Has anyone else had this happen? Here is the scenario, my son just turned 5 in October and he was diagnosed in March 2010. He gets 4 units of Lantus at bedtime. Starting last Friday we had 2 mornings above 200 (261, 210) then 2 below (153, 132) and then 2 above again (237, 244) so the decision was made to increase his lantus to 5 units last night. This morning he was 348. What is up with that? Anyone else have this happen where the BS was higher after an increase like that? The rest of the day his BS is between 75 and about 150. He is not sick and has been eating Normal.
Since it is cooler out and we are not outside as much his Breakfast and Lunch Humalog was increased to 1 for 30 and his dinner is still at 1 for 40. We eat a late dinner (around 7pm) so we do not do a bedtime snack.
The only other change is that in mid October we started using the pen needle to give the lantus instead of the syringes. As a coincidence after we switched we had to increase from 3 units to 4. We still use syringes for Humalog and are not opposed to going back to the syringes if that would help even things out with the Lantus.
Any thoughts are appreciated.
Carol
Have you tested him in the middle of the night to make sure he’s not going low and rebounding?
Also, it’s eight months after diagnosis so if he’s been honeymooning it’s possible that could be ending (if it hasn’t done so already).
Finally, a 1-unit increase is pretty huge for someone only taking 4 units (that’s a 25% increase). I’d increase by half a unit at a time for such a low dose.
It could be that the extra Lantus is making him to low at night and the higher than usual reading in the morning is the rebound from that low. Testing in the middle of the night is the best way to see if this is happening.
Usually when this happens is because the humolog is not covering and/or he may have the Halo effect where the liver kicks in and increases the sugar levels in the early part of the morning (4am-6am).
Besides the rebounding problem, I would also question the pen. When I was on Lantus, I used syringes but I have used Apidra in the SoloStar pen. I would think that the pen is the same, it is just the insulin that is different and they are both made by the same company. When I tried the Apidra SoloStar pen, it did not give small doses accurately. I compared by shooting one unit from a syringe onto a plate and did the same with the pen – it wasn’t even close. Two units didn’t work any better. Someone from another message board had samples from his doctor that did the same thing. I hope I never have to go back to MDI because I would never use the SoloStar pens, and I don’t want to go back to syringes either.
You can get insulin out of those pens by injecting a syringe into the end you attach the needle to. I would try that so you don’t have to go up a full unit. You might be able to rule out pen problems also.
It might be worthwhile to get your Lantus in a vial and use 1/2 unit syringes. I use BD 1/2 unit, 3/10 mL/cc, 8mm, 31 G, and they are very similar to the feel of pen needles.
It’s probably not relevant, but I use these syringes with my Apidra in a vial, and when I want a half unit with my Levemir, I use a syringe on the Levemir pen; pen needles on whole units on the pen.
Ironically, I have the exact same question. I was diagnosed in August and have been taking 9 units of Lantus at bedtime. My morning numbers were going into the 130’s so I was advised to up to 10. Since I have upped to 10 my sugars have been way higher, like 150-170. Same thing, an increase in numbers with increase of Lantus…??? So weird that this is happening to your son too. I am going to test during the night tonight. Question for those that responded, after a low your body rebounds high? I too think my honeymoon period is ending.
She can also use syringes with the Lantus pen. If she bought the vial, she would be wasting a ton of insulin using only 4 units a day. Lantus is not very stable. One pen would last her one month and she would have a 5 month supply for one copay with a box of pens. Alot of people use syringes with pens.
Yes, after a low, your body rebounds high. Your liver spits out glucose when your BS is low.
The other thing, alot of people need to take 2 shots of Lantus a day not one. You can try doing that.
Well maybe these experiences might Help? ( and not in any particular order)
1.Using Lantus? It spikes- 2-3 hrs after taking it… thus test then
2.What’s the BG When Taking it? It could be too Low ( 80-90’s) and either (a) Get them up or (b) eat some Protein- I eat Deli Meat…Chicken/Turkey/Ham - a few slices
3- Is the Pen working? Air Shots…After Changing the needle are mandatory… If leave the needle On for Mutiple shots? Air Shots before each shot…
4.-On low Dose…? Ck the needle after withdraw… is their a Big Drop left? = 1-2 units… I Leave it in for a count of 5 and tap the button
5-using the 29 gauge short Needle is fine… but if your injecting in fatty tissue? Best use the 30 gauge Reg.Size needle…
6-Alternating sites is also mandatory… Feel for Lumps in your usual place you’re injecting…change sites…
7-I don’t eat 3 hrs b4 Bedtime… Gives both digestion and The Bolus to Work… If have to have a snack? “0” carb snacks…( for me, it;’ DeliMeat)
8-For a Child and teen? I’d be happy with a 120-130 AM reading… and no hypo’s overnite…
9- For adults? Maybe ok as well… if it means no Overnite hypo’s… You have the other 16 hrs to get nice 100’s to get a nice 115 ave for the 24 hr day…
10.-If high ( +110) at Bedtime ? I take a CB ( Correction Bolus) and not increase my Long Lasting…
11- I converted to LEVIMIRE when it came out to try it…I had too many Over nite Hypo’s using Lantus or too High in the AM’s taking less…( even after taking it in split doses-every 12 hrs ) …rarely get a overnite hypo anymore… and yes, I take split doses…every 12 hrs…
- Don’t expect too much from your Dr.'s… Unless your’s has Several -Successfully controld T1’s
Get the Books and keep them handy… Think Like a Pancrease, Using Insulin and Dr.Bernsteins- Diabetic Solutions…
hope 1or more of these will help give you ideas to pursue…and try…
last A1c- 5.53%
This to me is a red flag alert for insulin doses being too high at some point during the night and he is rebounding. The 348 number is the kind of number you will see during site failure or rebound (rebound numbers are very high and very hard to bring down the rebounds). I would reduce the overnight insulin immediately, then stay up and do an hour by hour basal test overnight. I also agree the extra unit is too high; he is only five. If adjusting, I would only go up by half unit increments or less.