Questions about Lantus

[Kyle's Mom]

My son was just switched to Lantus about two weeks ago. We were started on just two units of lantus and are now up to six. We give it in the a.m., around 8:00 a.m. I had been warned that it would take a while to get the dosages correct. My question is this. My son could go to bed at 10:00 over 200 and be 60 at 11:30 p.m. (or at his 2:30 a.m. check) with no correction given at bedtime. Does this usually happen with Lantus? Any suggestions? Thanks!!!!!!!!!

[Nancy in VA]

We used to have a nighttime low with Lantus. It didn't matter if we gave it morning or dinner, we still had the nighttime low. We honestly just got to the point of expecting it and trying to get it more at 10pm than at 3am because it was easier to deal with if we were still awake!! Not kidding -that's what we did. The CDE had run out of ideas for us except 1) go to the pump (which we were planning on doing) or 2) switch to Levemir.

[MelissaC]

Danica,

We are starting to experience this problem too - Although I think it is due to too much Lantus - We have been all over the place lately and have gone from 6.5 units at 8pm to now 9.5 all in the matter of three weeks - sometimes it works and sometimes it doesn't... I have heard others on this board speak about splitting doses - 1/2 in the am and 1/2 at night - Sorry I can;t help but wanted you to know that I can relate :cwds:

[Amy C.]

My son was on Lantus for nearly six years. I learned to base the dose needed on the night time blood sugar reading. I adjusted the whole day's dose based on the middle of the night reading. Then I adjusted the Humalog so that he stayed in range during the day.

The best control we had was when the Lantus was split into two shots: one at 10:00 pm and the other at 7:00 am. After about 6 weeks, I grew weary trying to remember the doseages for all the shots and decided to use the pump.

Giving a heafty bedtime snack may help in your child's case.

[Abby-Dabby-Doo]

Danica~
(I like your name)
Is this nightly or a couple times a week? I like the advice the others gave you, I just wanted to throw one more at you. Could it be that he's having a lot of exercise that day, and it's effecting him in the middle of the night? Blood sugars will drop 12 hours later from high activity (or sometimes later than 12 hrs). Just something to watch for if this isn't nightly.

[ScottB]

We had issues with lantus for a while as well but I think it was because our son's pancreas was still putting up a fight. He has always taken it before bedtime and at fist his Endo unit kept raising his dosage every week because at first his morning BG would be the higher than his bedtime BG but suddenly he started waking up in the morning with a dangerously low BG and hypoglycemic. We then kept reducing his lantus dosage 2 units at a time, wait 2 or 3 days to see if we noticed a change and do the same routine again and again until we found a balance. His BG was taking such a nose dive that we were intentionally having him go to bed with a high BG to counterbalance the possible nose dive in his BG so he wouldn't wake up hypo. It took some time but once his pancreas was done "honeymooning" we finally found a dosage where he can go to bed with a BG of say 120 and wake up with a BG between mid 90's to 110. He will eventually be on a pump but that wont be until the first of the year.

[hartpukas]

We have been on Lantus for over a year now and we experience the same low(s). I am in the habit of checking her every two hours after she falls asleep - granted there are many nights that I am not checking e-v-e-r-y 2 hours, I base it on her numbers. Regardless, I usually need to give some milk to bring her up and to fight off a possible lo - lo. We base her needs for Lantus on her morning numbers (we give her Lantus in the a.m.) if she starts waking up "higher" for a few days in a row then we increase Lantus by 1/2 unit.

We can rectify the need of nightime checks if we switch to a pump however we are just not ready yet. I want to...but she just started preschool and things are going well so I dread rocking the boat. I am thinking of starting the pump next summer. :confused:

[payam7777777]

My son could go to bed at 10:00 over 200 and be 60 at 11:30 p.m. (or at his 2:30 a.m. check) with no correction given at bedtime.

reduce the lantus dose IMMEDIATELY!

it's obviousely too much for him.

start by say 3 units instead of 6 and observe him during the night: test at 10:00pm, 12:00pm and 2:00am if his bg stil drops more than 30 reduce the lantus dose even more say to 2 units. do the adjustments in the lantus dose until when the bg drops/raises no more than 30 point during the night.

[Heather(CA)]

My son was just switched to Lantus about two weeks ago. We were started on just two units of lantus and are now up to six. We give it in the a.m., around 8:00 a.m. I had been warned that it would take a while to get the dosages correct. My question is this. My son could go to bed at 10:00 over 200 and be 60 at 11:30 p.m. (or at his 2:30 a.m. check) with no correction given at bedtime. Does this usually happen with Lantus? Any suggestions? Thanks!!!!!!!!!

Too much Lantus...No that doesn't usually happen. Your goal is a 40 point differance. We usually do way better than that. I know a lot of people will disagree with this, but, we have had AWESOME results with Lantus, IMHO it's a lot easier to adjust it when it's given at night, and if you give it in the bootie, it helps with the slow absorbtion;)

Test him 3 hours after dinner then use THAT nuber for the 40 point differance. Fr example, if he's over 200 at 10. but yu ate a late dinner at 8, that's not a true reading, waith until 3 hours after dinner or shot if you give it after to know your starting #. The use the Lantus to keep it there throughout the night.

If he's say 200 three hours after dinner, then wakes up at 210. The Lantus is right, it's the fastacting that needs a change after seeing a pattern. I hope this helps....Lower the Lantus...

[TeresaB]

My daughter is on Lantus. Although still honeymooning, it took from the end of June until now; Sept. to get the dose straight. We give 1/2 u at 8pm every night & yes, I agree to adjust the whole day short acting insulin in combination. Olivia goes to sleep at about 170 and wakes up at 7am at about 100 bg. This seems to work for now. There have been a lot of nights at 3am prior to this that we had to give juice. We also give a hefty snack before bed like ice cream or Kashi bar w/ peanut butter.

[jeep_bluetj]

1. A 120ish drop in 2 hours is massive for just the basal insulin. Particularly 12 hours post injection. I'd wager there's something more going on.

2. Are numbers after this drop stable? If so, that gives more evidence that the lantus is less likely the root cause - think of the lantus dose divided by 24. That's the hourly basal. Would that amount (.25u/hr in your case) drop him that much any other time?

3. We (as opposed to Heather) found that a AM injection was by far the most stable (He had a peak at 4hours post, AM solved that)


We can rectify the need of nightime checks if we switch to a pump...

It was very much so the opposite for us. I rarely checked nighttime on lantus. I almost aways do now while pumping. The basal fluctuations seem to be much more wild while pumping.

[Heather(CA)]

1. A 120ish drop in 2 hours is massive for just the basal insulin. Particularly 12 hours post injection. I'd wager there's something more going on.

2. Are numbers after this drop stable? If so, that gives more evidence that the lantus is less likely the root cause - think of the lantus dose divided by 24. That's the hourly basal. Would that amount (.25u/hr in your case) drop him that much any other time?

3. We (as opposed to Heather) found that a AM injection was by far the most stable (He had a peak at 4hours post, AM solved that)



It was very much so the opposite for us. I rarely checked nighttime on lantus. I almost aways do now while pumping. The basal fluctuations seem to be much more wild while pumping.

No need to "oppose" me;) I mentioned that it's not for everyone, and I was talking about those in which the Lantus peaks. It doesn't peak in everyone however, and the time during sleep has no other contributing factors such as exercise or mis-counted carbs. That's why I think it's easier for those w/o a peak:D

[hartpukas]

It was very much so the opposite for us. I rarely checked nighttime on lantus. I almost aways do now while pumping. The basal fluctuations seem to be much more wild while pumping.

wonda'ful. how the heck can i check more than i already am. to pump or not to pump, hmmm... :confused:

[jeep_bluetj]

No need to "oppose" me;) I mentioned that it's not for everyone, and I was talking about those in which the Lantus peaks. It doesn't peak in everyone however, and the time during sleep has no other contributing factors such as exercise or mis-counted carbs. That's why I think it's easier for those w/o a peak:D

Why not? Some conflict makes for more interesting reading.... ;)

Yup - I think we've all seen different results sometimes. Time of administration of lantus is definitly one of those YDMV(tmbadshoe) things. You see one thing, I saw the opposite. Some find splits work. Some find better control with levimir.

Try stuff, and see what works. Too bad that usually means not sleeping during the "try stuff" portion...