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Lantus Question

Discussion in 'Parents of Children with Type 1' started by MrsBadshoe, May 11, 2007.

  1. MrsBadshoe

    MrsBadshoe Super Moderator

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    The korean student I'm concerned about is on Lantus. We have never had either of our kids on Lantus. So, my question is when you are newly DX and take Lantus is it part of your training that they have you test overnight?

    On NPH for the first week or 2 they had us checking at least like 2am...

    Do you need to check over night for Lantus???

    Thanks for the help??
     
  2. gsmom

    gsmom Approved members

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    When my d was dx back in March I requested to go straight to Lantus & yes the Dr. still had us do the overnight check. We did it at 3:00 am, guess just his personal preference.
     
  3. Megans Dad

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    when we were on NPH we tested at 02:00, when we switched to Lantus we tested at 02:00, and now that we are on the pump, we test at 02:00
     
  4. D-Dad

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    Ahh, the old night checking question. I think regardless of which regimen it is important to check at night until you get comfortable with your numbers.

    In my opinion Lantus is much more stable over-all. I was once told that NPH stands for “Not Particularly Helpful” – which hit home for me. I remember after finding out that many people have had issues with NPH, I asked our doctor why they put us on NPH and her response was, “I did not think you liked shots.” I responded, “Who does? But I want to do what’s best for my kid.” Anyway, I believe Lantus for a background/basal insulin combined with a fast acting insulin for boluses is GENERALLY the best MDI solution.

    Having said all this – some people will say you should always check at night. If we only had NPH – I’d agree.
     
  5. selketine

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    We did overnight checks but William was very young. What time of day does she take the shot? Lantus can have a small peak about 4-7 hours (or so more or less) after taking it. This is why we always gave the lantus in the morning. Some people find it wears out at night this way but it didn't for William.

    Seems safer to give in the morning if they are not doing overnight checks! Some people split lantus so as to avoid it not going 24 hours if they have that issue - we didn't.

    Well you know she needs to be checked at least once in the night to see what the heck is going on - this soon after diagnosis. I thought sometimes that people's insulin needs drop off at some point after going on insulin after diagnosis.

    The pedi endo should really be on the ball with them about what is needed - it sounds like he/she is not.
     
  6. miss_behave

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    I think that everyone should check every night. Diabetes doesn't go away during the night. You wouldn't go 8-10 hours during the day without testing, so why at night? Also there is something called Dead in Bed. It is rare, but a diabetic never wakes up in the morning, presumably from a low they never recovered from. As a diabetic teen, that frightens me. My parents check me twice every night, more if theres a problem. If I sleep over a friends house, I also make sure I check a few times. IMO there is too much risk.

    I have been tested at night after a normal day, and been 1.9 mmols (34) for no apparent reason. Lucky I was tested and treated. What would have happened if I wasn't? Would my liver have kicked out glucagon? Maybe, but not definitely. That is why i think it is extremely necessary to check during the night, unless you have a CGMS with alarms.
     
  7. Megans Dad

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    too true, just when a pattern of normal numbers through the night puts us at ease some crazy numbers always bring us back to reality
     
  8. Flutterby

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    The day that K was dx we gave lantus that night and checked at midnight (I believe, its been a while, so I can't remember exactly) and if that number was ok we were ok until 3am.. if it wasn't.. we had to keep checking.. I think that over night checking is extremely important.. especially for a newly dx person..
     
  9. MrsBadshoe

    MrsBadshoe Super Moderator

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    She takes the Lantus in the evening. She is 17.

    I had never heard that there is a peak with Lantus at 4-7 hrs out.
     
  10. Tamara Gamble

    Tamara Gamble Approved members

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    We gave lantus in the morning. I actually know someone who is a rep for Lantus and I asked him about the 12 hour split half and half. He said absolutely not. I know people have done it, I know that it has worked for them but he told me that one of the reasons is 4-7 hour peak during day avoiding night time lows.

    I have to say that as far as night time goes. Ty did much better on Lantus than on the pump. I don't know why, I just know that he did. Never a low at night or upon arising and very seldom anything over 170 upon arising.

    They told us not to bother with night time checks with Lantus. I have to say that I disagree. Tyler is checked every three hours around the clock. There are times that it is less due to grazing at a social event but on the whole we try not to deviate from this schedule.

    Tami
     
  11. D-Dad

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    Lantus has a small peak. Different for different people. Also, on a sperate not, many people do not know what you can draw Lantus and a short acting insulin into the same syringe for a single shot.
     
  12. Megans Dad

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    most people are fine with one shot per day but we know a teenager who had to go to two needles per day for Lantus because it just wasn't working, our CDE/DR/team were fine with that. its better than having and A1C over 10
     
  13. D-Dad

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    I'm having troubles communicating today.... let me try again:

    Lantus has a small peak. Different for different people. Also, on a separate note, many people do not know that you can draw Lantus and a short acting insulin into the same syringe for a single shot.
     
  14. caspi

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    We give the Lantus shot at bedtime (9 pm). We only do nighttime checks when there is a change of dosage, usually for 3 nights. This is per our endo. I will sometimes check late at night if he's had a crazy day.
     
  15. cydnimom

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    Both my son and I use Lantus - we split our shots as well because it certainly did not last the 24 hours. Its given at breakfast and supper - basically 11 to 12 hours apart. Depending on the day - including activity and illness - I usually check my son at 12:00 and if he's under 8.0 (145) I'll check him again at 2:30. If he is over 8.0 he's usually good to go. He's been doing Lantus for 9 mos though so we kinda know (in most cases) what his body will do. In the begininning I tested every night at 12:00 and 2:30.

    For myself I basically do the same. I do wake up in most instances if my blood sugar is low though. I haven't needed assistance for a few years.
     
  16. D-Dad

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    Let me add when we do check at night…..

    1) If we had a low in the past 3 days.
    2) If we are sick.
    3) If we had a lot of activity.
    4) If we change basals.
    5) If we can’t sleep.

    A low in the past 3 days in very crucial to me. I have no hard data on the issue – but anytime I have heard of a bad low or seizure – it seems that there had been a series of “less bad” lows which I believe must have depleted the stored sugar in the liver. So when ever I see low numbers, I’m extra careful – day and night.
     
  17. hold48398

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    When Mia was on Lantus, we started with Lantus in the morning only but found that she was running consistently higher late day and overnight, so we split the dose 2/3 morning and 1/3 night...and it worked great for us. I always tested before going to bed at around midnight and most nights at 3am.

    I am really concerned for the safety of this student. What if her honeymoon kicks in next week or she gets sick? Ugh. I wish I could help prevent what seems like an inevitable diabetic emergency in the near future...
     
  18. Ali

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    The nightime checking is also due to the fact that the basal requirements for many people vary over 24 hours. For me that is true. Lantus did not work well for me, my basals at night did not match up well with the action of Lantus regarless whether I took it AM or PM. I did not try a split dose but went to the pump pretty quickly. Also, Lantus was not constant in my system but again if your basic basal needs vary it can be hard to sperate out the action of the insulin from your bodies basic changes. My 24 hour basal rates go from .8 to .35 and they have changed over time.
     
  19. A&Ds Mommy

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    Dylan gets Lantus around 7:30 at bedtime and then DH checks him every night at 3:30 am. There have been times when we will check him around 10:30/11:00 when we go to bed if he has had a rough day with his numbers or when changing the doses.
     
  20. Mama2H

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    We check Hailey at midnight and 3 am regardless of activity, she is just too unstable to skip it.
     

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