I am a new Type 1 diagnosis..less than 6 weeks...44 years young. I am on 10 units of Lantus nightly. Question, many tell me to take it in the morning ans not night...numbers range 44 to 595...slowly coming down.. last night I was 90 going to bed and 52 at 3 a.m. I can feel the low coming on.. also on 1000 metformin and bolus at meals if number is 200 or higher..also, many tell me to take insulin with every meal regardless..4 units... any advice?
lantus am or pm?
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The amount of bolus insulin depends on what you eat. the insulin must mach the food there is no "X" amount for each meal "unless you eat EXACTLY the same thing at each meal and your BG is the same each time before you eat.
Lantus has a small spike at ~ 12 hours so taking it in the AM would produce a bigger BG drop at night.
Lantus has a small spike at ~ 12 hours so taking it in the AM would produce a bigger BG drop at night.
When I was first diagnosed I was put on Lantus and told to take at night. But if I wished I could take in the morning. I don't think there is a real exact time on when it should be taken. I was off for some time and started again a few days ago and started in the morning but saw that I had some pretty high numbers in the morning. But with exercise I am back down so yesterday was my last again hopefully for a long time.
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I dont know what Language is. Your a T1 it maybe that 10 IU is too much.
Why are you on metformin?
It sounds like you didn't get properly educated on Insulin therapy.
As a type 1, you usually take a basal Insulin (lantus or levemir) and a mealtime insulin.
Your "treatment plan" sounds like a mess.
Also, type 1s usually don't take metformin as the only thing that stuff will do is kill your islet cells even faster. Maybe your doc put you on metformin to lose weight?
You should really talk to your doctor or find another one. I'm afraid the help we can give you won't be enough.
Your numbers range from hypo to severly high blood sugars which is a result of a lack of education and insulin.
It is exactly this rollercoaster what will cause damage to your body.
As a type 1, you usually take a basal Insulin (lantus or levemir) and a mealtime insulin.
Your "treatment plan" sounds like a mess.
Also, type 1s usually don't take metformin as the only thing that stuff will do is kill your islet cells even faster. Maybe your doc put you on metformin to lose weight?
You should really talk to your doctor or find another one. I'm afraid the help we can give you won't be enough.
Your numbers range from hypo to severly high blood sugars which is a result of a lack of education and insulin.
It is exactly this rollercoaster what will cause damage to your body.
My guess you haven't settled in on a low carb diet...some doctors don't like them and don't prescribe them. In order to learn how things should work you need to get one of the books suggested on this forum and read it quickly. It may be that your doctor doesn't know if you are type 1 or type 2 and is using the shotgun approach?
I personally found that Lantus sent me low about 4 hrs after my basal dose of 18 units at night. I tried to take it in morning and found it petered out before the next morning. So I tried taking 1/2 in the am and 1/2 in the evening, and that is what worked for me. But you have to find out what works best for you after hearing what everyone else does. There is no silver bullet, diabetes is just a bunch of hard work, if you are going to manage it well.
Good luck!
I personally found that Lantus sent me low about 4 hrs after my basal dose of 18 units at night. I tried to take it in morning and found it petered out before the next morning. So I tried taking 1/2 in the am and 1/2 in the evening, and that is what worked for me. But you have to find out what works best for you after hearing what everyone else does. There is no silver bullet, diabetes is just a bunch of hard work, if you are going to manage it well.
Good luck!
Julian? You are mistaken about metformin on both counts. It does NOT work in the pancreas killing islet cells like the sulfonylurea drugs do - it is a biguanide, which do not hammer the pancreas to produce more insulin. Metformin is prescribed for insulin resistance, so it may very well be helpful for type 1 diabetics who develop insulin resistance (and there are many - some even on this very forum).
http://en.wikipedia.org/wiki/Meglitinide
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:wave: I'm one of them.
I have lost 60 pounds in the last 7 months....I don't think I am eating enough...not a big, multiple time eater. I am on 10 u of Lantus nightly... my numbers in the a.m. are perfect. This a.m. 88.. they roller coaster thru out the day... Dr. Wants me on a 1500 cal. Low Carb diet..trying to eat correctly..I know the language is working overalljulian said:
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I take my Lantus at 7Pm as I find it really convenient with your schedule.
It depends on solely your carbohydrate intake for your meal.
I have a ratio which I have figured out for my quick acting insulin when I eat meals.
My ratio is one unit per 10 grams of carbs.
You just need to experiment and see what yours is roughly.
One other thing to note is if your out of range (40-80) being the range you'll need to add an extra amount of units depending on how high you are.
I'm on Novo Rapid so if I was say 100 and I want to about 60 I'd have 4 units.
But if I was consuming 40grams of cabrs I'd just ad 4 units of Novo Rapid to that.
If your not consuming any carbohydrates you don't need to have any insulin unless you have a high blood sugar level and just want to bring it down.
It depends on solely your carbohydrate intake for your meal.
I have a ratio which I have figured out for my quick acting insulin when I eat meals.
My ratio is one unit per 10 grams of carbs.
You just need to experiment and see what yours is roughly.
One other thing to note is if your out of range (40-80) being the range you'll need to add an extra amount of units depending on how high you are.
I'm on Novo Rapid so if I was say 100 and I want to about 60 I'd have 4 units.
But if I was consuming 40grams of cabrs I'd just ad 4 units of Novo Rapid to that.
If your not consuming any carbohydrates you don't need to have any insulin unless you have a high blood sugar level and just want to bring it down.
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I too find the biggest spike from Lantus is about 4 hrs. I started taking it in the am because I couldn't remember at night. I have a habit of napping on the couch before we go to bed and when I wake from that I'm just too groggy to deal with it. It works out fine for me but like others have said it's something you'll have to experiment with and see what works best for you.
We have members here who must bolus for everything they eat - even protein - so we try to be careful about advising others how to administer their insulin. And if you just want to bring down a high number - which I sincerely hope is the goal here - then you must know your correction factor (how many points 1 unit of insulin will drop your blood glucose) and calculate your correction from that, or you'll be on the roller-coaster all day long.
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I have found that switching my Lantus from bedtime ( around 10 PM) to before dinner, that I seem to get more consistent numbers.
You need to find out what your formula is for a bolus. That is how many units of rapid acting insulin do you need for each carbohydrate. I think you overdosed on fast acting insulin for your evening meal when you awoke at 3 am with 52 points. I don't think the Lantus was responsible for the low. What time did you take your evening Lantus shot?
I like to go to bed with 120 to 140 at 11 pm and will snack if necessary to get me there. I take my 11 units of Lantus at 9pm.
I eat a light supper of only 20 to 30 carbs so my last fast-acting insulin shot of the day is only 2 to 3 units. This, I think, protects me against a nighttime low.
I generally awake with around 100. This is my target, anyway. Some times I am only 70. If I am, say, 150, then, I take 1unit of Humalog and delay breakfast for an hour or so.
They say your basal insulin should be 40 to 50 percent of your total insulin intake. If you are using 10 units of Lantus you fast-acting insulin should only be 10 to 15 units daily.
I don't know what the Metformin does to this ratio, but obviously alters it. Why are you using Metformin? It is normally used by Type 2Diabetics. I tried it once to see if it would reduce my lows, by reducing my fast-actring insulin. It didn't work.
You might ask your doctor about what role the Metformin is suppose to play.
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I agree with Shanny, I think you should be actually talking to your doctor about this, as of yesterday I was taking my Lantus twice a day morning and bedtime was doing good, my carb count is different for each meal, your correction rate is probably different than a lot of people here, are you exercising that would throw your sugar off too, you have to go back to your doctor and get these questions answered
When/if type 1 diabetics develop insulin resistance, metformin works for them the same way it does for type 2s. Yes, type 1s can develop insulin resistance, due to weight gain or whatever. My guess would be that using met would reduce their insulin dosage, but Richard or other type 1s here would have to answer that question. I'm sorry met didn't work for you in reducing your lows, but it's primary function is to reduce insulin resistance. It works well for a great many of us - all types.
Lantus AM or PM
I am a type one been diagnosed for ten years now, am 37 years old. I take my lantus in the morning because I hate waking up in the middle of nite with lows which is what usually happens since I take insulin with each meal I eat plus the 15 units of insulin once a day. I tend to struggle with my diet choices which is usually what gets me in trouble. In time u will find what works best for u.
I am a type one been diagnosed for ten years now, am 37 years old. I take my lantus in the morning because I hate waking up in the middle of nite with lows which is what usually happens since I take insulin with each meal I eat plus the 15 units of insulin once a day. I tend to struggle with my diet choices which is usually what gets me in trouble. In time u will find what works best for u.
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