Need help with Lantus split dosing

Hey everyone, I’m on Lantus and Humalog MDIs, and things were ok but in the last month they are getting crappy. I’m after help and suggestions on what’s causing the massive peaks and lows I’m experiencing. I’ve made some pretty graphs of my last 7 days so you can see just how bad it is. Please view my blog post about it here. I would greatly appreciate your help in helping me figure this out to reduce the fluctuations in bg. Thanks everyone! :smiley:

View my blog post here: http://kaitake.blogspot.com/2011/07/i-want-off-this-damn-rollercoaster-can.html?m=1

I was similar to you and I was once found sitting on the font in a church stuffing sweets during probably my 5th or 6th hypo of the day. A man walked up to me, whom I have never met, took one look at me and said, “You are on human insulins, aren’t you?” I wondered what he was saying but then he went on to say that there are many people who are overly sensitive the human insulins - nothing human about them - just that they are man made - and that I was probably allergic to them.

He put me in touch with a group campaigning for patient choice - Insulin Dependent Diabetes Trust - and the choice to go on to Pork insulin. Their e:mail is enquiries@iddtinternational.org and they have been brilliant. My doctors and nurses were extremely obstructive during the time I tried to go on pork insulin - one said I might be allergic to it (well, let me try for a few months and see if I am - I will come back to you and eat humble pie), another said that it was not available (not true, there are several of us in this town who are on it - but go to hospitals out of town to get it - another said that they knew what was best and that I was obviously doing something wrong. They dropped me completely when I went on pork insulin and I was left for 18 months without any kind of support. But that is just them, not all clinics are bad.

Long story short, I finally got it, and I have been so much better, hypoing maybe only 2 or 3 times a week - though obviously I have my good days and my bad days. It is less harsh than the chemical version. If you are a Muslim or are Jewish (both of which do not eat pork, or pork products) then the Bovine (cow) variety is also available. Contrary to popular belief, animals are not killed simply for their insulin - that is a biproduct of meat production, like leather is for shoes.

I would, if I were you, get in touch with IDDT and ask them to send you their welcome pack - you will see your own story written in there! I am sure they saved my life.

What you say about porcine insulin is very interesting. My first diabetes nurse has a daughter with T1, and she was on it. Porcine was the only sort of insulin she could cope on. I’d never thought of trying it myself, so thank you for the idea! :slight_smile:

Yes this is what my diabetes care team think must be happening. They believe I must have lipodistrophy in my abdomen because I’ve been injecting there for 23+ years. Trouble is, I’m not convinced that is the problem. I’ve done a 1 month trial injecting only into my thighs (which I found very painful and inconvenient) but there was no change to me diabetes control. I also have no “lumpy bits” and I do rotate around my tummy. What’s troubling me the most is that my regime was working fine, and then it just went to hell in a handcart! :stuck_out_tongue: thanks for your suggestion. :slight_smile:

Sorry, you also mentioned smaller meals and stress. Yes stress definitely makes the fluctuations worse! I’m eating about 100 carbs per day as food, plus another 15 - 50g as emergency food. I’ve been trying to shift to lower GI meals, and lower carb overall. It seems to make the lows worse with low carb as I don’t have enough of a buffer. Of course, the problem could be that my carb counting is slipping - too many guestimates.

You started out saying you wanted help with split dosing Lantus - and so I’ll go back to that! Splits are anywhere from 80% in the morning on arising & 20% at bedtime to 50-50. I started by deciding the least I could take without going low overnight, and it happened to be 20% of the total daily basal dose. To check it of course requires laying off breakfast and testing the hourly blood glucose til noon on the first day, no lunch the 2nd day and testing the hourly glucose 1 pm to 5 pm, then skipping supper the 3rd day and testing the 6pm to bedtime glucoses. Tweaking then to keep the glucose within 30 mg/dL of itself - when not eating or not having had insulin. It takes several days but is worth it.
One can only find out what’s keeping a roller coaster going by reverting to eating only a couple grams of glucose and seeing what a small amount of insulin does to handle it. If you have had things ok, you know what insulin to carb ratio has worked for different kinds of carbs. Maybe the ratio has changed for a period of the day:maybe insulin resistance is increasing. Take a type of carb that is vegetable not high starch, not pancakes, not pizza. What is the insulin doing with that at one period of the day? Try again at another period of the day. Establish the new ratios if that’s what it takes.