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Permalink Reply by Jodil on October 5, 2011 at 2:33pm

Sorry to hear this. When sugars are high in the am this is called "Dawn Phenomenon". I have the same thing and have not really found a way to fix my sugars except I take my Lantus at bedtime and then I may give extra humalog to bring down my sugars or in the middle of the night or very early morning I take an extra shot to bring them down.

My endo did suggest splitting the Lantus dose but I have not done this.

Good luck

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Permalink Reply by Dennis on October 5, 2011 at 8:28pm

I Use MDI- Used to Use Lantus, Now Levemire as my Basal and Novalog..Ave 6% A1c's for Yrs now but it's been very difficult with alot of Extra Testing and Constantly Changing ..

Per One Starting Method for Determining How Much Basal to take ( From the Book-Think Like a Pancrease) and I will try to Explain it, but I strongly Suggest you Get the Book..

Formual For a Starting Basal
1. Your weight
2. X 0.454 to get How many Kilo's you weight
3. And Here's the Tricky part.. There are Different Factor #'s , depending on:
A. Your Age
B. Being Very Active, Moderately Active to InActive..( Senendary) ..
4. Using and Adult that is Moderately Active = a Facotr btwn 0.20 to 0.50 or ave of 0.35

5. EG: Adult Female, weights 100 lbs x 0.454 = 45 Kilos x 0.35 Factor = 16 Units of Basal for 24 hrs..
6. The Goal is Supposebly to Have your Basal Cover your Overnite BG's and keep it from going No More than +30 Pts Higher than what your BG's were when you went to Bed..
Thus you go to bed with 100, Should get up no higher than 130..

7. The Trick I found was? Taking Enough At Bedtime to do that and NOT Go Hypo over nite..

8. And If After a Few days your Getting Up Higher than that +30 pts more? You're Supposed to INCREASE That Basal Dose In 10% Increaments.. every 2-3 days , until you start Getting Up No more than +30 pts higher than your going to bed with..

9. In the Meantime, while your doing this part, you Set your Alarm to Reach over on your nightstand and Test. and if your Above 120? Take a Correction Boulus Of Novalog to get you thru the Nite.. ( or the next 3-4 hrs ) and then Make a mental note to increase it by +10% the Next Nite..and so on..
and keep Waking up and testing 3-4 hrs after Taking your Basal and take a Correction if Above 120, until your Finally Waking up after that 3-4 hrs and staying at or below 120 range..

10. If your Testing 3-4 hrs after and Your BELOW 100? You best Take a Glucose Tab to keep from going Hypo.. and thus REDUCE your Basal by -10% the next nite..

In your case of Getting Up in the AM with 150-200's? And assuming your going to bed IN Range of btwn 100-120? I would Increase Your Basal Dose by +10%, every 2-3 nites until you are Getting Up In Range..

If I go to bed with a Above 120? I also Take a CB.. of novalog + My Basal..( Seperate Shots of course)

Caution! I had Lantus Spike on me after about 2-3 hrs..! Thus Make sure your Going to Bed at or above 100 and test in that 2-3 hr Timeframe to be sure your not going Hypo..

Then there is Doing A BASAL TEST.. Google It..

The Lantus May last 24,16,12 or even only 8 hrs in you, thus Why gots to do a Basal Test.

I found That My 1st goal with LLI was to Just to Get up in the AM with-in my Target Range ( 80-120) and If my +4 hr Readings AFTER my Lunch & Bolus of Novalog , were Too High Per my I:CR.. ( Insulin-to-carb-Ratio) Then That was a Indication my Basal was Slacking off after about 12-14 hrs and I best Start Taking a Booster ( or 2nd Basal Dose) at Lunchtime.. ( this Is because I new my Novalog Last only Less than 4 hrs in me )

If your Going High After Getting Up and Btwn Bkst and Lunch?
1- I hope your eating Bkfst of some kind
2- Your I:CR ( Insulin-to-Carb-Ratio) may not be Enough- Reduce your I:CR to take More Insulin..
3- If drinking Coffee in the AM? It can Raise BG's.. I have to take 1 unit for every Cup I have ( With Creamora ) Since the Caffine Stimuates My liver to Put out Sugar...


I hope that Helps

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Permalink Reply by EGirl on October 6, 2011 at 3:13pm

Wow. This is really helpful! thank you so much for taking the time to write this. I am DEFINITELY going to give this a try. :)

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Permalink Reply by Zoey Stevens on October 6, 2011 at 6:03pm

hey Friend, I have seen the head hancho at the Whittier Diabetes research institute, and she had me split my Lantus dose, to see what might happen. I did and it brought my overall numbers more in line throughout the day and in the mornings. She also had me increase my Apidra (fast acting insulin) to a higher ratio in the mornings. I'm no doctor, and everyone is different, so check with a pro before you try anything that anyone here suggests might work.

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Permalink Reply by Nancy on October 6, 2011 at 6:22pm

I use to be on MDI and had to split my Lantus dose into 2 rise starting at 3pm that would just keep going until bedtime. I ended up having to split my dose, one was at 11pm at night and the other was at noon and here's the weird part, my night dose was 4 units higher than my noon dose. It is a matter of trial and error but be conservative in your changes and test like crazy. Good luck.

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Permalink Reply by christy on October 24, 2011 at 3:53pm

I split my Lantus dose cause I just cannot seem to do more than 18 units at night without dropping REALLY low...but then for those later morning hours around 10-11, 18 isn't enough to cover me, so I take it every 12 hours and it worked well for me...trying to get it back to where it was working...had an issue with insurance paying for Lantus and was on Levemir for almost a month and having HORRID results with it.

@ Nancy my night Lantus is 18 and I take 13 during the day. Yes it is definately trial and error and finding what works, but definately be conservative in any changes you make and test a lot.

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Permalink Reply by Cinderfella on October 30, 2011 at 6:19pm

I have been on Lantus for approximately 5 years, starting with one big dose at bedtime. By dinner time the next day, it was pretty much worn off. It's been my experience that Lantus does not work for 24 hours like promised, but really more like 18 or 20 hours. That would leave one with a huge hole in coverage towards the end of the duration. I started splitting the dose in two about a year into it and that has made a huge difference. I take half in the morning and half at dinner time. I would highly recommend it.

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