Lantus question

Treatment Insulin
#1

Ok, so I got my "training" for insulin yesterday I will be taking and I can start.. I am nervous I admit it (not because of the needle because of lows)

Anyhow, I am just getting Lantus at 5mg (ml??) at night .......
which they said shouldn't cause any lows because it is really low dose. But I am new so what do I know right...:)

But here is what is weird..I have been having problems with my BGs for the past year - not going down in the morning, being high even though I don't eat much etc...

I am on Metaformin 2000 mg (just switched from ER at 1750mg and went up a bit with regular) and Januvia 50mg.

For the past week (right before I start the insulin) my numbers have gone down.. I have had some fasting below 130 and even a 99 yesterday (wtf? It had been a while since I ate but normally that doesn't matter with my BG) BeforeI was getting like 160 to 180

So, the questions... How much will 5ml of Lantus lower BG at night?

I guess now I am more worried because - weirdorama - my numbers are lower now for whatever reason this week...

I want to start tonight but now I am concerned that this will take me too low....

damn crazy BGs that make no sense whatsoever! lol!

Any advice? Insights?

#2

I started out much like you with my insulin using 5 ml of Lantus a night for the first year along with Metformin. I never had any lows in the morning at that low of a dose, it was only when we ramped up the dose to 15 ml that I saw any lows, and those only occurred after pretty strenuous physical activity, and only then in the afternoons.

I would definitely recommend following your docs advice and starting it now. The sooner you start insulin hopefully the longer you can go without having to start MDI(Multiple Daily Injections).

If you are concerned about going low, I think you know the answer I'm going to give you. Check your BG right before you go to bed, set an alarm for 2-3 am and check your BG again, then check your BG right when you get up. If you see a drop of more than 30 during these times over 3-7 nights, call your doc and let him know, he'll want to lower your dose.

Yes, insulin can cause Hypoglycemia, but it can also prolong the need to take fast acting insulin. If you are concerned that you are feeling low, test immediately if for no other reason than to ease your mind about lows and to get a feeling for what a low really feels like.

#3

thanks Kevin! Nice to meet someone else who started the same...

I have had a low before (like you after too much exercise) so I know what it feels like ... I am wondering if my body goes low when I am asleep will I wake up? The low I had before was when I was awake..

My BG tends towards dawn phenomenon lately...

I am a light sleeper and don't well as it is so I would prefer not to wake up at 2am! I do test before I go to sleep and my meter is on my dresser close to my bed.. I am thinking I will keep some glucose tabs by my bed just in case...

I guess if I eat closer to when I sleep it might prevent help prevent that too.

#4

So I took my shot .. pretty easy.. gonna try and take it at 10pm ish...

Questions.. i was still munching on some popcorn - not finished Can I still eat after I do the Lantus... I couldn't see any not since it is 24 hours but just wondering...

#5

I'm not a fan of snacking before bed to prevent lows. It tends to lead to weight gain and can end up being a crutch you extend to other parts of your day. Learning how much insulin you actually need is the important part, if you snack before bed you won't find that out.

I'm a light sleeper too, which is a good thing when you use insulin, its rare I miss a low at night(they are exceedling rare for me, maybe one every 3-4 months). Testing in the middle of the night definitely sucks, but I'm not talking about forever, just for one or two weeks. Just keep your tester by the bedside, click on a flashlight, test, interpret the number, eat glucose tab or two if you are mildly low, if not go back to sleep.

Anyways, snacking before bedtime leads to some strange dreams.

#6

Yeah the difficulty with shots is more in our head than reality. BD makes "Nano" needles for both pens and syringes, I'd get some if I was you. They are the smallest they make.

Lantus has nothing to do with your mealtime BG, its to cover BG rises not related to eating. For now your Metformin and Januvia should be helping with your mealtime BG rises.

#7

Don’t worry, the long acting insulin so like lantus are the easy ones. Even if they ever do cause lower numbers they would just cause low tendancies or levels to drift a bit low, it won’t cause dangerous or scary crashes… The rapid acting insulins require a lot more caution and finesse

#8

Good luck with your Lantus start. You've already received some great advice. I just want to comment on your dosing terminology. I know there's a 101 things going through your mind right now but it will help you with your doctors and others to use the right terms.

The amounts of insulin that people with diabetes take are measured in units.

One form of insulin packaging is a 10 ml vial. At a concentration of 100 units/ml, that equals 1000 units of insulin.

Insulin is also packaged in pen vials. These are 3 ml vials. At a concentration of 100 units/ml, that equals 300 units of insulin.

You are likely starting on a 5 unit dose; a 5 ml dose would be 500 units!

I wish you the best with your insulin start. Keeping a log is a great way to learn what your body needs and will help you talk about your experience with the doctor.

#9

I don't think you mean "5mL", I think you mean "5U" or "5 units".

I think it's great you're on insulin and it is working well for you.

Yes, hypos are a worry, but that's why we check our bg so often. The central part of "intensive management" consists of measuring bg's and tweaking insulin doses. It sounds like you started off with a very nice first guess of a dose, and you are already tracking/recording your bg's and analyzing them. Excellent start!

#10

I do agree the rapid acting insulins can be scary-hyper-fast in onset.

But I don't think we can say that basal insulins never cause problems either. I know for sure the hypos I've ended up in the ER and ambulance rides with, were most definitely changes in my basal needs (due to exercise or alcohol) that I did not change my basal dose for.

#11

Ok, what exactly is going on here?

lol! I was starving the next day after I took the Lantus! Actually I was starving in the middle of the night Friday after my first dosage.. I had to get up at eat a protein bar..

I am NEVER hungry at least I haven't been for a long time.. My stomach never growled and felt empty for along time and I didn't eat much and now, I was so hungry yesterday.. I had to keep eating throughout the day..

A friend told me that I that could happen on insulin.. But I am taking so little.. Last night I didn't really get hungry but I notice I am going to be eating more..

Hope I don't gain too much weight!!!

I read it is because the body doesn't process your food properly if the insulin is low or not being used.. I felt like that was the case with me before.. I guess now it is working better and using the food I eat which is good - and that might be why I am hungry now..???

#12

Yes, 5 units - as Terry corrected - I dial to 5 on my pen.. :)

#13

Did you check you BG when you were so hungry in the middle of the night? Can be a sign you are low.

#14

Yep. 140..... I am not as hungry today... I got a 98 before dinner! And my morning number is better. (low 100s) Whee!!! I can eat more.. maybe my body needed to adjust for a day? I hardly ate much before the insulin TRYING to keep number low - something switched I guess! Maybe it was trying to tell me that it was starving finally!