I currently am at 22 units of Lantus and I low carb (30-50 carbs a day). I am finding that my morning BGL's are in the 60's 2 hours after eating (2 hardboiled eggs, 8 oz V8 juice for a total of 10 gms of carbs). When this happens it usually tells me it is time to go down with my Lantus; however, what I am finding is as I go down I continue to stay lower in the morning but as the day goes on, my aftermeal bgl's are rising. I should note that last week I was at 28 units and came down to 22 about 3 days ago. A month ago I was at 30 units and it didn't seem like enough lantus then suddenly I started going low in the morning and went down to 28 units and that worked perfect for awhile then started going low in morning again, during that time, I did lose about 12 lbs. Now, my 2h pp readings are quite a bit higher after lunch and a lot higher after supper. Previously I was able to keep my bgl's between 75 and 110 and now my after meal numbers are creeping into the 150's to 180's and taking a long time to come down. So, I am thinking my basal is maybe too high but then when I see my getting higher as the day goes on, I am thinking my basal is not high enough (I know the basal is not supposed to help much with spikes but this pattern is happening with the lowering of the Lantus). I also take 1000 mg Metformin in the morning before breakfast and late afternoon before supper. Any ideas or help would be appreciated.

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My idea (although I am unfamiliar with the drug) is that your Metformin dose may need to be increased or changed to a different drug. I believe Metformin helps your body use the insulin you produce, especially after meals?
If you are taking the Lantus in the evening, it could also be that it's wearing off as the day goes on. When I took Lantus it didn't last 24 hours for me and I had to do two shots each day, otherwise my blood sugar would rise a lot towards the time of the next shot.
I was wondering if it was wearing out as the day went on. It never used to but that would make sense with what I am seeing.
Good point Jen. Splitting your lantus dose in two doses every 12 hours may be beneficial. A lot of type 1s prefer it.
Make tiny changes and track according. Lantus is not intended to help you recover after a meal. It is a basal insulin. It may peak for a period of time. It definetly is not a straight line basal. I noted that you also mentioned a weight loss. That can make a change in your dosage. When I was on MDI, I had to change to a morning dose vs. Night dose. It seem to help. Your numbers are good great A1c.

Before I went on the pump I was taking 80 units of Lantus a day. And I struggled with keeping my numbers in line. A simple change by my Dr. on total daily dose and I:C ratio made a big differance.
I take a split dose of Lantus and do pretty well, but I also take Humalog to cover meals. I'm also on Amaryl and metformin to help me keep my BG's under control.

Myabe if you tried a split dose or injecting at different times of the day, you might get different results.
Thats what I am thinking, a split dose may be the solution.




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