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Permalink Reply by Clare on August 2, 2012 at 3:23pm

I never actually thought about where I inject humalog and lantus, but I routinely follow a morning lantus shot with a morning humalog shot and they are both in my stomach. I guess now I will actually think about where I am injecting before I inject. But I don't think I can remember a time when I wiped out the actions of either of my insulins regardless of where I injected them.

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Permalink Reply by Clare on August 2, 2012 at 3:33pm

I too find lantus is not a true 24 hour insulin. I take 13-14 units in the morning depending on what kind of activity level I am expecting like if it is a weekend and I am playing golf I'll take 13 if it is a work day I'll do 14, then 13 at night regardless of the day of the week. But figuring it out has been a whole lot of trial and error - lows, highs and everything in between. Once you do get it "right" for you it is an awesome feeling just knowing what to expect makes life a whole lot less complicated. So keep at it and know you have a cheering section here to help as much as possible.

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Permalink Reply by dejahthoris on August 2, 2012 at 7:29pm

We do not split the lantus into two doses. I do not want to add an extra shot. We moved it to the morning. This has made a HUGE change for us. His night numbers have been FLAT. Sometimes we have to watch for a peak in the Lantus in the afternoon. Good luck!

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Permalink Reply by Clare on August 3, 2012 at 3:32am

I did that initially started taking the full 30 units in the morning and got immediate measurable results. Both from an A1C point 7.5 down to 6.9 with much less uncertainty, but it was still not optimized so the CDE and I looked through all my meter data and decided to split it. That has further increased control and taken the 6.9 down to 6.1 in a couple of months. It crept its' way back to 6.4 recently but I'm ok with that. Not having to constantly worry about the high/low roller coaster has improved my life immeasurably. I use a lantus pen and nano needles so the extra shot is incidental for me.

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Permalink Reply by Leo2 on August 3, 2012 at 6:09am

Hi Char. Your basal dose is set too high for the amount of Humalog you've been used to taking or you would not get those lows. It takes 3 days for BG to settle after starting it.
Do a basal test: don't eat breakfast the first day, and test every hour, record it; hold off on lunch til 12 so you get numbers thru 12. 2nd day skip lunch and test thru afternoon every hour; 3rd day, skip supper and test thru bedtime and it would be lovely to have a test during the night. Your basal should not cause a fluctuation of more than 30 all day and all night - or are you doing mmol?
This is your choice. The doctor sets the basal dose or you do it. And since you have to deal with it, do the testing so you know what that dose is doing to your BG. If he has a team, you can get some more consult from his CDE maybe.
While some do 1/2 at evening and 1/2 in morning, do not be surprised if you find you do better to have very little in the evening and a majority in the morning or vice versa. When you have test results from around the clock, you'll find a lot of people here can read them and help you interpret what to do next.
When you said you're taking Humalog about 4-6 units every meal, it sounds like your insulin to carb ratio is not established. How many units per carb gram is what you want to work with. And if you use non starchy veggies first to test that out, it's easier before seeing if your Humalog can cover starches/grains or can cover above 25 grams. It can't be worked out til the basal is tested thruout the day. You have to do trial and error and corrections for awhile.

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Permalink Reply by Char8833 on August 7, 2012 at 2:03am

Hi Leo & everyone else thanks so much for this . I havent done the Dafne course yet so no carbs ratio not really established . I read Dr Bernsteins book and am trying to eliminate carbs. I am a 28 year old Type 1 diabetic weighing 68kg and gym everyday. I am testing 10 units at 10pm and 10 units at 8am of Lantus, Then normally it is between 3 - 5 for other meals. But just seem to be yoyoing up and down. Should I reduce the Lantus ? You seem to know what you're talking about I feel lost ! Going away in 3 weeks and really want to have more control. Also noticed iv put on 2kgs in a week since starting Lantus ?? Now think I should switch to Levemeer - seen lots of posts about this. I will def try hourly testing and holding off - all tips are super appreciated.

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Permalink Reply by VetHost on August 9, 2012 at 1:59pm

I too am a fairly new user of Lantus, which replaced the NPH I used for decades. The change made a world of difference to me because it has helped eliminate the drastic lows that came as a result of NPH's uneven action; i.e., Lantus is more predictable.

I take more Lantus than NPH--my dose is 60 units in the morning. With NPH, I'd also take Regular to cover meals, whereas today I use Novolog (16 units before each meal). Sometimes I'll take a supplementary dose before bed, but I have to be careful not to overshoot (pardon the pun).

I hope this bit of information helps you somehow.

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