I can’t figure this out but I’m suspecting it’s the Lantus. I take 15U in am, 10U in pm. I also take Metformin 1000 2x day. I can tolerate 10 to 15 carbs spaced throughout morning/afternoon. At around 5 pm, my background numbers start rising and I can’t do any carbs.
I am experimenting - last 2 days I’ve added .25 (that’s right - 1 mg divided in 4ths) in the early evening and it seems to reverse this slow rise that begins around 5. Any ideas?
I’m so confused about whether I might have LADA or MODY - I have factors that might suggest both. Gestational diabetes, hypothyroidism, slim sibling with T2, other siblings with hypothyroidism, T2 on both sides of family. I’m about 20 lbs over right now but that’s partly due to they thyroid being out of whack - just recently made some adjustments and lbs are slowly coming off.
I gotta get my C-peptide and GAD tests done - I wanna know what flavor I am.
I have the opposite situation where I’m carb sensitive in the morning & my lows are in the afternoon &early evening when I’m most active. Could your 5 PM rise have anything to do with exercise earlier? Some people experience a low after exercise followed by a high later (others, usually Type 1s, have the reverse). Are you eating particularly fatty foods for lunch or afternoon snacks that could be causing this by delaying digestion?
How high are your late afternoon highs?
Great that just adding .25 unit helped! Sounds like you’ve solved the problem. No hard & fast rules, but Lantus typically takes about 2 hours to start working.
All basal insulin has some peaks & valleys. Levemir turned out to be more level for me. My endo believes it’s more stable & predictable than Lantus.
Hi Gerri! Thanks for replying - I took off for a long weekend.
I must say, I’m a bit discouraged about the lack of response on the board - maybe it’s because I’m new or I just don’t know how best to approach members.
Anyway, my afternoon highs we in the range of 150 - 195. You’re right about no hard and fast rules - because the Amaryl helps sometimes, sometimes not. What gets discouraging sometimes is the lack of consistency even when I’m working so hard to be consistent myself.
I’m going to talk to my Endo about Levemir because it’s intended to be delivered twice a day, while Lantus is not (even tho I’ve been doing so).
Gerri…a lot of people need a different ratio at different times of the day. Your Lantus could be wearing off, or you just might need a higher ratio at that time. I do. I am pumping now so can not blame Lantus…I am on a constant basal for 24 hours. I do use a 1:10 ratio bolus in the evening as opposed to a 1:15 the rest of the day and after midnight.
Let us know what your blood work turns up. Good luck.
A lack of response can be discouraging, but I think it has most to do with when you post…some times there are more of us on line. Also, as I understand it, if there are no responses before other blogs are posted, it gets shifted off the page. Try adding to your own blog to keep it on top!
Hi Elaine
Thanks for the reply. I do feel like the issue is the basal since my #s only go up during a time when I have not eaten in 3 hours or more. Interesting, I didn’t think about the “ratio” Since I don’t take bolus insulin, not sure how this works for T2s.
That’s the beauty of this site and why it’s so great - you find people who can relate to your particular issues - which is amazing considering how unique each person’s experience with diabetes is!
Since just adding a mere .25 unit of Lantus brought down highs of 150-195, that’s great! I hope this continues to work for you. Always constant tweaking. Understand how frustrating it can be. All we can do is be consistent because our bodies are constantly changing. Sometimes I don’t even want to know how many other factors are at play because I’m doing all I can with low carb, exercising, eating at regularly scheduled times, etc. Anything else I had to attempt to control might send me over the edge:)
Lots of people take Lantus twice a day, despite pharm claims that it lasts 24 hours.
You’re doing great!
Nah, lack of response has nothing to do with being new. Just what Elaine said. Timimg when people are on-line & discussions get pushed off the main page when new ones are started, or someone replies to an older one. Tu D is such an active group, which is awesome. I’ve missed some great topics because I never saw them.
Not sure what this means, but wanted to follow-up. I cut out the Amaryl because it was making me hungry - and wasn’t consistent about helping the issue. Well, after some experimenting the last few days, I discovered that if I took an extra dose of metformin mid-afternoon (500), that did the trick.
Not sure what to make of this, but oh well, it worked.
How interesting. Not very helpful if it’s making you hungry! How long have you been taking Amaryl? What dose? I’m Type 1, so have no direct experience with oral meds. All I know is that Amaryl doesn’t appear to work for long periods of time from what I’ve read. And once again, everyone’s chemistry is unique.
Glad the metformin helped. We really do need to be our own doctors, nurses & pharmacists.
Other than basing it on body weight & tweaking to see what works, I have no idea either how basal is dosed for Type 2s.
Have you looked at Oneless’ blog on Symlin? Seems to be a wonder for a lot of people. Wish I could take this, but I can’t.
Why can’t you take Symlin? I’ve checked it out a bit, but it’s really intended for T1s - I’ll have to wait and find out more for T2 usage.
You’re so right about being our own caregivers - no one knows our bodies like we do.
I’m still experimenting - so today I took 1250 mg for my am dose of Metformin - we’ll see what happens. For T2s, especially of my insulin-resistant flavor, I use a very small dose of Lantus - but I am going to talk to my Doc about switching to Levemir - I’m just soooo my mother’s daughter, feeling like I have to “use up” the Lantus I have left.
I’m probably not remembering this correctly, but I think I’ve heard of some Type 2s using Symlin, but perhaps for them it’s more for hunger control. Oneless would know.
I can’t take Symlin because I have gastroparesis (delayed stomach emptying). Symlin delays digestion, so contraindicated.
Interesting - I’ll have to do more research. My gut (no pun intended!) tells me that I would want anything that delays digestion - I’m hypothyroid (slow metabolism) and take meds to speed it up.
Gastroparesis - seems like I read something about this in Jenny’s book but will have to look it up again. How does that affect you as a T1?
That is sooo interesting - they are just now starting to look at hypothyroidism & diabetes together - it’s part of the what they are now calling polyendocrine syndrome or autoimmune polyendocrine syndrome - they are just hitting the tip of the iceberg. I have said for years that my theory was they were connected. I was diagnosed with hypothyroidism years before diabetes. Somehow it made sense that if food wasn’t being metabolized as quickly as normal, it would raise you blood sugar.
Now I wonder if there is any connection between hypothyroidism and gastroparesis??
As for the experiment - so far so good, but later today will tel the tale.
Gastroparesis sucks because it’s near impossible to time food to insulin because I never know when food will hit by bloodstream. I can be low at two hours & soaring at five. Instead of taking insulin before eating, I have to take it after & even then it doesn’t always work right. Depends on how much I eat & what I eat. So in addition to all the other food restrictions, I have to eat things that are easier to digest & chew very well. Raw foods are a no-no, but I eat salads anyway. I do ok at breakfast & lunch, but dinner is always a crap shoot because it’s my largest meal. I can’t go to bed for at least 5 hours after I eat or I won’t catch the highs to correct them.
I’ve definitely got some thyroid problems, but endo won’t put me on supplementation because I’m just borderline low.
Agree that it seems that diabetes & thyroid problems are related. Both autoimmune endocrine disorders & so many diabetics have thyroid issues. Though, lots of people with thyroid problems aren’t diabetic.
Not sure about your theory of food not being metabolized quickly raising BG. The theory behind eating low GI is that it digests slowly to keep BG more stable. People with normal pancreatic function have insulin to cover what they eat whenever they need it. As soon as BG gets high, there’s insulin to sweep it away.
Gatroparesis is a side effect of the vagus nerve being impaired by high BG. Would be interesting to find out if people with thyroid disorders have this, too.
Cheri, I have a few friends with more than 1 autoimmune disease, although not the diabetes hypothyroidism combo. It is scary. Glad today is going well for you.
Hi Gerri -
I wanted to follow up with you on what I finally discovered. Doh!!! I needed to change my Lantus dosage. I needed to move most of it to the am (30U) so it would get me through the day, and then I only do 4U after dinner. Everything’s been good for the past few days (she said with crossed fingers).
Anyway, thanks - I have very much noticed that you are always so interested and so helpful to everyone on the site).
Just read this thread, were you tested for Gastroparesis? How did you find out? Is it because you’ve been Diabetic for a long time? I’m sorry for all the questions. Do you just eat smaller meals then.
Thanks for the update. That makes sense & glad to hear it’s helping! Your fasting reading ok on such a low evening dose? One thing I’ve found, in case this is helpful, is to take the evening dose right before bed.
Keeping fingers crossed here that your good numbers continue!
That’s great you figured it out! Hope that keeps working for you. Sorry I couldn’t be any help but I only take the oral meds and don’t understand the others. It’s nice to have others who can help you. Hope to keep hearing good reports.
