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Gaia
08-26-2009, 06:51 PM
Sorry in advance for the stupid questions.

What exactly is a Lantus peak? When does it happen and what happens? How do you determine when the peak is?

Thanks. :o

momma_fish2007
08-26-2009, 07:03 PM
I'm still semi-new but I understood that Lantus didn't peak that it just kicks in after 5 hours and then is a steady level til it's out of the system.

CaelinsMommy
08-26-2009, 07:52 PM
Since theoretically Lantus is supposed to keep BG's steady within 40 to 50 points; it is my understanding that a Lantus peak is a point in time when the Lantus kicks in and drags the BG down in a similar action to a fast-acting insulin. Like everything else if there is a peak the timing will vary from person to person. I used to think that Caelin had a peak but then figured out what the endo's office was doing; giving an uncovered bedtime snack to cover for a dose of Lantus that was actually too high. I would think that, however, a peak would occur in an individual who the Lantus does not last a full 24 hours for. (there was something in the endo's thinking out loud about this when we switched the time of day we administer the Lantus)

ETA: This is just my personal understanding. It may or may not be correct.

hawkeyegirl
08-26-2009, 08:45 PM
We never saw a Lantus peak, but some do. It's a time when the insulin is at its strongest. Some people give Lantus during the day so the peak will occur while their child is awake.

Becky Stevens mom
08-26-2009, 08:48 PM
We were told that lantus wasnt supposed to peak thats one of the reasons we wanted to switch from NPH which had a definite peak where Steven would have to have enough carbs in him or he'd go low if the peak happened when he didnt have food in there. Ive read that lantus does peak in about 20% of users. This is when after a period of time its action becomes stronger kinda like the NPH and can drive BGs low if there are no carbs being eaten then. I think to figure out if your kid is having peaking with lantus you would have to test at night to see if theres a marked drop ever. Steven will sometimes drop low about 6-8 hours after getting his lantus shot. And remember Kris, no questions stupid in here:cwds:

haffgus
08-26-2009, 09:06 PM
My understanding is that Lantus does not peak, but works steadily throughout the day. Keep in mind that the body's insulin requirements are not steady throughout the day. Erica requires less background insulin mid to late morning, and more background insulin in the late afternoon/evening. When she was on Lantus, this required us to make sure she had a 15 carb free snack mid-morning so she wouldn't go low, and more insulin with her dinner Novolog shot to keep her evening BG in range. If you are seeing a pattern when at a certain time of day when your son is going low, and think that the Lantus is "peaking", it may just be that his body's needs for background insulin at that time of day are low. With the pump, we are able to set the background (basal) insulin by the hour to give her less insulin in the late morning, and more in the evening.

BrokenPancreas
08-26-2009, 10:17 PM
Hmmm.
I have been logging forever, and my dd goes low around 12-1 in the afternoon.
She gets her Lantus at 7Am

I have since learned to give her an uncovered, and I just realized that I should have the doc put this in the 5o4.

I Was also told that Lantus has no peaks or valley's, but thanks to you guys, I think I figured out why she goes low at that time!

Heather(CA)
08-26-2009, 10:37 PM
From what I understand, about 25% of kids get a peak with Lantus, Not the big one like on NPH...But still, a peak. YDMV but for most I think it's around the 4/5 hour mark. Something that MIGHT help if you think your seeing a peak would be to always give Lantus in the bootie. This helps with slow absorption. My son has never had a peak, so part of what I said I picked up from being here.:cwds:

Heather(CA)
08-26-2009, 10:38 PM
Hmmm.
I have been logging forever, and my dd goes low around 12-1 in the afternoon.
She gets her Lantus at 7Am

I have since learned to give her an uncovered, and I just realized that I should have the doc put this in the 5o4.

I Was also told that Lantus has no peaks or valley's, but thanks to you guys, I think I figured out why she goes low at that time!

Does she exercise just before that time? If so, it could be that too...:cwds:

wilf
08-30-2009, 08:26 AM
I actually ran a poll on here, and I believe about 2/3 of respondents indicated that they observed a Lantus peak for their child. Lantus is a remarkably steady basal insulin compared to the older basal insulins like NPH, but it does nonetheless seem to have a noticeable peak (a concentrated time period of a few hours when it pulls down BG levels).

You can find the poll here:
http://forums.childrenwithdiabetes.com/showthread.php?t=35041&highlight=Lantus+peak

buggle
08-30-2009, 10:36 AM
Brendan had a noticeable peak. We split his dose to try to even things out. Since he's been pumping, he's so much more stable than he was on Lantus. He must be one of those people where Lantus doesn't release very evenly.

MamaC
08-30-2009, 11:48 AM
Since starting Lantus, Tom has had a "peak" at the 5 hour mark; just recently it has been noticed at about the 4 hour mark. It is a much gentler peak than NPH or Novolog. What we try to avoid is a "dual peak" where Lantus and Novolog are potentially peaking at the same time. If he shoots them at about the same time, we are good. If he shoots Novolog a couple of hours after Lantus, not so good. With him splitting his Lantus AM and PM, this can present a dosing challenge a couple of times throughout the day.

Gaia
08-30-2009, 12:03 PM
Thanks for all your replies. I think I understand it better now. Im not so sure if Joey is peaking or not. The other night when he went to bed - after taking his Lantus- he was 111. This was about 10 pm. When I checked him at 245 am he was 149. Since his correction factor is 150 and above, I didnt correct. He woke up at 225. GRRRRRR. Some days he will wake up in range a few days in a row, then he'll have some lows so I lower the Lantus by 1. Few more days of in range numbers then up he goes again. I just cant figure this out!! ( insert hair pulling smiley here. - we REALLY need this on here IMO )

Heather(CA)
08-30-2009, 02:36 PM
Thanks for all your replies. I think I understand it better now. Im not so sure if Joey is peaking or not. The other night when he went to bed - after taking his Lantus- he was 111. This was about 10 pm. When I checked him at 245 am he was 149. Since his correction factor is 150 and above, I didnt correct. He woke up at 225. GRRRRRR. Some days he will wake up in range a few days in a row, then he'll have some lows so I lower the Lantus by 1. Few more days of in range numbers then up he goes again. I just cant figure this out!! ( insert hair pulling smiley here. - we REALLY need this on here IMO )

A peak would make him go down at the 4/5 hour mark, not steadily up...If this happens two days in a row. I would up the Lantus 1 unit. :cwds:

Gaia
08-30-2009, 02:54 PM
Well, this was Friday night. Last night he stayed over a friends. If I do a 3 am check tonight will I still have even results with skipping a night?

wilf
08-30-2009, 04:06 PM
Well, this was Friday night. Last night he stayed over a friends. If I do a 3 am check tonight will I still have even results with skipping a night?

What do you mean, skipping a night?

Becky Stevens mom
08-30-2009, 04:22 PM
What do you mean, skipping a night?

I think she means testing during the night, not skipping the lantus dose:)

Heather(CA)
08-30-2009, 05:06 PM
Well, this was Friday night. Last night he stayed over a friends. If I do a 3 am check tonight will I still have even results with skipping a night?

Yea, I probably wouldn't have trusted the night he stayed at a friends house anyway lol:D

Gaia
08-30-2009, 05:09 PM
What do you mean, skipping a night?

Yes, I meant the 3 am check, not the dosing. Sorry if I wasnt clear :o

wilf
08-30-2009, 10:21 PM
Yes, I meant the 3 am check, not the dosing. Sorry if I wasnt clear :o

Ok, I just wanted to be sure what you meant. :)

Anyhow, I'd normally not change Lantus unless we had two "normal" nights in a row where BG was rising or falling significantly (by more than 40 points) overnight..