Long acting Insulin

I received a call from doc Friday and wants to put me on long acting insulin. I was diag. in Dec. have been on Metformin. Made me throw up all the time so she put me on glibizide 4 X daily. I t is not lowering my BG. Last week it was running in the 300’s, on a good day < 166. I understand one of the draw backs is that it causes weight gain? any info would be most appreciated. Feeling like I’m doing something wrong. I am rigid on my diet and can’t seem to reduce BG…

Sandra…there was a post awhile back titled “Fat Lantus,” I think that talks a lot about why long acting insulin causes some of us to gain. I think that the thinking is that insulin is the fat producing or storing hormone and the more we use or produce in response to carbs, the more we gain. I have not gained on Lantus but I try to maintain a lower carb diet. See if you are able to find that discussion. Good luck to you.

Dear Sandra.

You have not done anything wrong your pancreas may of stopped working to some and you will need insulin. Actually using insulin may help preserve some pancreatic function.

Weight gain may be a problem the more so in the beggining with the excessively high BG you may be eliminating some glucose in the urine which is not a good, in time and will stop as blood glucose goes down.

To countract the weight gain like elaine has said I also eat a very low carb diet this prevents you from going into a weight gain spiral. In addition to the Fat Lantus posts. Also you can click on my name in this reply and look at all the posts from everyone in particular in : “how many carbs do you eat per day posted by Manny Hernandez”

A low carb diet is a good idea. Do this until you get the BG near the normal range. Then depending on how much you pancreas recovers and how insulin resistant you are and if you can prevent weight gain without a low carb diet, you can add some carbs WITH A LOW GLYCEMIC INDEX.

Also ask the Doctor for a fast acting insulin since you may need that also to cover the highs caused by meals. Nearly all diabetics need this.

A good start is to go low carb add as much Lantus as you can without going low at night. Ask the Doctor if you can split you dose in 2 one inthe evening and one 12 hours later. This is better because in some people it last 18 hours and in some people more than 24 hours. This depends on the dosage and the individual.

Then if 2 hours after meals the BG is still too high you need rapid insulin.

Anthony and Elaine thanks for the help. I did go into the archves and read the posts on Lantus. since being diagnosed I have been on a low card rigid diet. although I have to say that it is becoming very boring. One thought I have is that I am on several other meds. I have had 4 back surgeries and am fused from T10 all the way down to L3,with rods on each side of my vertebral column and a 3" pin in each of the vertebrae. Because I have horrible pain I am on a Fentenyl 100mcg patch and 4 hydrocodone a day for break through pain. I wonder if these meds could be contributing to my high BG levels? I have only had upon fasting a norma BG reading once. the rest of the time it is fairly high which has brought me to the doc wanting to put me on insulin. I am trying to lose some weight and am limited to exercise because of my back and both knees being replaced, I don’t need something to cause weight gain.

Wow Sandra…sorry to hear you have been going through so much. The meds very possibly could be responsible in some way. I hope they are able to bring you some relief.

Low carbing can be very boring. There are some great cooks on this site with ideas for all kinds of wonderful sounding variations of meat, eggs, veggies, nuts…even desserts. Maybe we could start a low carbers support group.

Dear Sandra.

I am so sorry to hear about your back problems. I once had an ulcer at the same time as a sore back. The pain was excruciating like being speared right through . The ulcer responded to triple therapy, antibiotics, anti-acid and gaviscon. The back pain went away with weight lifting. So happy ending.

The problem with a handicap is like my Brother who had hydrocephalus and diabetes at the same time could eventually no longer walk. This of course makes the diabetes way worst because exercise is an antidote.

God gives most people at least one cross to carry. Carrying several at at time is no fun.

We all dont need something to gain weight.

Low carb boring but gangrene of the feet is not a really exciting prospect either. Thats what happened to my brother with uncontrolled blood sugar.

My Endo said that metformin and insulin combo can be weight neutral if you dont overdo the insulin and your body tolerates the metformin. You could ask for that.

I am on 40 units ( this is a lot, I weight 248 lb way too much) of Lantus and only 15 of rapid per day. No metformin. And very low carb. Hunger is manageable. And I may actually be loosing weight. I do a moderate amount of exercise.

You could ask for Lantus and use as much as possible without creating nightime lows. Get a bit of fast acting insulin and use moderately before meals Metformin, low carb and as much exercise as possible and minimize stress.

The above sounds like a shoe: big on the inside and small on the outside or juggling 8 balls. It is.

Dont know about your pain killers how they affect BG, hydrocortisone alledgedly raises BG.

Hi Sandra,

Weight gain is not a certainty while on Lantus or any other Insulin. If you’re eating a reasonable diet, you probably won’t gain weight on Insulin. The problem is that most of us diabetics are used to getting away with eating more than we should, and when our bodies start working more like non-diabetic people’s (that is, our blood sugar comes down to more normal levels), then we do what non-diabetics do when they eat more than they should - they gain weight!

I’ve been on Lantus for a month now, and I’ve actually lost a few pounds. But I do watch what I eat, and I wouldn’t characterize my diet as rigid and boring as you do below. It’s unfortunate that you are limited when it comes to exercise - are you completely unable to, or are there some things you can do? Even a few minutes a day can make a difference.

Maybe a good start would be to try to make some changes to your diet to make it less rigid and boring. Nobody wants to eat like that! What do you find so unappealing - maybe some of us here can make some suggestions that will jazz things up and still be healthy and good for the blood sugar.

And one more thing - Lantus has done wonders for me. I was like you - numbers in the 200s and even 300s sometimes (even when eating next to no carbs and exercising every day) and a “good” fasting number was around 200. After 3 days on Lantus I was seeing 100… 120… even 86! It’s truly amazing to all of a sudden see those kinds of numbers. So don’t be thinking you’re doing something wrong… some of us just can’t control it with diet & exercise. Don’t ever think of it as you “have” to take Insulin, think of it as you “get” to take Insulin, because it truly can do wonders for you!

I was just reading this post to be reading and I found it interesting. I also am on Lantus and have experienced significant weight gain. I take Lantus at night and Humalog with meals. My morning readings are perfect but by supper time my sugars are so high I become a slow moving slug wanting to do nothing. Granted my diet is not the best due to the lack of income, but I do try. But the idea that Anthony had about splitting my Lantus up into 12 hour incriments might help. Never thought of doing that, Thanks for the wisdom!

Dear Nicole.

It was other bloggers that thought of the idea. I was just trying it.

The beauty is that it matters less if the Lantus lasts 18 hours or 26 hours. For instance if you are injecting your insulin before bedtime say 10:00 pm or 11 pm and it only last 18 hours then the next day by 4 or 5 pm you have nothing left to cover supper.

Also you can go low at night if it last more than 24 hour because you overlap.

Spilt the dose and see if your morning BG are as good as they are now. If not you can increase the after split dosage at bedtime to help the morning BG if need be. Using a bit more Lantus means using less Humalog and that is ok (unless you pay for the Lantus and get the Humalog free, just joking). It is my impression that using more lantus and less humalog helps control hunger but I have no proof at all of this. any thoughts out there?.

In addition to the above problem is your supper too carby? Could you get better after supper BG with more Humalog at supper time?

Insulin needs a bit of tinkering. Watch out about using too much. You can get into a carb craving, eating more carbs, injecting more insulin, weight gain, carb craving … Death spiral.

I was in tears about my uncontrollable weight gain using insulin. This web site suggested a low carb diet. I cut my insulin from 75 to 55 units per day. 2 shots of 20 units of Lantus each and about 15 units of novorapid before meals and the blood sugar readings are better. AND I DO NOT FEEL UNCONTROLLABLY HUNGRY.

Barbara, thanks for your comment. I am learning to eat more meat. I just have never been a meat eater and am finding that a bit hard, but in time with adjustments I will be fine. I just need to realize this is a new way. I will go to doc today and start the insulin and I am sure my numbers will improve. As far as exercise, I am limited by neuro surgeon as to how much I can do. I am trying to walk in shorter lengths several times a day… This will do less harm on my joints and back. I have a tredmil so that is a doable thing. Since my knee replacements I have found it a bit harder to do exercise but think this is the way to go.

Thanks Anthony for the info. I will go to doc today and start the insulin. I just want to get bg as close to normal as possible, don’t need any organ distruction, diabetic feet or retinopothy or neuropathy… I will get a handle on it. Exercise is very difficult do to back and knee repacements and I have to have a hip replacement but have held off due to the diag. of diabetes and feel I need to get it undercontrol before I throw something else at it. But the way I see it is that the good Lord gave me another day and for that I am thankful and will try to do it justice and do whatever is necessary. I appreciate all of you for being concerned enough to help out. Have a good day Anthony.

Elaine , thanks for advice. I am finding some good suggestions in the past blogs. there are some very astute people within this family and I so appreciate their input.

Walking is great exercise, so you’re off to a good start.

I hear you on the meat stuff. Although I never really avoided meat, I am definitely eating a LOT more meat since I’ve been diagnosed. I would so much rather have a peanut butter & jelly sandwich than a turkey or ham sandwich… and making just about every dinner revolve around meat and still be interesting and tasty hasn’t been the easiest.

I’ve found that soups help, even when they include meat, it doesn’t feel like I’m eating a big hunk o’ flesh every night. I probably make chili once or twice a week for that reason (plus it’s tasty & low carb). Vegetable soup with some pork or beef in it is also good. Stir-fries also are good, but you have to limit the rice and also make the sauce yourself because the bottled stuff is full of sugar and other carbs.

Also, a big key is cooking things for yourself - you don’t mention if you cook or not. So much pre-packaged stuff is loaded with carbs. Like the stir-fry sauce. And canned soup, sheesh, the crap they put in that! So when I talk about food, I’m assuming that if you’re buying pre-packaged meals, you’re checking the nutrition values or (better yet) making things from scratch. It’s a hassle, I’m not going to lie about that. But ALL of diabetes is a hassle, from the drugs to the shots to the exercise to the eating… best just to accept that part and get on with your life. After all… we have all this knowledge now, we GET to apply it and make ourselves healthier. A hundred years ago? We’d be blind… or crippled… or dead.

Soups and chilis are great. You can make up recipes or follow any number, but make a huge batch, freeze a dinner sized amount and some one person lunch size portions. When it’s already made, it’s so much easier to grab something healthy. Another good one, if you like them, is stuffed peppers. I use half veggie soy crumbles and half burger…lots of chopped mushrooms and a tiny bit of brown rice and a low carb tomato sauce. They freeze well. When you are craving a sandwich and sick of meat, try egg salad. Starbucks has one (it’s huge, just eat half)…good for when you are out.

Barbara, you are so right. I do have the knowledge through you all and I have read just tons on the disease and what to do and not to do. It is up to me now. Since the alternative sucks I think I will be compliant. Yes, I do cook and always have. Just more careful as to what I am using now. I feel pretty good about it all. I am anxious to go to doc today and get started on the insulin. It will have to do better than the oral has been. Today when I woke up and tested my BG was a whopping 256. I just think I will have better control with the insulin. I will also invoke some walking even though that is a hard thing for me with the other problem, back etc.But am confident I can do it. thanks for all your help.

You have some good ideas Elaine. I have taken Sunday afternoons to cook and make up the weeks meal. My significant other and I make up like TV dinners. That way I don’t have to fool with the cals. or the carb numbers each meal. It is already done. Tell me Elaine, what is this veggie soy crumbles. I haven’t heard of that before. where do you get it. Sounds like a good additive to meatloaf, peppers etc. I also keep hard boiled eggs around for a quick protein snack. Now I need to find a good protein powder. We bought one of those Jack LaLane juicers over the weekend. It seems like it will be good for shakes, smoothies, vegetable drinks etc.

You sound just like me… my fasting numbers were between 190 and 240 until I got on the Lantus. Now they’re 90-120, mostly (I’m still figuring out the exact dose).

Dear Sandra.

For sure you will have better control with insulin. I had no control with oral insulin boosters i.e.sulphonylureas and same problem with weight gain. With the oral pills there is no way to match insulin demand with supply.

The crumbles are made by Morningstar Farms and I think Boca Burgers has one as well. It is the same stuff that they use for veggie burgers, just looks like ground beef. You add it to the beef after it is cooked and like most soy, pretty much tastes like whatever it’s with. You can use it instead of beef but I like a mix. I use it in tacos, too.

Some of the cooks here turned me on to unsweetened Almond Milk to use in smoothies instead of yogurt and sugar free fruit flavored syrups to use as a sweetener. I use the peach flavor and some frozen peaches and berries. A little vanilla helps make it taste richer. I just tried almond flour in a recipe and it worked well. Libby has wonderful dessert ideas!

Hi Sandra,

I’m Type 1 & have been on Lantus (now on Levemir) without any weight gain. In fact, I’m trying to gain weight, which is a challenge on a low carb diet.

Talk to your doctor about taking your Lantus in two doses. I had the hardest time with high fasting numbers because my doctor told me to take Lantus in one morning dose. Contrary to the pharm info, it doesn’t last 24 hours. Once I started taking basal right before I went to bed & first thing in the morning, my BG improved greatly. I’ve discussed this with several endos & basal taken at night lasts 8 hours. Don’t ask me why because the reasons given were way over my head, but it gets used up faster while we’re asleep. Must be taken right before bed.

Please beware of soy products. Soy is NOT the miracle food it’s promoted to be. Lots of info you can Google about soy warnings. Many diabetics have thyroid problems & soy is very antagonist to the thyroid. It’s also highly allergic.

Whey isolate protein powders are good & the isolate form is the best. Don’t use soy protein powders. Check labels because some have a lot of carbs & chemicals added. Unflavored whey protein powder has 1-2 carbs per scoop & lots of protein. You can use unsweetened almond milk (very low carb) & flavoring to make yummy & filling shakes. Pea protein powder is also a very good protein powder. You can add it to soup. For shakes, you have to add flavoring because it does have a slight pea flavor.

Juicing veggies can add up to a lot of carbs, depending on what vegetables you use.

The Low Carb Cafe & Linda’s Low Carb Recipes & Menus have great low carb recipes. Amazing how good it can be.