I’ve been on Lantus for 6 days now, and I’m definitely seeing results, but I have a few questions. I’m gonna call the doc and ask about this, but also wanted to get input from all of you.
1 - Doc said something about Lantus taking 6-8 weeks to get to full effectiveness. I thought that insulin was immediately effective, and I’m certainly getting immediate results. Can someone comment on what I might see after 6-8 weeks?
2 - Does Lantus do anything for spikes after eating? I know it’s a slow acting basal insulin, but not sure if that means it doesn’t do anything to control spikes or if it does a little bit or…? I’m asking because even though I’m seeing much lower fasting blood sugar numbers on the Lantus, I still see spikes if I eat carbs. This morning I tried some steel-cut oats (18 net carbs) for the first time since being diagnosed, and was 177 an hour after. Yeah, I know that’s a lot of carbs for first thing in the morning… but I’m just curious as to whether or not I should expect the Lantus to do anything about that.
3 - How much Lantus are you other Type 2s on Lantus taking? Doc told me the average amount a Type 2 takes is 50 units a day to get to a fasting blood sugar of 110, but that it obviously varies and I’ll have to figure out what it takes for me. I started at 10 a week ago, and moved it from 17 two days ago to 20 yesterday, and woke up with a blood sugar of 85 today! Previous to that my lowest fasting was at 146. I’m wondering if the results after a relatively low level of Lantus is indicating that I may not be all that insulin resistant, but actually just not producing enough insulin naturally.
Another piece of evidence that may be in favor of that is that I don’t seem to respond much to Metformin (2000 mg/day). I do see some results - the minute I started taking it, I stopped losing weight (was losing 1/2 pound a week previously). I also seemed to start digesting food better (I won’t go into details on just how I know this… let’s just say it’s a bit TMI, so just trust me!) I also saw a little bit of change in my blood sugar but still got fasting numbers around 200 until I started on the Lantus. My understanding of Metformin is that it prevents your liver from producing too much glucose. Fine and good, but if I don’t have Insulin to use the glucose that it does produce, I can see how I don’t see much results from Metformin.
#1. i don’t think he meant that it would take 6-8 weeks for lantus to become effective, just that your body adjusting to the regimen of insulin and what it will do for you. #2. lantus is a basal insulin. it will not be for the spikes of carb eating. Lantus will be your base. 18 carbs is NOT a lot of carbs for a meal. you are not on a MDI regimen as of yet, and if you are seeing 177 an hour after meal, prior to lantus that number would have been probably 277. #3. I would look into getting the book “think like a pancreas” for you to better understand how this all works.
I’m not sure what your Dr. meant by 6-8 weeks. There are a lot of variables that could effect your dosing besides time. Don’t be affraid to track yourself and adjust your doses of lantus. I had to switch to 2 shots a day of lantus because my body was processing it in about 20 hours instead of 24 shooting my BG into the 4 and 5 hundreds before my next dose.
Lantus does not spike after eating but does spike and fall, it’s so gradual that it is hard to notice. It took awhile for me to find the spike. I was taking 15 units at 9am and 9pm and sure enough 3pm and 3am my BG would drop like a rock for some reason. It was simply how my body was reacting to the Lantus so just be aware and test if you feel goofy. Look for the patterns and adjust your Humalog(Type 1) or food intake(Type 2) as needed to correct for this.
Do not understand the Doctor’s logic. It works in about 1 hour and keeps on working for some variable time from 18 to 30 hours depending upon the human using it. You are not going to see anything because if you ate 18 grams of diabetic friendly carb and the blood sugar spiked you obviously need fast acting insulin like humalog. And the dosage of Lantus you need may also depend on how much humalog you use.
Lantus will not do anything unless your pancreas is working well for after meal spikes and if it was then you would not need the Lantus.
The doctor’s statement that the average amount of Lantus is 50 units per day is interesting. Seems like a lot since I take 50 per 30 hour period which works out to 40 per day in addition to 30 fast acting. I am grotesquely obese at 250 lb. Less massive people should need less i.e. it should be proportional to mass as most drugs are. Met a slim and trim type one diabetic and he said he was using a total of both speeds of 55 units per day and I think he weighted somewhwere around 150 lb. He normally uses about 1/2 and 1/2 of Lantus and Novorapid (similar to humalog) but he said when he forgot his Lantus during a hunting trip he was fine with the same total dose using the fast only and a hell of a lot of injections. This is how pumps work…
Last paragraph. I get very sick, if on metformin for more than 3 weeks so I personally cannot testify in its favour. But my Endo well respected in Calgary said some of his patients have added metformin to their insulin treatment and have lost weight. When you are on insulin and something makes you loose weight it is gold. I dont know what the rational is and do not entirely understand how Doctors minds work. But as an Engineer I would get my blood sugars reasonably close to normal at all times using 1/2 Lantus and 1/2 fast. You can try and fiddle the lantus /fast ratio but that is fine tunning and with our present meter accuracy you may not find the difference. See if you are gaining weight on the insulin and if so reintroduce the met to see if it helps with weight gain if so and it does not wreck your health you have a winner.
Happy to hear of your success with Lantus. That’s great!
Agree with what everyone has said. Lantus, & any insulin, works immediately & doesn’t remain in the body long. Don’t understand the 6-8 week period. It took a lot of experimenting to find the dose of basal that worked for me, so perhaps this is what he meant.
Basal will not help with post meal spikes.
Everyone is different regarding the average amount of Lantus & I’m clueless as to what Type 2s need for basal insulin. I’m Type 1 & take 8 units a day–4 in the morning, 4 right before bed. I’m slender, so my insulin requirements are less than what a larger person needs. I have much better control since taking two separate doses because I have dawn phenomenon.
If you don’t mind some advice… If you have dawn phenonmenon, eating very few carbs for breakfast will help your post meal spikes. For those of us with this condition, BG keeps rising in the morning. I eat protein & only 6 carbs at breakfast. This has helped me tremendously & keeps me from being hungry. I was on Lantus, but have better results with Levemir. But, this is an individual thing.
Really glad your doctor suggested basal insulin for you!
I have found that i spike more after meals with lantus yet it is effective for keeping my blood sugars quite level throughout the day; I usually take nova rapid before i eat high carb meals and this drops my blood sugar right away, both lantus and nova rapid are a great team for stabilizing my blood sugars
Can you elaborate on what you found the difference to be between the Levemir and the Lantus. I wonder if it is not a good idea to change brands as they may all be a bit different and this may give so relief from possible anti-bodies to one brand of insulin.
I’ll try. My endo thinks that Levemir is more stable & therefore more predictable. For me, this seems to be the case. I had more between meals lows & highs on Lantus than I do on Levemir. I’m actually taking less Levemir with better results. I was diagnosed in late May, so I don’t know if this would have been long enough to developed a resistance to Lantus. Whatever the reason, Levemir works better for me.
Results are all that matter, but I like that Levemir doesn’t expire as quickly so it’s less expensive in this sense & it does cost less to begin with. It also doesn’t sting like Lantus.
Would be nice if there was a test to see which brands work best with everyone’s different chemistry!
Dear Gerri. Thanks. I will ask the pharmacist if it is available in Canada Lantus was only recently approved. The instructions re Lantus are quite explicit about it expiring after 28 days. Interesting to hear that you had stinging with Lantus. My tummy grease does not have many nerve cells so I have never felt that. I think it is a good idea to do a comparaison as you said the results count.
That isn’t a Type 2 dose. You are probably insulin sensitive and very likely NOT to be a Type 2.
Stop taking the Metformin and see what happens to your blood sugars. It is completely safe to stop metformin. (I checked that out with my doctor years ago.) I found that I only needed maybe 1 more unit of insulin when I stopped Metformin, so that was that.
With that insulin sensitivity you probably need a fast acting insulin at meal times and a doctor who understands that you are not a Type 2. This is really important. I have been through this whole thing myself and the only way I could control meals with Lantus was by taking a dose high enough that I was hypoing at night, waking up with pounding pulse etc, and eventually developed a huge problem with pounding pulse that took weeks to go away thanks to being in a hypo-fighting mode for weeks.
My doctor (or more truthfully, his “diabetes nurse”) were clueless about what was happening and did not even recognize the symptoms of late night hypo. Even now, they have me listed as a Type 2 when my TDD for insulin is never over 12 units. Oh well, at least I get the prescriptions I need, but that is mostly because I demand them.
As far as I’m concerned, the jury is out on as to what type I am. However, I am happy with my Endo & Doc. They seems to understand that this whole thing takes time to figure out, and my Lantus dosage will definitely tell them something.
However, I am not going to just stop meds without speaking to my doctor first. But I will speak to him about it. What would you expect to happen without Metformin?
I dropped down to 18 units of Lantus last night. Went to bed with BG at 113, work up at 93. Makes no sense, since 3 days ago I was at 146 in the morning with 17 units of Lantus the night before. But I had been eating badly over Christmas, still, fasting is supposed to be fasting, right? Any food effects, regardless of how badly I ate, should be gone after 8-10 hours with no food. Crazy stuff, this diabetes.
Well, as so many others have suggested in other discussions, everything you say does lead to the thought that you may be Type 1 (or at least 1.5) rather than Type 2.
