Replies to This Discussion

Permalink Reply by Phill Dill on October 22, 2010 at 6:15pm

I am not as familiar with Latuis as I am with Levemire. I am switchig just the oppsite but with any insulin if you have lowered your activity and not you carb intake the bgl will go up. The scar tissue deffanitly makes a difference in absorbsition rates for use. From what I have been told that the stomach is the fastest, leg or arm is second and the buttotics is the slowest for absorbtion. With any diabetic the levels can go crazy at times you have to watch them closely and determine if a little more insulin will help or hurt you. I am not a doctor this is from my personal experiences. If you take it twice a day I suggest that you take a higher dose in the morning as you are awake and can make adjustments quicker if needed.

Permalink Reply by Emmy on October 22, 2010 at 10:38pm

Yes, scar tissue is well known to affect insulin absorption. Switch to a new site and rotate within that site. Do not use your current site for at least a couple of years, or until the scar tissue is gone. That's the advice I read recently on this issue.

I hope it helps.

What you ate the day before will contribute to your morning fasting numbers. If you had too many carbs and not enough fast insulin to cover them, you'll have a morning high and may continue high all day.

Also, if you have any sort of infection, even a hidden one, this will raise your blood sugar. So can getting things like the cold or flu.

If you have to increase your dose, as Phil suggested, it would be better to take your basal insulin in the morning, so you are awake and can correct any lows. I would be more inclined to look at the previous night's food as a possible cause of these morning highs.

I switched to Levemir because I started having mid afternoon and middle of the night lows on Lantus. I was also concerned about the increased cancer risk. Since starting Levemir I'd had less unpredictable lows. Some people need a slightly higher dose when on Levemir, some stick with the same dose. I do an am and pm injection of Levemir for best effect.

Permalink Reply by Tony on October 23, 2010 at 8:21am

Do you feel like Levemir is better, the same or worse than Lantus? Does it work good for you? Do you have to take more or less Levemir compared to Lantus?

Permalink Reply by Emmy on October 23, 2010 at 5:39pm

I prefer Levemir, I haven't had night time lows with it. I did have to increase my dose, but that's common with switching basal insulins. Everyone is different, and one insulin might require a slightly higher dose than another one. I'd rather take a little more and have no night time lows. You might need a little more Levemir than you did of Lantus, or the same dose, or less. You just can't tell until you've been on it for a month or so.

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If you are less active, and do not reduce your carb intake, you need more of your mealtime insulin. The basal insulin might also need to be adjusted upwards if your morning number is creeping up in spite of adjusting at mealtimes.

It works this way: if your morning number is too high, you increase your basal insulin slightly, and wait 3 or 4 days to see how it affects you. Do not adjust again until you wait those 3 or 4 days because it can take that long for it to make any real difference. Work on ONLY the morning number until you get it right and its stable for at least a week or two, before working on the mealtime numbers.

If your morning numbers are fine, but you are still high after meals, adjust your carb:insulin ratio. Again, make only one adjustment and wait a few days before making any further changes.

Also, work on one or the other, not both at the same time. If you are adjusting your basal insulin, leave your mealtime insulin the same, and vice versa.

This is how my diabetes nurse advised me and it really helped. You should probably talk to your doctor before making adjustments, as there may be something you are missing. Always proceed with caution when changing insulin doses. My diabetes nurse taught me specifically how to do this safely. You really need training to know how to handle it safely, so you don't have any dangerous and unpredictable lows.

Permalink Reply by Tony on October 25, 2010 at 8:55am

I tried Levemir last night and it kept me good all day and lasted 24 hours. I took the same amount that I take of Lantus and it worked so much better. I might try increasing Lantus tonight and seeing if that works and if I'm still getting high then I'm going to switch to Levemir. Lanuts sometimes covers me over night then In the morning if I don't eat it spikes way up for no reason. Levemir kept my sugars good all morning even without eating anything.

Permalink Reply by Phill Dill on October 23, 2010 at 5:54pm

Well I am getting blood work on friday prior to switch then in 30 and 90 days
my switching lots of meds have to do with cost for my insurance total is about 4500 for them and a few changes like to pens will save them 425 a month. Then test less as that is a high cost and probably to a cheeper meter and so on till they are happy.

Permalink Reply by Tony on October 23, 2010 at 7:55am

So if I eat more carbs or an equal amount of carbs and I'm not as active but I still cover them good with humalog Ill still need to up my Lantus dose? I'm going to switch to Levemir tonight and see if I do better with it, Thanks for the help and info.

Permalink Reply by Phill Dill on October 23, 2010 at 4:37pm

What you have to look at is lantus is a long lasting treatment so any change will take time to notice. Is one better than the other that I can not answer as I like the levemir and have no reactions to it. I take 90cc daily for a long lasting treatment. Which humilog do you take as that can also have an effect. I take 3 insulins daily so a balance is what you have to find and sometimes can take a while to do that for each person. As for me this is the line that works at the moment.
I am on a 1800 calorie a day intake and I work outside physcial labor.
15cc humilin R @ 06:45 eat
45cc humalog 75/25 @07:30
45cc Levemir 70/30 @10:30
eat @11:00 15cc humilin R
eat @18:00 15cc humilin R
45cc humalog 75/25 & 45cc Levemir 70/30 @21:30


With all of this I got my A1c down to a 10.9 my previous were Nov 2009 11, Feb 2010 11, May 2010 7.9, Aug 2010 10.9 I had issues as I broke my foot and ankle so still have trouble now only limited walking. For 5 years I had numbers from 5 to 8 for some reason things went off the charts so you have to pay attention at all times.

Permalink Reply by PJ on October 25, 2010 at 8:13pm

I found that with my Lantus, I had to split the dose to get good control all day and night. Mine didn't last 24 hours with the 1 injection at night. I was waking all the time at 160-170 no matter what I was when I went to bed. When I split the dose, I did have to add a couple of units to each dose to get the good numbers, though. I've been using Lantus for almost 1 year and the only "low" problems I have with it is when I don't have a small carb snack before activity or half way through my work day. (My job involves walking up and down long hallways for almost 8 hours!!) :) Going up 1 or 2 units of Lantus won't hurt you, but do check with your primary if you're unsure. If you're on the right dose of Lantus, your blood sugars should stay within 10 points every time you check when you're fasting. You can check this by fasting for different meals. Lantus is to keep up with what your liver kicks out. Also, if you do split the dose, make sure you take it 12 hours apart. It doesn't matter when-whatever 2 times are good for you. Just take it consistently at the same times. I set my alarm to go off to remind me 15 minutes before I'm supposed to take it. Good luck and hope this helps!

Permalink Reply by Tony on October 26, 2010 at 9:32am

I think I'm going to switch to Levemir. It lasted the full 24 hours and it kept my sugars perfect. It might have something to do with Levemir going right into your blood stream and binding to albumin in your blood and Lantus stays in you and slowly dissolves then it goes into your blood.

Permalink Reply by JaninaWalker on December 6, 2010 at 12:07pm

I have had trouble with Lantus since June...but it is more an issue with the lantus than with me because sometimes even 2u over a 12 hr period of no food will put me into a serious reaction.
I make zero insulin of my own, known via C-peptide test.
But I used to take a TDD of 15u of insulin, now it varies.
Are you leaving the needle tip on a solostar or other cartridge for several days, even though you might recap the needle after the insertion?
Or do you put a new needle tip on each time?
Are you keeping the active cartridge OUT of the fridge for the up to 28 days that it is valid to do so, or are you taking it in and out of the fridge...because the manufacturer tells me that latter type of constant temp change will degrade the insulin.
I also suspect that leaving a needle tip on for several days may also allow it to degrade because when I did that for one Solostar that was going to last me 2 weeks if I took 20u per day....I found near the end that I had to increase the doses and my ketones were extremely high as if the insulin was working at only 25-50% of what it was able to do at the beginning of use of the cartridge.
But then I also found that while #1 cartridge worked OK even though I kept it in the fridge and only very briefly had it out just for the injection and never left it out by mistake longer than 1 minute....that cartridge did work all right for the two weeks,
But #2 was bad from day 1, and on day 2, I complained to the manufacturer...that is when I was told it HAD to be left out of the fridge. so I did that for the #3 to #5 cartridges, but they were still unreliable.
Since you are only using 7u, I suspect that you have good results at the beginning of the cartridge and it worsens as time goes on for that particular cartridge.
At 7u daily for you, and a 300u cartridge means it could last 42 days, for you, if it could be useful that long...and I bet you wish it could be...and probably would be as angry as I am that the company says they will not warrant the effectiveness beyond 28 days....that indicates that they do know it degrades under different circumstances.
I am now purposely putting on a new needle tip each time to see if I can get longer effectiveness, as I found it worked ok for about half way through the cartridge and then I was experiencing much higher ketones in the latter half and was having to supplement with regular humalog insulin because I felt so AWFUL, as if the Lantus was just not working except at 50% capacity.
So, I wonder if you have left the needle tip ON or whether you take it off when you leave it at room temperature.
Because of the misery with Lantus since June, I am going to meetings about switching to a pump because I always feel better when I do a day of only overlapping humalog.
Your last ques about exercise...I know it has an immense effect and I always take less insulin on a day I plan to walk a lot and the next day I need less insulin if I have walked for about 3 hours or 10km. A short 15 min walk is not the same, but it is better than nothing. ALL use of muscles will result in a proportional activation of receptors as the body goes looking for more glucose to replace the glycogen just used in the muscle cells.
Also, chromium is needed to facilitate receptor activity, so you will see insulin needs go down slightly.
Since you take so little insulin and are so new, I even suspect that with supplements that I could suggest, you might not even need to take insulin. I'm thinking of starting a group about supplements.

Permalink Reply by Tony on December 7, 2010 at 6:17am

Well I think Ill have to keep taking insulin because I also had the C-Peptide test and it said I don't make any insulin of my own. I've had to up my Lantus from 7 to 9 and it seems to be working better. Im also really interested in using supplements to help with my diabetes and my hashimotos hypothyroidism.

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