I have switched from my animas ping back to MDI. When I was on MDI before I did not have a problem with the dawn phenomenon(probably because I was newly diagnosed)but now I do. So what do you do to help with this? Do you skip a bed time snack? Just wake up high and correct in the morning? Any help would be great. I am also figuring out how much lantus to take(currently not taking enough and slowly increasing everyday).
I use Levemir and take a nighttime dose more than three times my daily dose, but still I struggle with Darn Phenomenon. A key question is whether your ping basal profile had increased overnight basal levels. If you did, then you may need to do some work to obtain higher overnight basal levels with Lantus. You can try to adjust the Lantus levels, but you may not get high enough without experiencing daytime lows. Some people wake at 3am and test and inject rapid, but that bites. If found taking NPH allowed my to take higher overnight basal levels without causing daytime hypos. Some people actually augment Lantus or Levemir with a nightime NPH shot, but NPH is notorious for highly variable action.
Yeah my night time basal was 1.2(a little on the aggressive side) and during the day .75. I think I’m just gonna switch back to pumping. I just wish supplies were not so exspensive. I went to bed last night at 144 on a empty stomach to wake up at 4 am at 270 and spilling keytones. I started at 23 units of lantus 4 days ago and have been bumping it up every night to last night being 30 units which so far seems to be good for during the day. There is no way I’m waking every night to take rapid insulin I’ll be pumping before I do that
Yeah, it's pretty darn hard to achieve a smooth basal coverage on MDI, even without DP! Just fyi, when I got my Ping I applied for low income waivers from animas and they not only waived the 20% payment for the pump my insurance requires but put an additional 30% discount on the ongoing supplies. I'm not really in a position to afford a pump but that certainly helped (and I couldn't imagine going back!)
Really that’s good. Do you have to prove how much you make?
When I switched back to MDIs, I tried many different times of the day to take my Lantus - I was either waking up low or high. Now I split the dose: half at 10:15am, half at 10:15pm (well, almost half - 7u in the morning, 6u at night). I can wake up at 6am at around 150, but when I finally get up at 9-10am, it's back down to 104, or so (without a correction).
Oh yes, I had to send in complete proof of income paperwork (tax info). I thought I would have to do that every year, but it's been a year and a half and I just keep getting my discount.
I had that problem too before I went on the pump...my highest night basal rate is 3 x my lowest rate in the afternoon. When I was on Lantus, splitting didn't help at all.
If I had to go back to MDI I would try as bsc suggests and try a split Levemir dose.