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Yet another Lantus question

Discussion in 'Parents of Children with Type 1' started by monkeyschool, Apr 22, 2011.

  1. monkeyschool

    monkeyschool Approved members

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    Does Lantus have a calculation/formula to how it holds/drops numbers?

    What I am trying to determine (because the way I am asked that question doesn't even make sense to me) is if there is some formula depending on the amount of Lantus to the amount of drop (all other variables aside) that we see in a peak....or a formula for the amount of Lantus relased during a peak to then try to figure out that drop amount. I am curious if you find that the lower or higher the Lantus dose the lower or higher the drop in number, or if the drop is the same (meaning it starts at higher numbers, but drops the same amount on average)...again all other variables aside.
     
  2. bibrahim

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    I am not quite sure what you are asking but are you wondering about how much you need to go up or down on lantus? We were told to go up or down 1 or 2 units at a time and we based that on the wake up number. If she was under 120 or so we would go down a bit. If she was waking up high, we would go up 1-2 units at a time and wait several days between adjustments.

    The meal doses were all different 1:C ratios after a while. We would go from 1:10 to 1:12 to 1:15 and so on until we got it right. It was never very long until we had to adjust again. Taking the classes really helped.

    On the pump it is the same thing...constant adjustments. I don't know if that helped at all.
     
  3. wilf

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    In answer to what I think your question is, no there is no formula that would allow you to know whether Lantus will have a peak (causing lower blood sugars in your child), and if so how strong. You just have to do testing to find out.
     
  4. monkeyschool

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    Yes, thank you - this is more or less what I am trying to determine, but also if the higher or lower the amount of lantus the amount of drop stays consistant or if the amount of drop varies (proportion vs consistant drop)....ie. If someone drops an avg of 60 at 10 units will the also drop 60 points at 20 units or if that drop numbers gets broader/smaller based on the amount of Lantus.

    I am in the process of lowering Lantus one or two more units over the next couple of weeks and am curious to see if the peak will be less or not.
     
  5. monkeyschool

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    Interesting. So you are making the Lantus change based on the wake up number? We're consistently waking 85-95.....already dropped 3 units, but the wake up numbers aren't really budging yet. I've been trying to do it based on the fasting numbers through the day, but having a hard time that way because we don't have a lot of times when carbs are not at play.

    Thank you :)
     
  6. bibrahim

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    Yes, that is what we did. We started at 17 u then went as low at 13 or 14 u I think. We were back to 17 or so when she started the pump and now she hovers between 18-19 units basal per day. We had a lot of lows on lantus and she has hypo unawareness. Her lowest low was 37. That was not fun to see.
     
  7. monkeyschool

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    Thank you again. 37 seems SO low.....we do 60s a lot, but had a couple of 40s.... 42 is our lowest so far, and for those lows she too was unaware. My DD seems to feel when she hovers around 70, but not when she has fast drops (either Novalog or exercise type lows). Those we've caught by testing alone, but after some juice she will feel awful on the climb back up (and is a bit delirious, itchy, etc...then around 70 she'll start getting the shakes while climbing).

    We'll do another drop in a couple of days and see what we get....we were told 1/2 - 1 unit at a time (but we are on pens so we can't do 1/2). After reading your post I can't see why it would hurt to drop 2 units, after all we'd be heading high rather than low.

    :)
     
  8. bibrahim

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    It's good to check it out with the endo but for me the wake up numbers seem a bit low. It might be good to ask for the dexcom if you can document the hypo unawareness. I wish I would have asked for it sooner. I got into a fear of hypos and her hgba1c showed it. We are working on being more comfortable at lower numbers although the 37 concerned me as I wasn't expecting it.

    The other 37 or so was after being in the hot tub for just a few minutes and I learned my lesson there. Also had a few 39's at night but thankfully worked throught that by adding some more basal adjustments. She has several different basal rates and that is one huge benefit for us on the pump. We sort of had the misconception that they had to be out of the honeymoon before getting a pump then decided to go for it before the end of the insurance year as we had met our out of pocket stop loss from the hospitalization. We didn't have to pay out of pocket for the pump due to this. So thankful it all worked out...it was a little dicey as my insurance was ending also and things were close time wise. Good luck with everything with your daughter.
     

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