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Questions about Lantus ??

Discussion in 'Parents of Children with Type 1' started by Rusty, Dec 17, 2008.

  1. Rusty

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    I have a few questions about Lantus. I hope someone may be able to explain to me. I guess what I want to know is, are consistent waking numbers dependent on consistent bedtime numbers or willl the lantus work through the night and bring down to desired range ?
    Lets say bedtime check is 150 and waking number is 100.
    Now if bedtime check was 200 would an expected waking number be 150 or would the lantus work and still bring down to 100 ?
    Now on the other hand if bedtime check was 100 would a waking number around 50 be expected ?

    I know Lantus is a background insulin and holds Bg down after the humalog wears off. I would really appreciate if someone could help me better understand how the lantus in designed to work when fasting while sleeping.

    Thanks Rusty
     
  2. danismom79

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    Basal insulin isn't really designed to "bring down" BG (except NPH). Its function is to counteract glucose output from the liver.
     
    Last edited: Dec 17, 2008
  3. Rusty

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    So if the basal is correct should i see very little drop no matter what bedtime number is ?
     
  4. Tigerlilly's mom

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    In theory this would be correct. But it is another YDMV thing, for some Lantus does have a slight peak several hours after being injected.
     
    Last edited: Dec 17, 2008
  5. Kalebsmom

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    For us, when Kaleb was on Lantus we did see some number drops. It all depends on what time he gets the Lantus. When Kaleb would take it at night we had some problems. Once we changed his Lantus to morning it helped even out through the night.
     
  6. Denise

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    hmm, we were just discussing this the other day in re: to Molly. She seems to have huge drops a lot of the time w/ her lantus at bed. She can drop as much as 150 points with it. I wonder if switching it to morning would help her?:confused:
     
  7. Lee

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    The ideal is not to drop or rise more then 40 points - that is how you know it is set correctly. However, many folks have a tough time due to peaks and such.
     
  8. Rusty

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    London gets his Lantus in morning and i still sometimes see big drops, Mostly from 3am till morning.
     
  9. Tigerlilly's mom

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    Rusty - I also see a drop in Tyler around those hours, I used to think it was the lantus, but now he is pumping and I am still seeing the same drop. I think this is common.
     
  10. Lisa P.

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    Others will fill you in better, but I've struggled with this myself, so my take is this.

    In theory, all other things being equal, lantus is supposed to keep you perfectly even. If you somehow didn't eat anything all day and night, the lantus should mean that your bg stayed the same the whole time. That's how you want it set, if it brings you down it's too much, if it lets you go up it's too little.

    In reality, when they sleep, these other things happen.

    Dawn effect brings bg up as the body kicks out more sugar to get ready to wake up. I thought this was a 4 to 6 a.m. thing, but my CDE tells me with a toddler it can be midnight, and we see it at around then.

    If they start higher, their kidneys kick in, so that a kid that starts the fast at 300 will not end at 300 even if the lantus is correct, because she urinates out lots of sugar.

    After a good night's sleep or if numbers are good, lots of people have the pancreas kick in in the early morning hours, so that 150 might stay at 150 with lantus, but you actually see it go down to 80 because your own body is contributing.

    Basal rates at night are different than during the day, we have now seen (thanks, lee) that our kid needs 1 1/2 as much basal insulin during the night as during the day, so fasts at different times show different results.

    When we did lantus, it peaked at 2 hours and then started to disappear at about 20 hours, it wasn't the steady 24 hour drip we thought it would be.

    Like herding cats for us.

    Good luck!
     
  11. TheFormerLantusFiend

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    It shouldn't drop you, but IF you're honeymooning, it should let you drop to normal numbers.
     
  12. Heather(CA)

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    Your right, Lantus is a back ground insulin...It's goal is NOT to lower bg's at all. but to just keep them stable. Giving the Lantus in the bootie is a big help with keeping the bg stable.

    The goal is to keep them within forty points of the after dinner number when you feel the fastacting is gone, for us that's 3 hours, for others it's longer...

    So, If you start at 200, and end at 100, that's too big a drop and the Lantus needs to be lowered. Even from 150 to 100 is iffy.

    I only use Seth 3 hour after dinner number and the morning number to adjust Lantus, there are way too many variables during the day in my opinion to be reliable, exercise for example.

    On the flip side, if you go to bed at 120 then wake up at 180 and this happens a couple of day in a row...he Lantus needs to be raised.

    I hope this helps:cwds:

    During honeymoon, your child can drop into the 80's and it's fine, if they drop into the 70's lower it :) I just learned that from Saxmainac ;)
     
  13. Heather(CA)

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    In that case, it needs to be lowered:cwds: IMO that's too late to be a peak. Lower it by 1 unit. Either that or it's not the Lantus but the honeymoon, what is his after dinner fastacting and waking number?
     
  14. Heather(CA)

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    Is the drop steady? Or sudden? Where are you giving the injection?
     
  15. Denise

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    yes, it is fairly steady through the night...and we give her the lantus in her bum...
     
  16. Heather(CA)

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    If the drop is steady and not sudden like a peak, I would lower it by 1 unit:cwds:
     

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