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Tricks to avoiding night time lows with Lantus?

Discussion in 'Parents of Children with Type 1' started by Hudson_Rocks, Jun 12, 2011.

  1. Heather(CA)

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    5 units is a VERY small amount of Lantus for a 11/12 year old. So, I would listen to your Endo...They are being conservative.

    Just for comparison, Seth was 7 @ dx'd and I think he started on 7 units.
     
  2. giddyup_go

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    We always gave Lantus at 6 in the evening, around the same time as dinner. If it was necessary to change it a bit, we could safely go an hour either way. If you get off by more than that, you can back it up / go forward by 1 - 2 hours each day until you get it at the time that you want.

    We *always* based the Lantus dose by morning / fasting numbers. Always. And we always aimed to not have BG drop by more than 40 points. But we also always gave a night time snack...the amount of carbs depended on what bedtime BG was.

    Lantus did not "peak" for Elizabeth. My sister had to do two lantus shots though...one in the morning and one at night, because Lantus did peak for her.

    Somewhere around here (this forum) is a great calculation to use to base the lantus dose on.

    When elizabeth was first dx and she was on novolog, NPH and lantus, her lantus dose was 2 units. Once we dropped the NPH she went up to 12 units of Lantus right away. Over the next several months with tweaking etc she was up to 22 units and then switched to the pump. When her pump malfunctioned a few months ago and she was on MDI for 5 days, I started her on 24 units of Lantus and it wasn't nearly enough. I should find that calculation again myself and see what her starting dose would be according to weight, etc. Her TDD for basal on her pump is 23 units, but Lantus always seems to be a higher dose than the 'logs' for basal.
     
  3. Lisa P.

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    If you look at the siggy, the OP's son has a fairly unusual case with other meds involved, I'm sure that makes it more complicated.
     
  4. Heather(CA)

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    That's probably why their starting at 5 units...All I said was listen to your Endo. Do you disagree?:confused:
     
  5. dejahthoris

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    You experience sounds similiar to ours with the exception of the NPH part. We are on 23 units of Lantus and have been a bit higher. This is higher than most folks I have seen, so it is good to see another kids at that age and range. It is something I have wondered about.
     
  6. Lisa P.

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    Nope, didn't mean to sound like I did!
     
  7. Kyra's Mom

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    We have been having the same issues. When I test at 2:00 am DD will be between 240 and 280, but when I wake her up 5 hours later at 7:00 am she can be as low as 50, but usually in the 60 -75 range.

    I did ask my endo about this and was told that she may be in a growth spurt and that growth hormones released during sleep can make other cells insulin resistant and this is why I am seeing a high at night and then a low in the am.
     
  8. emm142

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    I was dx'd at 14 and I'm very very sensitive to Lantus. Even now, when I'm on over 20U/day basal through the pump, I only need 4U Lantus per day. (And I'm not producing any insulin of my own.)

    If the OP's son is only having mildly high BGs without ANY Lantus, I don't see a reason not to start conservatively... I'm guessing when Seth was dx'd his BGs were running a lot higher..

    Of course the OP should discuss this with her endo. But there is no need to blindly accept the endo's orders - she can discuss alternatives if she would feel more comfortable doing it a different way. The dose may likely be raised to 5U or above, but depending on the circumstances it might be fine to start slowly.
     
  9. Heather(CA)

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    5 units is conservative.
     
  10. emm142

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    Sure, whatever.

    I have given my opinions and my reasons for holding them. The OP can do as she and her endo team feel appropriate.
     
  11. Hudson_Rocks

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    The reason for the addition of Lantus is because his fastings have been hovering around the 120-140 range and we would all like them a bit lower.

    So he did his first injection late this afternoon, we decided on 5:30 for now, and 2 units. (I am very conservative ;) ) His pre-(late)dinner BS at 8:15 was 90(!). He hasn't had any Humalog today. Dinner was mostly protein, not a lot of carbs so we did not do any injection prior to dinner. We shall see what his post-meal is in awhile here.

    Thanks again for all the input; I appreciate the different points of view -- gives me stuff to think about.
     
  12. Lee

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    Fasting 120 - 140 sounds like heaven to me ;)!
     
  13. wilf

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    You can give Lantus any time of day. There is a fair range of opinion of what is the best time of day. If the time of day you are using works for you, then stick with it. If you have problems with it, then change it to see if another time works better.

    It is certainly possible to change the time of the Lantus shots.

    Is your son honeymooning?
     
  14. Hudson_Rocks

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    Yes, I would suppose so.

    I am still in the processing phase....a little bit of denial creeps in at times, so it's then that I'm hesitant to say things like he is honeymooning; part of me still hopes it will go away :cwds: Not to worry, the reality is most certainly there underneath it all, but sometimes I like to hide from it, mentally. Does that make any sense?

    When he had his blood work in December, all things looked very normal except for of course the glucose and the islet cell antibodies (1:4, just slightly above the reference range for "normal"). I don't know about the GAD (it shows "normal" on the faxed page but I see no numbers and wonder if I am missing a page; I do know from the endo appt last week that he does not have insulin antibodies). Anyway, the first endo told us that we caught it very very early. His C Peptide then was 2.8 and his insulin random level was 17.1; his fasting insulin level 2 days before that was 13.8 --- if any of that means anything to you. :)
     
  15. Hudson_Rocks

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    When I wrote that I thought: "I bet there is someone who thinks those are pretty decent numbers" :)

    The PA also mentioned it as a way to try and help preserve his pancreatic function.
     
  16. Hudson_Rocks

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    His fasting today was 109.

    About 30 minutes before we were going to do today's dose, he said: "I feel low". Tested, and he was 68! He had not had any quick-acting to that point, and had even eaten some potato chips a couple hours earlier. So, he had a snack and as usual we over-did it and he was 222. :rolleyes: However, he was down to 104 ~3 hours after that, presumably on his and Lantus' steam. So I guess we're doing okay at 2 units for now?
     
  17. Heather(CA)

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    Just a thought...if he'sh oneymooning, that can bring him down as well...:cwds:
     

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