I was on metformin 2000 and glyburide10 per day. I felt fine but my A1C went to 13.2 from 6.9. About 2 days after that I started feeling the tingling in my feet. On January 31st I started Lantus 10 units. On March 12th, I was up to 48 units. My best results were at 40 units. I went back down to 40 units and my numbers were much better than when I was on 48 units. 1st day fasting 64, after breakfast 283, after lunch 269. 2nd day fasting 96, after breakfast 204, before lunch 147, after lunch 236. 3rd day fasting 64, after lunch 215, before lunch 141, after lunch 176. All this at 40 units
I’m going to go to 41 tonight and see what happens. Is this taking too long or will it take longer to find the right dosage???
Your thoughts would be greatly appreciated.
A couple thoughts, Kal. 64 fasting is a bit dicey. If you wake up at 64, you might have been too low during the night.
More important your fasting and before meal numbers are good, but all of your after meal numbers are too high. I’m assuming you test 2 hours after eating? Lantus is not meant to cover the carbs you eat. It is just for background insulin, to give you enough insulin to keep you at a fairly steady level without food. It sounds to me like you need mealtime insulin as well. You can’t control after meal highs with Lantus.
Well, I know it is not something you want to hear, but insulin when used properly consists of a basal insulin like Lantus to keep your fasting levels down and then a bolus insulin to eat the huge blood sugar surge you have when eating. Even if you stabilize to consistent numbers with a Lantus only regime, you will always balance high blood sugars after a meal against lows between meals. Having larger and smaller meals (in terms of carbs) will also mean you have additional variation.
What can really help with a Lantus only regime is really cutting the carbs at meals. The other thing is taking glyburide with a basal insulin is a total waste, you should talk to your doctor about dropping it.
I should have added that I am NOT taking any medicine by mouth.
All I take is the Lantus.
Thanks all
I’m not going above 42 units - my doc is out until the 24th, when shecomes back I will find out what to do about the after meal highs. I think she wants the Lantus to do it all. I hope not.
I wake up when my blood sugar is low. I always have for some reason. If I must than I must. Do you know anything about the tingling in my feet? I know it isn’t normal but will it go away when I stabilize?
If she is a PCP she might not know too much about insulin regimen. BSC is right, the most effective regimen is basal for your background needs and bolus for meals; that is what a non-diabetic pancreas does naturally and that is what we need to simulate with our insulin. Many of us find we have to really advocate for ourselves with our doctors. I also recommend getting the book Using Insulin by John Walsh which explains it all in detail. I don’t know if the foot tingling goes away with stable numbers, but I’m sure someone on here knows.
I agree that reducing carbs will lower your after meal spikes, but also, have to cynically say you might not want to do that because then your doctor will see better after meal numbers and not realize you need a fast acting insulin for meals!
Tingling in the feet may be bad news could be neuropathy. Should get better if you can get your BG into the normal range ASAP. Your post meal BG are much too high. Why would you want to use only lantus.
I don’t but I think my doc wants me to.
It’s your body, Kal, You are the one who will suffer from future complications from numbers consistently too high. If your doctor is not willing to prescribe the medication that will help you manage your blood sugar, my suggestion is to find a doctor or an endo who will. Some people are able to start on just long-acting insulin because their insulin release hasn’t yet failed to the point they are spiking too high after meals. Unfortunately, this is not the case with you. If you take more Lantus, you will start to have lows before meals, and during the night, but your after meal spikes won’t be lowered. Long acting and rapid acting insulin serve two very different purposes.
Thanks
I THINK YOUR MISSING PART OF THE EQUATION. MAINTAINED HIGH BLOOK SUGAR NUMBERS COME FROM EATING. EATING PROPERLY WILL DROP YOUR NUMBERS OVER SEVERAL HOURS AFTER A MEAL OR SNACK.
WHAT BRINGS DOWN THESE NUMBERS IS A COMBINATION OF MEDS AND PHYSICAL EXERCISE.
WITH GOOD HELP FROM A GOOD DOCTOR, YOU SHOULD BE ABLE TO STABLIZE YOUR BLOOD SUGAR LEVELS OVER SEVERAL MONTHS. (MEANING 6 TO 12) DON’T EXPECT INSTANT GRADIFICATION.
Don’t want to be the bearer of bad news, but you your post meal numbers are too high. Basal insulin works slowly & steadily. If you took enough to help lower your BG after meals, you’d be horribly low in between meals & overnight. Raising Lantus won’t help & will send you dangerously low overnight. As the others have said, fasting isn’t all that counts. Lowering carbs, exercising & being on the right treatment is key to stable BG. It’s damaging to go from 64 to 283.
Jerry, please don’t write in all caps.
Are you a type 1 or a type 2?? My guess, based on your usage of metaformin previously, is that you are type 2, in which case you might not need to bolus for meals. Apologies if I am incorrect. Don’t let anyone scare you about numbers, I really don’t think you need to fear the tingling symptoms unless you’ve had bad readings for years. When I was on Lantus, I had all sorts of weird tingles, they went away when I stopped using that kind of insulin (on Humalog now). You can even get tingles from TOO MUCH insulin! So relax and just concentrate on feeling your best and doing what you can to lower your results :o)
Lantus was a HORRIBLE insulin for me, I fair much better on an insulin pump running Humalog insulin. If you must use it though…play with it one unit at a time. Adjust from 40 to 41, give it like two days to take affect…body is slow at accepting changes.
Best of luck!
But you don’t say why not. We don’t write in all caps unless we want to SHOUT!
Ow, I hurt my eyes.
Thanks
I thought that might be the case. Today was a good day - Highest BG was 171. All the rest were under 138.
I am a type 2 - they said it was caused by stress from a bad DVT (blood clot). Today was a good day - Highest BG was 171. All the rest were under 138.
Thanks for the reply.
Just to clarify, being Type 2 doesn’t preclude the need for bolus insulin. The need is determined solely by blood sugar. If someone spikes two hours after eating on a regular basis, they need to take insulin to prevent those spikes. And I agree with Gerri, you are spending way too much time high. 171 is, of course, better than 250, but studies show that complications begin to form from prolonged periods of time spent above 140. Just curious, what is your doctor’s objection to bolus insulin? I could see him hypothesizing that you might be able to manage on just basal, but the results are showing he is wrong.
The only thing different about being type 2 is that, unfortunately doctors often have low expectations that their patients can or will work to manage their blood sugars, so they don’t encourage them to do so. Sad really.
Neuropathy is probably too pessimistic. Tingling in the feet could also be cause by too low blood sugar. Get a book called using insulin it will explain modern insulin treatment.
You bet you. I might be a type 2 and I use tonnes of bolus insulin much more than the type 1. Only dangers is weight gain that needs strong counter measures. My lows are not a problem.