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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 :amen:
Are you taking a rapid acting insulin at meal times?
 

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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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