So. I’ve been doing research on splitting the Lantus. The reason we are looking at this is, V takes 18 units at 7:30 in the evening. He is low in the mornings, 50 - 70. Some mornings it’s before breakfast, but, more often he goes low 1 - 2 hours after breakfast. He’s reduced the breakfast bolus to 6 units, (for 135 carbs) taken 30 minutes after he eats to try and stop the lows. Not working.
He gets that sorted, is okay for lunch and 2 hours later, then the numbers climb until 7:30, usually forcing a bolus correction around 5. We’re thinking he’s taking too much Lantus, to start, and that a lesser amount, say 16, split 50/50 would work.
I’m trying to get all of the information together before we call the doc. She’s more willing to listen and less willing to slap him in hospital if we are prepared with some knowledge…
Which insulin dosage to change (to stop the low) is always a question at some level.
Sounds like you have three different things happening IMHO.
Likely a GAP in the coverage approaching the 730 lantus dose. The lantus is dropping off and letting him rise.
Excessive breakfast short acting
He’s getting a bounce from his earlier low. THe body not liking lows kicks in sugar “too late” but kicks it in anyway…
Now why would you want to split the lantus dose??? Splitting means at at least two points in the day the front and back end of either dose you have literally “double” coverage where the two doses overlap. That should be factored into the discussion too!
Merely my opinion I could surely be mistaken…
Stuart . .
There is an obvious (to us) gap starting about 2 hours and going about 2 hours after the Lantus dose - so that is a toal of 4…
He takes less than half ‘per carb’ rapid for breakfast as he does for lunch and dinner… Any less and he might as well skip it completely.
We try to take the bounce into consideration… Really, we have thought about your 3 points and have not been able to come up with any other solution than too much Lantus at times and not enough at other… Thus the thought about splitting.
