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Novolog just isn't quick enough...

Discussion in 'Parents of Children with Type 1' started by CButler, Jan 22, 2009.

  1. CButler

    CButler Approved members

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    DD is on the high side (200s) today due to basal changes gone wrong. On days when she wakes up high, Novolog just doesn't work quick enough for us. It takes a good 2 1/2 hours to REALLY bring it down. I know it's morning(late morning here), but I bet I will be fighting this until afternoon. Then all I hear is "I'm hungry" all day until it gets down.

    Question:
    Does anyone else have the same problem?
    Would Aprida help us?

    It's frustrating to make basal changes, find out it needs to be changed again and wait it out.

    Last week was lows, this week highs. UGH!
     
  2. StillMamamia

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    We get the same - if BG is high at awakening then insulin resistance is greater.
    I don't know if Apidra would help:eek: but my feeling is Novolog works, just needing more basal tweaking.

    Good luck.
     
  3. BozziesMom

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    Call your endo and see what they think about the Apidra. I know lots of folks see faster action with it. We don't, but we're weird anyway. :rolleyes: But we are having better luck with it overall now that we're getting in the swing of it. The loss of the tail has been great.
     
  4. czardoust

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    I would see if the Lantus needs to be raised or if you can give her a second dose 12 hrs after the first one. Ask the endo, Kat had Dawn Syndrome (the creeping high BS) before we switched her to Lantus twice a day.
     
  5. CButler

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    I am finding that the Lantus, given at 8Pm every night, is not working the way I WANT it to (HA!) all day. She needs less between 5-7AM,and afternoon through early evening, and more 8AM-lunch. I was thinking of asking the endo about splitting the dose or maybe even Levemir.
     
  6. jdr

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    Our endo told us that if BG stays high for several hours that it often takes a larger dose of fast acting insulin to break the high. (body builds up more of a resistance to the insulin) This seems to hold true for us.
     
  7. BozziesMom

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    Have you tried giving it in the morning?
     
  8. Skyefire

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    You might want to try give the Lantus in the morning, Phoenix is the same way, he needed the peek of the Lantus to be in the morning and needed it to be weaker at the same time 5am-7am (That is still his lowest basal rate of the day) it might help keep the numbers in check again. Also I find with Phoenix when he wakes up high I need to give him a little bit higher dose of bolus, even if it is just a tiny bit helps him come back into range quicker.

    Good luck
     
  9. CButler

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    What time in the morning? And ONLY in the morning? not split?
     
  10. BozziesMom

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    Yep. I would think first thing in the morning - maybe around 7 so that it kicks in right when her needs are greatest. Then it should be tailing off of a bit by that 5-7 am.
     
  11. Skyefire

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    We gave it at 7-8am depends on when he woke up so it peaked about 90 mins later. I was told the reason to do this is because sometimes it does not last the full 24hrs so at the tail end it is usually still working but not as strong as when you first received the dose. Perfect for early morning sensitive basal needs.

    I would not split the dose without try the AM first, my worry would be the 5-7am window and I would worry about having a bit to much in her body at the time of day with 2 injections... Also why switch right to an extra injection if you dont have to.
     
  12. twicker1

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    We always did Lantus in the morning, never in the evening. We did try to split the dose for about a week, but it was hard to get the evening dose if we were out and about. The only problem is that from our experience and what I've read, Lantus (although it's not supposed to have a peak) peaks about 4-6 hours.

    We are on the pump, and I still don't see the Novolog really working on BG until about the 2.5 hour mark. I've never been able to understand post meal numbers because he could be high at two hours, but at the third hour he will drop like a rock.
     
  13. cwdAdmin

    cwdAdmin Administrator Staff Member

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    Off-label Reminder

    Although Apidra and Lantus use is off-label for children under age 4 (Apidra) and age 6 (Lantus), health professionals sometimes still prescribe these medications.

    Please discuss the options, benefits and risks of off-label medication use with your diabetes health care team.
     
  14. Rusty

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    Why is Lantus off label for children under 6 ? London started on it at 16 months of age. I was never told this, is there something i possibly should know about him using lantus at his age ?
     
  15. CButler

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    Elizabeth has been on Lantus since a month after her diagnosis, but now she is 6.
     
  16. twodoor2

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    With Novolog on a syringe, overbolusing helps because it will start coming down a bit faster, but you have to be very careful and check BG every hour to make sure it's not coming down too quickly or she doesn't go too low. With a pump, it's much more easy to correct with Novolog because it gives a running estimate of IOB so you don't overcorrect with carbs later after the overbolus. You can also set higher temp basals to get that correction working better and faster.

    Typically, if it takes Novolog a long time to get the BG down, and you're not getting into range after the correction, there might be a basal issue and/or an inaccurate ISF. This might not be your case, but I would urge you to make sure that these variables are correct before you just switch over to Apidra, because if you don't fix these issues now, you're likely to have the same issues even with Apidra.
     
  17. CButler

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    Yes, you're right Marsha. There's no need for me to change to quickly. We were having a bad day that day and I was ready to chuck it all! She has been going back and forth on the basal amount since she is STILL honeymooning. And I think the Novolog problem is also that she has some emotional issues and sensitivities and peaking numbers make it worse.

    We go see the CDE next week and I will get her opinions. She is really good.

    Thanks for the advice everyone has given.:cwds:
     
  18. cem

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    Apidra

    I know people have had great luck with Apidra and I am so glad, but we have found in our daughter (it is truly different for everyone - a blessing and a curse) it doesn't have a faster onset, just a faster drop between 2 and 3 hours after we bolus. Since she is 3 we can't prebolus before meals (sometimes we can but not always) and on Apidra she is spiking higher after meals than she did on Novolog. I can't wait for something truly faster than Novolog for us!
     
  19. wilf

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    Why is there a sticky on this thread?
     
  20. Lisa P.

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    My guess is to sticky the moderator note about apidra to avoid giving the appearance of advocating an off-label use.

    CWD went through a few adjustments in March, I would guess there are more difficult waters to navigate legally as you become more of a public entity. :confused:
     

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