Lantus is a wonderful basal insulin during the day, and I do not want to go back to NPH, Ultralente or another basal insulin, but the results during the day or night are not consistent. How do people with a dawn rise [ED: dawn phenomenon], or another rise during the night manage a Humalog/Lantus plan?

The peakless action of Lantus (insulin glargine) is so well documented that I think that you should start by looking at other aspects of the insulin regimen to explain the high dawn and before breakfast blood glucose levels.

The first is that glargine dose is too small. You might not notice this during the daytime hours, but it would result in high overnight blood sugars. The other possibility is that you are still giving a bedtime snack and here the carbohydrate load (especially if the snack is high in protein or contains unhydrolysed starch) could result in a glucose load that would not be contained by the basal glargine.

DOB