Dinnertime Lantus causing night time lows?

My 3 1/2 year old just did a “sensor study” and we got some good info from it. But some of the changes the nurse made have me awake in the middle of the night scratching my head and waiting to see if the second round of fast-acting carb will bring my daughter back over 100 so I can go back to sleep.

When she was first diagnosed, her Lantus was given at night and she was going low. They took her off Lantus for a while since she was honeymooning and did fine without it. When we got rid of NPH for her, they brought Lantus back but in the morning because of the experience of going low at night with it in the evening. Well, this latest change has us giving Lantus in the evening again and, this morning she woke up low. Tonight at 10:00 she was 87. Woke her up and gave her some milk to get her up over 100 so I could sleep. Tested again at 11:30 and she was 89. Woke her up and gave her 1/2 cup juice and now I’m waiting to test to see if she’s come up enough. Could this be the Lantus in the evening causing this? She did have a correction at bed time because she was over 200 but that was at 7:45. Wouldn’t the majority of that be gone by now? And she didn’t have a correction last night before bed and she woke up low.

I was also reading about Lantus being faster-acting if you accidentally inject in the muscle…maybe I screwed up the injection? I don’t know. Any wisdom out there?


i have to take my lantus in the morning because i was doing the same thing. i think some ppl just handle lantus better in the morning. i seem to be very sensitive to it at night. I would suggest talking to the doc and switching it back to morning doses if it continues to drop

You are doing the right thing by asking questions and being concerned, Her Lantus may not be the exact dose and time for what she needs keep an eye on her and bring all these questions up to her Endo. We all have different needs hers just needs to be tailored to fit her. The injection site should be Subcutaneous or just beneath the skin not into a muscle. I have the opposite problem then your daughter and suffer from the dawn phenomenon when I go to bed its fine and it spike’s while I’m asleep so mornings I started off very high Lantus just before bed took care of it for me,

Thanks for your replies. I am pretty convinced, since she woke up at 89 after roughly 21g of fast-acting carb during the night, that Lantus at night is not for her. And, maybe her dose is too high. We bumped it up since she has been sick but maybe she’s getting better and her dose needs to be decreased. She also had an unexplained low after nap time yesterday… The other thing that the nurse changed this week is that her bed time correction scale was increased. So last night I would have given her .5 Novolog on her old scale and instead I gave her 1 with her new scale. I think the combo of Lantus at night and new correction scale really did not work.

I definitely have some questions for the nurses tomorrow.

I have to say that I am so grateful for you all. I know that I can type in my frustrations and questions and that I will always get a thoughtful, helpful response from someone.

tudiabetes.com ROCKS! :slight_smile:

With her being so little I would worried too. Sleepless nights in abundance. I have a 4 year old, he is not diabetic but I am and I had a scare with him not long ago, and it was scary indeed. With Lantus as a adult I have never had lows with it and took 320 a day split in two before being put on my pump. But you just never know with a little one so I would be on the phone with her Doc for sure. I could just imagine your worry at night. Or anytime for that matter. Good luck with her and take care.

I’ve been getting problems with my Lantus dose as well and now I take it at 5:30 pm so I can catch the peak before I go to bed. I may also move to taking it in the morning. Per the instructional pamphlet, I don’t withdraw the syringe for about 10 seconds (I guess so the Lantus can form a stable precipitate that will dissolve gradually over 24 hours).

The accelerated absorption I’m experiencing is probably because my dose is small (for an adult) and I suspect this is a constant problem for children whose doses are tiny. I’m getting variable absorption speed from day to day even though the dose is the same.

I had problems with Lantus causing lows, even at lowered doses. It’s not as stable as it’s marketed to be & I had peaks & valleys. I’ve had much more level results with Levemir. Like many people, I take split doses of basal–one in the morning & one before bed.

Another bonus of Levemir is that it doesn’t sting like Lantus. Lantus is acidic. Levemir doesn’t expire as quickly. Lantus is kaput at 28 days & I noticed marked potency as it approched the 28 day limit. Levemir lasts for 6-7 weeks.

Thanks. Levemir being more stable from one day to the next is my next step. I’m getting squeezed in the middle because I want to lower my dose from 14 units to avoid lows but as I lower the dose to 11 units I get a counter-acting effect of the dose dissolving a little faster due to being a smaller precipitate. I’m hoping Levemir will allow stable absorption even if I split it into 6 unit doses. I don’t even want to try a 6 unit Lantus dose!

The weird part that I may never figure out is why I got such great results with 14 unit doses for years and now it isn’t working for me.

My Levemir dose is 6 units. It was pretty much the same dose as Levemir, but with better results. I use my thighs or upper butt for injection. Have you tried this since the stomach is supposed to be the fastest site?

I’ve heard of people developing some resistance problems after years on the same brand.

Hope Levemir helps you!

Thanks, Cathy…
I lowered her Lantus to 4.5 tonight…don’t know how much that will help but I thought I had to give something a try. Probably still will be a sleepless night but she went to bed at 187 so we’ll see.

Your good results from 6 u of Levemir is very encouraging. I’m holding off 'cause I rarely go to the doc but this is a good reason to. Yes, I’ve switched to using my buttock just to rule out sites as the cause. I was using thighs before. I’ve been tracking the total peak plus overnight drop I get from an 11 u dose of Lantus: 50, 37, 40, 112, 87, 30, 46, 39. Meals and meal boluses add an x factor to assessing these results but even so the variability is kind of stunning to me. The last 3 I know for sure were in the buttock, so maybe that will work. What I used to get with 14 u dose was no more than a 30 point peak and it was very reliable.

That’s a big range. I take Levemir immediately before bed & hours after meal boluses. I take another 6 units before breakfast. I’m a small person so need small doses.