 units every 2 - 3 days until they are AND then try backing off by 2 units every few days to see if they still stay where you want them. Take it slowly and allow a few days between changes to be sure of what you see. Extra BG testing during this time is strongly advised. If in doubt seek medical help. This way is safe and hopefully will rebuild your confidence in your treatment.

 

[fgummett]

You might want to try Levemir if you are modifying your dosage for DP -- it has a mild peak and you can time it to cover ...

Frank, I was dx'd in DKA and my C-peptide was mid-range, 15 mos later -- so despite the remarks I have heard that T2's "can't" go DKA -- it is a concern!

Levemir is always an option of course and may have a better profile for you.

I was not downplaying the possibility of DKA in Type 2 (although technically Linda I thought you were a Type 1.5... ultimately IDDM) but I see little concern for DKA so long as the OP has some basal insulin on board (probably secreting endogenous as well) and the means to test BGs and correct with Novolog if necessary. But as above I am NOT a Doctor, so I am trying to offer cautious advice as best I can

---

ETA

and as Jeremy suggested: are you confident that it was the Lantus you gave and not Novolog by mistake? It happens to the best of us :hippie:

Has anything else changed recently? Different diet? Significant weight loss? Acute illness?

 

[foxl]

Yes I am a T1.5, and am rather vociferous about recommending close scrutiny of anyone diagnosed in DKA and then getting a Type 2 label!

Still, running high can be dangerous.

 

[jwags]

I'm so sorry this happened to you, has this happened often? Do you think you injected it in a vein? I would ask your doctor about a CGMS. You are definitely a candidate for one. It almost seems you are very sensitive to insulin. I agree with the others starting all over on a very small dose. I know you have other health problems I wonder if that enters into it. Do you have a glucagon kit and can you teach your Mom how to use it?

 

[Shalynne]

Yes I am a T1.5, and am rather vociferous about recommending close scrutiny of anyone diagnosed in DKA and then getting a Type 2 label!

Heyyyyy...!

I resemble that remark!

Worse, I've slowly become aware that my HMO diagnoses "diabetes." Period. Ya wanna know yer type? Ya gotta ask! And then go back and take the tests you should've gotten in the first place, 'cause they don't know.

I thought complete diagnosis was downright basic medicine. Silly me!

Breeze ... :hug:

If you don't feel confident to make your own adjustments (and I know the feeling well), can you call or email the doc for further advice?

 

[breezeonby]

How much Lantus did you take in your split dose? As in, how many units? It almost sounds like you took your Novolog instead of your Lantus by mistake.

Cheers,

Jeremy

My split dose would be 50 units. I check my insulin really close so and I have a blue case for my Lantus.

 

[breezeonby]

Are you confident to change your dose yourself or do you need to see your Doctor?

100u of Lantus per day (as basal) sounds like you have significant Insulin Resistance to overcome. If it were me (and I am NOT a Doctor) I would try injecting 25u Lantus twice a day ( for a total of 50u per day) and still bolus with Novolog for meals as necessary. There should be little fear of DKA so long as you have insulin on board BUT by testing BGs frequently you could check for rising BGs and if need be correct with some Novolog -- if you are confident to handle that yourself? If not then I'd suggest you need to see a diabetes specialist.

---

Edited to add...

If your Fasting BGs are not where you want them in three days try raising the nighttime Lantus by 2 units every 2 - 3 days until they are AND then try backing off by 2 units every few days to see if they still stay where you want them. Take it slowly and allow a few days between changes to be sure of what you see. Extra BG testing during this time is strongly advised. If in doubt seek medical help. This way is safe and hopefully will rebuild your confidence in your treatment.

I can make my own adjustments, at least 2 weeks ago I would. I hope I still have the guts!