Lantus peaks

Type 1 and LADA
#1

Yesterday V went for some tests. (When they removed his pancreas they thought they saw something on his liver - so far everything is fine)

He’s never been willing to do a fasting basal test (Bad Boy!) but, yesterday he had no choice. He couldn’t eat or drink anything, not even water, after midnight and his last test was at 5:30pm so it was a long time. We wanted his blood sugar to be on the high side to start, because if he had to eat anything to correct a low we would have to reschedule the whole lot.

Anyway, here’s what happend:

Starting at 7:00 am he was at 190. He took his usual Lanuts (8 units) an hour earlier than usual.
He tested about every 90 minutes and varied from 180 to 205 until 1pm when he dropped to 140.
He then stayed between 130 and 140 until 6pm when he finally got to eat.

This, obviously, wasn’t his normal day, but still…

We may have discovered the cause of his afternoon lows.

Does anyone else have a regular Lantus peak?

If so, do you adjust the bolus that is prior to the peak time? Or just have a snack to compensate?

BTW, I think this convinced him to do a proper nighttime test as well.

#2

My husband, Vern. Since he has to do all the testing and injecting I get to do all the research and stuff here. We share ;-))

#3

Glad all went well with his tests.

I found Lantus had peaks, despite company claims to the contrary. Lantus tends to take about 2 hours to start working. When I switched to Levemir (don’t know if this is available in France), my BG was more level. Levemir also has a more stable shelf life compared to Lantus & doesn’t sting. I found Lantus to be less effective as it approached the 28th day. Levemir lasts for 6-7 weeks.

With consistent afternoon lows, less of an afternoon meal bolus would help. I find it easier & more accurate to take less insulin than compensate with food. Many people need different I:C ratios for different times of the day & afternoon tends to require less insulin when people are more active.

#4

My experience… Lantus doesn’t “peak” exactly, but my insulin needs in the afternoons are MUCH lower… it took me a while to learn to take enough lantus to keep my afternoon #'s good, and then compensate for the rest somehow.

On my pump my basal has a rise overnight, and it dips lowest in the afternoon… that’s just how my body needs it’s basal coverage.

I do want to caution you with basal testing on MDI - often in order to “fix” one problem, you end up creating another… so be careful and me mindful of differing insulin requirements at different parts of the day. My experience on Lantus was that in order to take enough to have good fasting #'s, I actually wasn’t able to eat enough between 3-4pm to stop the lows that would inevitably follow.

#5

I had a very difficult balancing my lantus dose with my body’s basal rates, I ended up with a split does at night and the mornings, but found I never had enough insulin to prevent evening highs, without fighting lows in the mornings. I have since switched to the pump and it is much much easier to manage, as you do not have to worry about the peeks of the slow acting insulins. I definitely found lantus to have a peeks in my experience, but difficult to judge until you know where your own basals are…