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Lantus ?

Discussion in 'Parents of Children with Type 1' started by Sari, Jun 5, 2013.

  1. Sari

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    So Ross is on a pump. Has been since the day of diagnosis.
    When we go on vacations, the doctor always recommends for us to do a shot of long acting so he doesn't have to wear his pump all day and just attach for bolus'. Well the times we have tried it, he runs very high. It's totally frustrating. i thought this should have maintained him throughout the day. We tried again yesterday for a water party he went to. He gets 8.45 units of Basal for the day so i gave him 9U of lantus (bolusing throughout the day with the pump). He was in the upper 300s and 400s all day.
    Would love to hear some thoughts of either better ways to deal with water days or what I am doing wrong.
    thanks for the tips.
     
  2. Meredithsmom

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    Keep in mind that the activity and excitement can raise b/s as well.
     
  3. SandiT

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    I can't answer from pump experience, but I'll give a broad answer based on personal experience and what I've read here.

    I've read here (and experienced) that conversely to what you might expect, being on vacation tends to increase the need for insulin. Now, because the kid tends to be more active, you might think it would decrease the need, but it seems to work the opposite.

    While we were on vacation, my daughter's NPH needs rose day by day the entire time, and decreased after we got home. This seems to be reflected commonly by other posters on the board.

    So... my point is that maybe your young one needs a higher basal rate. Perhaps it's not simply about pump versus lantus, but rather about his needs being higher period, because you're on vacation.

    Talk to your endo and perhaps together you can come up with an increase amount of the lantus that's safe and effective.

    Hope that helps, and/or that you figure it out in a way that works for your family! :)
     
  4. hawkeyegirl

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    Frankly, I don't think it's terribly good advice to switch to Lantus just for a day or two. The correlation between pump basal and Lantus is not 1:1, and it could take up to a week to figure everything out. Personally, I'd rather cut open my own abdomen and give my own pancreas to my son to use than try to figure out Lantus for a couple of days. ;)

    We ended up doing "Cut the Cord" and got ourselves an Omnipod unit for $199 to use on waterpark/swimming days. We just had our first opportunity to use it this week, as our MM died, and it's going okay. I don't like it as well as our MM pump, but it does the job, and I think would be a much easier switch for a few days than Lantus would be. Just a thought.
     
  5. nanhsot

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    My son drew me an entire graph of why this is true, when he went on lantus for pump failure the other day. He's going into engineering if that tells you anything! Basically it takes a few days for the lantus to truly be working at its best, so doing it for a day or two here or there really doesn't work well.

    For water days we typically just hook up every so often and give missed basal as a bolus. In my son's case activity, particularly water activity, tends to cause lows so it works out well for him to just give the missed basal sporadically and then he hooks up for meals and time out of the water.

    If he's not actually immersed in water, he stays hooked up.
     
  6. nebby3

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    Also shots usually require more insulin because the one big dose is less effective than the little dribbles all day from a pump.
     
  7. SarahKelly

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    we tried this also and didn't have much success...instead now we bolus for missed basal right before removing, then again every hour or so based on BG numbers. We found our first trip to the waterpark that he didn't need much bolusing for missed basal as we were walking around a lot. Also, we increased his basal for the car ride there to about 150% of what it is normally at, not sure if that changes things, but it seemed to work. Oh, and again for the car ride home we increased it to the same amount for an hour.
     
  8. hawkeyegirl

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    I probably should say what we did before we got the Pod. We would bolus for half of missed basal every hour. When we reconnected, we'd do something random (like a full unit) and an increased basal of 200% for an hour. But still if we tried to be disconnected for more than 2 hours, it was a disaster.
     
  9. Michelle'sMom

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    ^^^I agree.
     
  10. Mish

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    Other than a waterpark or day at the beach, is there a particular reason why wearing the pump is something you don't want to do while on vacation?
     
  11. Sari

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    No, but the vacation is a big celebratory vacation to Aruba this year. Will be pool and beach all day, every day.
     
  12. Mish

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    In that respect, a pump vacation might be nice for him. Like others said, the going off for a day is hard. But since you already know it's a problem, what I'd suggest is maybe starting the lantus while still running a bit of basal through his pump for a day or two before your vacation (maybe replacing 50% of your basal with lantus) And then give him a few days to just get used to lantus being in his system again. This way you could easily correct any highs with temporary rates but you could also turn the basal off on his pump if you start getting too low. You could also keep a tiny bit of basal running the whole time - he could wear his pump when it was convenient but take it off most of the time.

    Maybe that would work.
     
  13. Lee

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    This is true, the other issue not mentioned here is that Lantus takes up to three days to exit the body, so you are potentially messing up the following up days.
     
  14. hawkeyegirl

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    Get the Pod, seriously. I can't help but think that it would be much easier than dealing with Lantus.
     
  15. MomofSweetOne

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    Ditto this wholeheartedly.

    Another fear I would have about traveling out of the country on Lantus would be intestinal upset and the havoc it wrecks with diabetes. You can't turn Lantus off or down once it's been injected.
     
    Last edited: Jun 5, 2013
  16. Lee

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    So true, so true! If you do give Lantus, brush up on your Mini-Glucagon doses. That really helped me when I was used to temp basals.
     
  17. swellman

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    Personally, I think if you need to move from pump to MDI for a vacation then you're doing something wrong. IMO just pump through the vacation and use MDI as an emergency backup.

    $0.02
     
  18. Heather(CA)

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    When you say for the day do you mean for 24 hours or just daytime hours?
     
  19. greenpalm

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    We were told to only make Lantus changes once a week because it takes so long to see the effect of the changes. I'm adding this because it supports what others have said about it not stabilizing right away.

    Incidentally I'm terribly jealous that your son it to use a pump from day 1. Oh the hoops I've had to jump through to get my daughter one. We have it now, but she can't use it just yet. Gotta go get educated.

    Enjoy your vacation! Aruba is lovely. <blush> my daughter was conceived there. We joked about naming her Aruba. ;-) we could have nicknamed her Ruby!
     
  20. Beach bum

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    We swap over to untethered using Levimere in the summer and it definitely takes a few days for her body to adjust. And we definitely cannot do a 1:1 swap over, we usually have to increase the dose. In addition for us it doesn't last 24 hours so we hook up during the night and give her about 30% of what her basal would have been overnight.

    I so wish we could have cut the cord but my daughter is having some skin issues and when she tried the sample pod it only made it worse:( (even with barriers).

    If we were to successfully switch for a day, we'd have to do it for about 3 days to get the numbers just right. For us it's just easier to plug in and replace basal as the day goes on.

    Just thinking, is there a particular time of day he runs high? For example, as I stated above my daughter doesn't get 24 hours out of Levimere, so we hook up over night to supplement.
     

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