I want to break something. Had a great day great numbers the went to work. Took my Lantus at 12:20 start of my shift BS 89. I have been fighting lows at work so I decided to carb up a little extra and have a treat one package of PopTarts from the vending machine 65 carb. About an hour later I was still a little hungry and had a piece of fried chicken left over from dinner guessing 5-10 carb light breading pan fried. Test sugar around 2:00 (usual crash time) it was 189. Well around 3:00 I notice I am starting to sweat “crap going low” test myself BS 60 “Damn it”. Pop a glucose tab and grab my bag of honey roasted nuts I keep for when I catch myself in the mid 70s at work (I wont drive under 80). Test before leaving work at 5:30 still only 85(which is not bad and tend to be my in my standard range). Just frustrated and whining I guess I ate dinner and took my Novalog around 7:30 or 8. My endo say I don’t need to split up or change the timing of my Lantus but this is ticking me off everynight I go a little low 55-65 at work. I know its a physical job but from what I have read Lantis should burn through 70-80 carbs.
Most people do find that they do better on split shots than one shot a day. I was on Lantus before discovering the DOC so was only doing one shot of that. At the same time I discovered you can split it, I also heard about Levemir so asked to be switched. I totally understand your frustration. I was on Lantus for 5 years and could never get it to work right. If I did not wake up low, I ran high all day. If I woke up low, my days were normal.
I realize that you are fairly new at this, but you don’t need your doctor’s permission to change what time you take your insulin or splitting it. There are some people that won’t take an extra unit of insulin without getting their doctor’s permission, but you don’t seem like the type of person that needs their hand held by their doctor. If you are worried about splitting without your doctor’s approval, I would at least shift the timing of it and take it in the morning after you get off work. But unfortunately, the only thing you will be doing then is shifting the timing of your lows. If you do it that way, you will probably need to take less bolus for your meals that you eat during the day. I personally would try splitting it and see how that goes for a couple days.
I agree with Kelly. Try changing timing of Lantus a bit. Do it for a few days before deciding whet
Her it helped. If it doesn’t help, I would talk to my CDE about adjusting the amount of Lantus a bit. I find that exercise can really drop me sometimes, even when I think I have it figured out.
I just had another thought, Jim. The pop tarts could be to blame too. While they zoomed you higher, it’s such crappy (that’s a medical term I’m sure lol) you likely used it up faster. Next time try something a liitle more complex to drive you up — maybe banana or apple ( or both). I’m thinking the drab on the chicken may have hung around longer but it wasn’t enough.
Was thinking the pop tarts might be part of the problem. And never have been a fruit person veggies I love but fruit texture if off for me.
I agree - especially the large carb load without protein and negligible fat. Especially if you are making any of your own insulin (I see you are recently diagnosed) - I have had this happen to me after a large carb breakfast and minimal mixing of the meals (little fat and little protein), I was very high 2 hrs after the meal (around 200) then came crashing down to 41 at the 2 1/2 hour mark. At the time I was on Apidra, which would have been out of my system or at least peaked and done at about 1 1/2 hours for me, so my pancreas decided to work for a minute there).
FWIW, you don’t need your Endo’s permission to change your dose of Lantus, nor do you need his permission to split the dose. Every diabetic has the right to do what’s needed. You tell him after the fact. You tell him what number syringes you need.
It looks to me as if you need a lower dose of Lantus, not a split at this time. A lower dose at a time of day that will put its peak another time other than your heavy physical work! Then check what it stays 3 hours after eating, round the clock. It’s pretty hard to figure out your insulin to carb ratio when your Lantus’ effects are constantly needing correction. Lower the dose, then see if you need a split dose.
It is very likely you need less insulin now that you’re more in control.
Split doses do not have to be 1/2 and 1/2. They can be 3/4 daytime and 1/4 bedtime.
Some people going to split doses go to splitting in thirds, every 8 hours for a couple days, then deciding what they’ll do. It sort of eases into it.
Keep at it! Cheers to you! Let us know what you do!
The Lantus shouldn’t be burning through ANY carbs in the perfect world. It’s a basal insulin.
The bolus insulin is for “burning through carbs”. The Lantus is (agian perfect world picture but you can come pretty close in real life) there for your insulin needs other than meals.
And if you’re going hypo all the time in between meals, you have to cut your Lantus. Not necessarily by a lot but it has to be cut. I’m not sure why your docs are reluctant to do this, hypos at work, especially hypos at work even after Pop Tarts, means it’s time for a change.
Oh, BTW, those packages of Pop-Tarts from the vending machines? They send my bg’s to the 400’s every single time I decide “oh that looks like a good hypo remedy”. 65 carbs is A LOT.
I’m on lantus too don’t give up once you find the number for you it works like a charm! If your fighting lows a lot id drop my dose. Lantus doesn’t cover meals its not supposed to. Are you on another insulin to cover your meals? I take lantus then take humulin to cover meals. Id ask my endo about adding another for you. Now I’ve got real tight control and I’m not battling lows or highs! Its really working well for me! My lantus has really helped me a lot its finding the right dose that’s tricky! Don’t give up yet ok. I’m glad I finally found that dose for me now lantus works like a charm.
When I was on Lantus I took my whole dose (35u) at bedtime. Even though it is not supposed to have a peak, I found that with me it did. About 6 to 8 hours after injection. I would go low around 3:30 and sleep through it. I’d wake up at 7 and have a BG over 300.
I wonder if reducing your bolus at dinner might help you avoid the low. Since you have a physically active job, that might be working to bring your glucose down once you get moving. You seem to be dropping very rapidly from 2:00 to 3:00. You might try one of those packages of peanut butter crackers as a little snack. The carb and protein will help to work a little slower and help avoid the crash at 3. A drop that fast seems to me to indicate that you’re having some sort of insulin peak. Given your physicality at work, you may need less rapid acting insulin at dinner.
Welcome to the world of Lantus. I had persistent afternoon lows even with lower doses, timing changes & split doses. Would hit me like a ton of bricks. I went to split doses on my own. My endo argued that Lantus didn’t cause lows (ha!), lasted 24 hours (ha, again) & taking two doses wasn’t necessary. Docs learn what they do from pharm literature & pharm reps. Too bad most ignore patient experiences.
Switching to Levemir solved the problem.
I remember when they switched my mom to Lantus, she had terrible night time lows. Went into seizures just about every other night. She switched to early morning and has had some luck goes low now more in the afternoons and evenings but mostly from not eating enough for lunch.
But you should be able to skip meals. If your mother goes low from bolusing too much for lunch, that is one thing but if it is from the Lantus, that is different. When I did basal testing with Levemir, I did mine for a full 24 hours and did not eat for 24 hours. Unless my Levemir was not set right, I was able to do it without a problem.
I have gone from a 1:10 to 1 1:12 ratio and am thinking of doing 1:15 on work nights. Snack wise I usually do 2 servings of honey roasted nuts ( roughly 1 carb pt a piece) while working with a few triscuits in between. If the timing is done right I stay in a safe range of 75-90 (Yes on the low side but I tend to stay around 85 through out the day between meals). The peanut butter crackers have worked great tend to keep them a bag of nuts or a peanut butter sandwich in my bag but do forget to restock my bag some days.
I get the texture thing.
I am using Novalog for meals. Try to eat sometime between 6-8 depending if I want to eat with the kids or wait for the wife to get home and eat with her. The lows are whats getting me I don’t mind sliding a little low (65+ thats when I usually catch em) it’s the sudden ones that smack me in the face and make me want to scream. Well burning through 70-100 carbs a night also gets to me but that is a different story.
I have found packs of peanut butter crackers on hand can really save the day.
Might try seeing what dropping my Lantus by 2-5 units (take 25 atm) if the splitting doesn’t work. During the day between meals its not bad maybe once or twice a week.
The Pop-Tart craving I have to blame on a friend. He was taunting me earlier in the day with em. I figured I would spike high but even out though out the night. My last Novolog was taken around 8 (4 units).
I can’t seem to find the discussion here, but there have been discussions on this site about exercizing and long term insulin (lantus and levemir) absorbtion. If you inject your insulin into your thigh, for instance, and then you go running, or go to the gym where you are exercizing muscles near the injection site, your long term insulin will be activated more quickly.
I think that might be your problem. You mentioned you have a physically challenging job, perhaps either post a new question, or search for info on activity levels affecting long term insulin absorbtion, if you don’t get the answer your need from this posting.
Yep she takes way to much Novalog and breakfast is a floating time for her while she has to eat lunch at a set time. I tend to skip lunch a few days a week and am fine as long as I don’t get to physical during the day.