Lantus help please... New user (formerly pumper)

Three hypos in one night, that is not fun. I'd ask a couple of questions:

  • What were the basal rates on your pump like?

  • Have you tried fasting during the day and seeing what happens to your bgl?

  • Does this happen every night?

  • Is there something else, exercise/food/novorapid that could be causing the hypos?

If you want I'd chat to your endo about it. Whenever I've switched from a pump to Lantus or vice-versa it's never smooth.

Just for good basal coverage and having to be less finicky about injection times I had a lot of success splitting Lantus doses. For me Lantus never made it the full 24 hours it was more like 18.

As for the lows... When I was on Lantus this always happened to me. Turned out I was on far too much of it. If I didn't eat for more than 3-5 hours I'd go low.

So, my guess is you're on too much Lantus -- even though 15u seems like a small dose. I don't see how splitting the dose is going to help that much with this. You could try having a larger dose in the morning and a smaller dose in the evening to ensure that the minimum effectiveness of Lantus occurs in the early morning. Or you could try a single injection in the morning for the same result. But you might go high in the morning... From memory my Lantus split was roughly 65%/35% am/pm.

Another option would be to switch to levemir and take a larger morning dose and a lower evening dose which hopefully would lower the basal insulin effectiveness even more than an uneven split with Lantus.

Also a bit of a crazy suggestion -- if a lower dosage of Lantus gives stable overnight bgls but high bgls during the day you could try using a small injection of Levemir or NPH in the morning to give a bit more basal insulin during the day.

tldr: Looks like too much lantus overall. Aside from lowering the dose I'd try a different injection time. And if it were me I'd split the injection just for coverage.

If you decide to lower the dose to titrate Lantus down I go down by no more than 10% every three days. Maybe overly cautious but I've never been DKA and never want to be.

Sorry for the long post. I hope it helps and best of luck. Constant lows are the worst.

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