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Hi

My name is Patty and I diagnosed in July. My A1c was 10.6. On metformin 1000 mg bid and Byetta bid I was able to bring my A1C down to 7.2 as well as correct most all of my dyslipidemia. I am now on Lantus solostar, 22u this morning and my fasting bs are still up around 160. The lowest I have gotten since the diagnosis was 159. I take my fasting bs and adjust accordingly. Does anyone have any insight to this problem. My post prandials are normal.

Thanks,

Patty
 

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Welcome aboard, Patty. This sure sounds like dawn phenomenon to me, and yes - it's a very stubborn phenomenon! . . . have you tried taking your lantus at night?
 

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Hi

My name is Patty and I diagnosed in July. My A1c was 10.6. On metformin 1000 mg bid and Byetta bid I was able to bring my A1C down to 7.2 as well as correct most all of my dyslipidemia. I am now on Lantus solostar, 22u this morning and my fasting bs are still up around 160. The lowest I have gotten since the diagnosis was 159. I take my fasting bs and adjust accordingly. Does anyone have any insight to this problem. My post prandials are normal.

Thanks,

Patty
Try moving your morning Lantus dose to bedtime. It sounds as though you might need your dose increased. You can add 2 units every 3 nights until your fasting blood glucose is around 120. As always check with your doctor before you increase your Lantus.
 

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Welcome to the forum Patty!

i hope that you visit us regularly. This is by far, THE best place for us diabetics to talk freely and openly about whats going on with us.

Please feel free to ask any questions that you might have, as i feel that there are no "dumb" questions

You can do this, you can.

-Eric
 

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Hi

My name is Patty and I diagnosed in July. My A1c was 10.6. On metformin 1000 mg bid and Byetta bid I was able to bring my A1C down to 7.2 as well as correct most all of my dyslipidemia. I am now on Lantus solostar, 22u this morning and my fasting bs are still up around 160. The lowest I have gotten since the diagnosis was 159. I take my fasting bs and adjust accordingly. Does anyone have any insight to this problem. My post prandials are normal.

Thanks,

Patty
Hi Patty

As Shanny says it sounds like the dawn phenomenon. Something we both share and try to deal with. I manage to deal with my BG without meds at the moment and my post prandials are regularly lower then my fasting readings.
It's your body thinking it needs glucose in the early hours of the morning so your liver produces some and dumps it in your blood for you.
I am starting to get a handle on my fasting readings by eating a small snack of protein just before bed that seems to reduce the issue and taking a walk before my evening meal.
Also if I eat to many carbs one day it throws out my fasting readings for the next 2-3 days so I think it is an accumulative effect.
Shanny has been dealing with this for longer and may have better advice.

Welcome to the forum.:)
 
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As Shanny has suggested, try moving your Lantus injection to a bedtime regimen. There's a possibility that your Lantus isn't working the full 24 hours. Let's say you get up around 8 AM, you get dressed and then go take your FBG and then do a dose of Lantus. If your basal insulin isn't covering the full 24 hours, which has been reported in some diabetics on Lantus, you may find the 8 AM test not proportional to your normal BG throughout the rest of the day.

If your Lantus runs out at say 20 hours (4 AM) then coupled with a DP a meter reading of 160mg/dL is quite the possibility. Try this in order to find out when your Lantus may be used up: Change your injection time tomorrow by waiting until 2 PM. Do this for 2 days until your system gets used to this. Ignore your FBG numbers for 2 days. On the 3rd day stay fasted, start taking blood tests at 8 AM, 18 hours after your day-before 2 PM injection. Test your BG every hour on the hour until 2 PM. If your Lantus is waning off before its 24-hour period you should see some rise in your testing numbers between 8 AM and 2 PM.

If you DO find that Lantus wanes off too early you do have choices. You can do the Lantus at night which may lower your DP...but still doesn't cover the few hours of its waning period.You can split (stack) your dosage so that you do X amount of insulin at 8 AM and another X amount of insulin later that night. It's a (sometimes) recommended regimen for Lantus...but mathematically that procedure still leaves you with a cut stacking 2 hours before each injection, instead of 4 hours before a full injection. Then there's the Levimir camp that finds their insulin works better in multiple doses.

Myself, I started out with a bedtime script for Lantus. Got night sweats...got tired of doing laundry once a week, went to a morning injection. My FBG numbers went up from 95 to 105-115, but the sweats stopped. Since FBG numbers don't last once you rise...I chalked it up as a good trade-off. I tried increasing my morning basal dosage to try and change the FBG numbers the next morning...that was a mistake. I'm now of the philosophy that injecting even one more unit of insulin than you actually need...is a BAD idea.

I also noticed that snacks, or your "4th meal" after sundown affects you FBG. I had to go in for labs yesterday morning so that required a fast - skipping my 4th meal of the day, usually around 8 PM. Normally, my FBG would be 110. Yesterday morning, after fasting for 12 hours and no 4th meal the night before, it was 95.

Whatever changes you decide to make, or not make, please...keep us posted. It's good information for everyone here.

FWIW
 

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You could try a high protein snack before bed that can reduce DP
 
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