Started insulin today. 15 units of Lantus. My bg did not drop below 270. I am now at 400 and unsure if I can go to sleep. Should I take more insulin tonight? Doctor said I could go up to 30 units per day but would need to increase a couple units per day. I have not been on insulin in 10 years.
I am very worried what to do.
Can you check your ketones, either urine or blood? How long have you been above 300 mg/dL? Are you instructed by the doctor to take meal-time insulin also?
Your body actually needs more insulin. What did you eat for your last meal?
Try to drink plenty of water and stay hydrated. Call the doctor as soon as possible. This is serious.
Sound like you need rapid-acting insulin to correct highs in addition to the Lantus you are taking.
Ideally I would agree. My understanding is that her GP started her on a basal insulin yesterday with a conservative dose. Probably was too much of a leap for the GP to also provide rapid.
And following up with what @Terry4 suggested. When your blood sugar is way high, check for ketones and be aware of the symptoms of DKA which include:
Throwing up
Feeling queasy or your belly hurts
Breath smells fruity (or like acetone)
Being Tired, confused, or woozy.
Having a hard time breathing.
If your blood sugar is > 300 mg/dl and you experience ketones or any of these symptoms you should go to the ER.
Still very new myself to the Diabetes lifestyle, but as you describe things, it sounds like you definitely should add fast-acting insulin to your arsenal to cover those situational highs. Lantus keeps the BG’s lower “overall”, but if you eat a high carb meal, that Lantus won’t help much…that’s where Humolog/Novolog/etc., come in handy for keeping the sugars from spiking post-prandial.
Best of luck!
Agree with everyone here, fast acting insulin to cover meals is clearly needed, even if only temporarily until good control is reestablished. 400 is just too damn high and needs to be brought down to avoid all the potential harm described in previous posts.
I suspect—this is only an educated guess—that you are seeing a GP and not an endo. GPs are generally much less experienced and comfortable with the ins and outs and details of comprehensive insulin regimes. That’s perfectly understandable and even reasonable given their patient population and the enormous range of conditions they deal with. That’s what specialists are for.
Thanks been waiting for endo for 5 months!! Relocated with employer in April to this city. Seeing endo on Nov 3!! Doing my best with GP in my community. Thanks!
How are things going? Is your blood sugar any better? How do you feel?
Hi Brian
Two of my sons and daughter in law are visiting so I had a very busy day. Just tested 148!!! Lowest in months!!!
Not sure about taking any insulin tonight
Thank you so much I really appreciate your help!!!
Hooray!
Basal insulin needs to be taken every single day. It is not something you want to discontinue when it is just starting to work. Not taking your lantus with levels like you’ve been seeing recently could be very dangerous. Please take it.
Congrats on the 148 that’s a heck of a lot better.
Second that comment. Basal insulin isn’t something to turn on and off like a switch. That’s asking for trouble.
And mega congrats on getting that number down from the stratosphere!
Thanks oh yes I will and was trying to decide if I should take any this evening because last night I took eight units that my blood sugar was at 400 so I don’t think I’ll take any tonight if my blood sugar is below 200but I’m not sure I’m not experienced with this so it’s great to get input from people I don’t know what number at night would indicate that I should take any units of Lantus because I know it’s slow acting but I am feeling better today thank you also very much
Wasn’t planning on stopping maybe I typed incorrectly I use voice texting a lot! Saved my eyes. I certainly intend to tak it daily!! Thanks
You should take the same number of units of lantus every day for the time being. It is not a day-to-day adjustable medication. If you’re concerned about it dropping your blood sugar too low do extra tests and have a snack if necessary (you’re nowhere near that point btw)
. Once the situation is stable and you have some more experience you might start fine tuning doses, but we’re not there yet.
Thanks, Sam. Last night I took 15 units in morning and 8 at night at 1030 as my bg was 400 last night. This morning it was 300 fasting. I took 20 units. My doctor gp said to increase a few units each day if it was still high as he started me at 15 units but said I could be taking 30 units if necessary. I eat a low carb diet, am 5’3” and 133 lbs. Will see what fasting is tomorrow.
Thought I would share a bit more detail. This is only day 3 taking insulin. I see an endo on Nov 3 after waiting 5 months. We just moved here and I have had to wait this long to get in.
Thanks again
If you’re at 143 now, might mean that you want to just keep doing what you’ve done recently, but hard to say. Good luck!
For what it’s worth, many people (including myself) find that Lantus works much better split into two doses and taken 2x a day anyway, because it lasts more like 20 hours than 24, so taking only once a day means spikes prior to that daily shot.
Thanks ok maybe I will try splitting the dose into morning and night. Just don’t want to go too low while sleeping but read it takes 6 hours to peak after injection
Lantus isn’t going to knock you on your butt with the amounts you’re taking. When I was first diagnosed my doc told me never to adjust doses more than every 3 days. I’ve found that to be good advice. What you don’t want to do is get in a wild goose chase adjusting doses constantly.
If you’re concerned about going low in the night your best bet is to set an alarm and test during the middle of the night. Over time it’ll become clearer what the best doses will be but don’t get in a tail chase pattern.
Hi,
Lantus is typically dosed once a day, though some do split it into twice a day to get a more even coverage. You will count your total daily insulin dose.
Yesterday you took 15 in the morning and 8 at night. A total of 23 units for the day.
So you took 20 units this morning. if you take 8 units again tonight (though that dose is too low given your fasting of 300), that would give you a total daily of 28 units, an increase of 5 units - which is a reasonable increase given how high your sugars are. You could even stick with this dose for a couple of days.
Then see where you fasting sugars are. If they are still very high, then increase your nighttime dose as instructed by your Dr.
As your sugars start getting lower and closer to target you will also need to do your adjustments more slowly. Some people have an initial target to get their sugars consistently less than 200 as a first step, before slowly dropping closer to final targets.
As recommended by others, don’t increase too quickly as it may take a few days to see a pattern.
I do think you need to be seeing your Doctor to get a fast acting insulin to cover meals. You don’t want to be using basal insulin (Lantus) to cover food because that will give you much higher risk of lows. Probably this will happen when you see the Endo on 3rd Nov.
Anyway, step by step. Slow and steady. Drink plenty of water. if in doubt test. You’re on a steep learning curve and you are also going to be feeling much better soon.