Guest guest Posted April 9, 2004 Report Share Posted April 9, 2004 Walt, I would like to endorse what Heidi has said about Lantus insulin. It is an insulin which should only be injected once daily, as it's purpose is to provide a 'background' of insulin for the whole 24 hours. Some people who require only small doses of insulin may be able to manage with just Lantus for a while, but, on the whole, a short-acting insulin is required, to be taken prior to meals. As your blood glucose levels remain elevated, you should speak to your doctor about also taking a short-acting insulin prior to meals. Good luck with sorting out your diabetes. Sue. (UK) > Message date : Apr 09 2004, 08:10 AM > From : " hhessgriffeth " > To : pancreatitis > Copy to : > Subject : Re: About a week on insulin - To Walt, please read! > Walt wrote: > I am trying to get my blood sugars down. In the morning I average about 110. Two hours > after meals even with lantis it is about 210. I am trying different schedules. My main > injection is 10 units before I go to bed. Then I have trying 3 units before breakfast and > dinner. This has helped getting it doing to 180. > I wish my endo knew more about pancreatitis I have had to educate him on my illness. I > can not wait until I get back with my primary care doc. She will be able handle thing better. > > > Dear Walt, > > Lantus (glargine) is a basal insulin that is designed to give you coverage for 24 hours. It > should only be taken once a day, or some people take a split dose every 12 hours. It > should not be taken any more frequently than that. People that are on Lantus, (I am one > of them), also inject a fast acting insulin like Humalog or Novalog for their meals. Once > you have injected Lantus, it takes about 5 hours before the insulin begins to work, so it's > not designed to be used prior to meals for meal coverage. For meal coverage, you should > be taking a fast acting insulin such as Humalog or Novolog, which begin working and peak > within approximately 1 1/2 hours. These insulins are designed to work with a person's > digestion schedule. > > The way you are taking your Lantus is totally incorrect. I cannot believe that an > Endocrinologist would only give you a basal insulin and not one to take with your meals, > since the Lantus is not designed to be used for meal coverage! Is this doctor familiar with > Lantus dosing schedules? Did this doctor tell you to take Lantus with your meals??? I ask > this because Lantus is a new insulin and many doctor's aren't that educated with how it > works. It is NOT designed to be taken for blood glucose control with meals. Additionally, > any adjustments in Lantus dosages should only be done once every three days. Since it is > an insulin that stays in the system for 24 hours and there is a 5 hour lag time after each > injection, adjustments to dosing take a full 3 days to take effect. > > You need to contact your PCP, and talk to her about getting another fast acting insulin for > meal coverage, or call the Endo back and tell him that you have spoken to a patient that > has been on Lantus (under the guidance of an excellent Endocrinologist and a Certified > Diabetes Nurse Educator), who has told you that Lantus cannot be used for meal coverage, > and that there are fast-acting insulins designed precisely for this purpose. The way you > are taking it now is totally incorrect, and if you have any doubts about this, I will post a > Lantus information and dosing website in my next post. > > For example, I take Lantus on a split schedule, a dose of 10 units at 8:30 pm and then > another dose of 5 units at 8:30 am., making my full 24 hour dosage 15 units per day. I > only started taking it in a split dose after a two month's trial taking it once a day. I found > that it wasn't providing coverage after the 22nd-23rd hour, so the split dose system was > initiated. When you do this, you do have to have a 12 hour period between each dose. > Then at mealtime, I take Humalog fast-acting insulin. The amount of Humalog that I take > with each meal depends upon how many carbohydrates are in that meal. I take 1 unit for > every 5 carbs. Most of my meals contain approximately 40-60 carbs, so I take 8-12 units > of Humalog at mealtime. I have dual digestion, which meals that my protein doesn't > digest until about 3 hours after I eat, so I have to split my meal dosage to compensate for > this. I inject a portion of the Humalog immediately prior to eating, and then I inject the > remaining portion of Humalog 1-1/2 hour after I eat. This dosing schedule was set up by > an authority on insulin and is designed for my digestive system, according to my weight > and other factors, so don't try to apply it to yourself. I was only trying to explain how an > insulin schedule is set up for most people taking Lantus. They take Lantus as their basal > insulin once a day, and then take their fast acting insulin with meals. Some people use a > sliding scale regimen, while others, like me, adjust the amount of fast-acting insulin they > take according to what their carb content is at each meal. I do not follow the ADA > pyramid diet with exchanges, as I find the carb allowance in that diet to be too high for me > to maintain adequate control. I follow a moderate carb regimen, with approximately 110 > -120 carbs per day. > > My aim is to keep my blood glucose within a range of 80-110. After meals my range can > go up to 140, at the very most. I test often (8-10) times a day, and inject Humalog up to > 8-10 times each day, also. I do whatever is necessary to keep my BG's within my personal > range of 80-110. It takes a lot of testing and understanding your body's reaction to > insulin before you can do this kind of precise control monitoring, and everyone is > different. > > I do think you should call your doctor and get some help with this before the 22nd. Once > you get the hang of it, you should be able to maintain the kind of control that will lower > those high after meal BG's, and once the suitable Lantus dose is established, you can > maintain a stable BG all day long. Meanwhile, if you have any other questions, please > don't hesitate to ask. > > With love, hope and prayers, > Heidi > > Heidi H. Griffeth > South Carolina > SC & SE Regional Rep. > PAI > > Note: All advice and comments are personal opinion only, and should not be > substituted for professional medical consultation. > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 21, 2004 Report Share Posted August 21, 2004 Walt.....Congrats......that is awesome news......I have many great friends in the program.....One of my best friends and Mentors turned 14 this year...again.....congrats dude Mark I just wanted to share some of my good news with you though. I will be celebrating 20 years clean and sober the 24th of this next month. Walt Quote Link to comment Share on other sites More sharing options...
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