Diabetes and lantus?

Question

I was diagnosed with diabetes two weeks ago, and I'm taking 50 units of lantus every night at 11pm. Last night an hour after taking my lantus I checked my blood sugar and it was 46 which is way too low, I think they have me on too high of a dose, I'm afraid that at night my blood sugar is going to drop to dangerous levels (I'm not overweight). My next appointment with the doctor isn't until the 20th, any advice is appreciated.

Answer 1

Hi, I think you need to call your doctor right away. Don't risk waiting for your next appointment.

I take 75 units of Lantus at bedtime. During the day, I take NovoLog (asparte) 35 units, before each meal. That is a fast-acting insulin that lasts about 2 hours, long enough for me to process my meals.

These amounts & types of insulin work fine for me; but I've had Diabetes for 6 years (Type 1). In the beginning, it was a bit of a roller coaster ride, with doses and/or types of insulin changing every few days & weeks. Finally, we got my glucose levels settled down just fine. Of course, there is the occasional time I will become hypoglycemic. By now, I usually know before checking that I'm too low — hands start shaking, heart races, back of neck gets sweaty, feel nauseated or feel unusually hungry, or I get spaced out.

You've been diagnosed only 2 weeks ago. You'll have to expect a certain amount of changes until the doctor & you find a good balance with your insulin. For me, at this point, I make my own adjustments with my insulin. Not my Lantus, since that is a 24-hour baseline insulin; but the NovoLog that I take before meals I can change. If I know I am about to eat a much larger meal than usual or a meal that is heavy on the carbs, I will raise my insulin to 40 or 45 units. Conversely, if all I'm going to eat is a yogurt, then I drop my insulin to about 25 or 20.

Don't just wait for appointments if you see your insulin is not lowering your levels enough or if you are in the situation you are now. Medically, you technically become hypoglycemic when you go under 50, which you did. But in reality, you are likely to experience hypo symptoms anywhere from 70 down.

You should have on hand, near your bed, some glucose tablets or gel, which can be bought in any pharmacy or store that sells diabetes products. This way, if you see your levels are too low, you have fast treatment. If you see you are hypoglycemic, take 15 mgs of glucose gel (one tube) or tablets. Wait 15 minutes & check your levels again. If you are out of the woods, you want to stay that way, so you then need protein. Eat one-half of a sandwich; peanut butter does it for me. The protein from the PB combined with the carbs of the one slice of bread, keep my numbers from falling down again.

It's very likely that your level of Lantus is too high for you. Let me just throw out a question for you — did you eat dinner that night? If you didn't, then it may not be that the Lantus is too high. If you did eat, well.... Also, you didn't mention if you take a fast-acting insulin during the day, before meals. I don't know anyone who only takes Lantus. But if that's all you need at this point, well, that's great!

How often do you check your glucose levels? I check mine 12 times a day. That's because I do "tight control," where you keep your levels between 80 and 130. That's not for beginners, though :) You should check as soon as you wake up, before each meal, 2 hours after you eat (2 hrs. from when you start eating), and at bedtime. Also, you need to check before you exercise/do sports and after you finish (excuse me if I'm repeating stuff your doctor already told you).

Don't worry about calling the doctor every day if you have to, at this point. The doctor won't mind; Diabetes is serious, and it will be up to you to control it.

I would suggest keeping a Diabetes Journal between now & your next appointment, and the next few after that. In it, you want to put your glucose levels & the time of day & the situation — dawn; before breakfast; 2 hours after breakfast (and the other 2 meals); before Lantus; and whenever else you check it. Many doctors ask you to do this; it gives her/him and you a picture of how your numbers are doing. Maybe the levels will show you need less Lantus but something before meals, for example, who knows yet.

Since you are newly diagnosed, I would strongly suggest you buy one or two books about Diabetes. I learned far more from the books than I did from the doctors, it's sad to say. But if I did learn something that I felt applied to me & would be better for me, I brought the information to my doctors. They always went along with what I learned. You can call the ADA ( American Diabetes Association) and they will send you a catalogue of books, or any good bookstore should have some.

Just a thought — if you were just diagnosed 2 weeks ago, I hope you have an Endocrinologist, because they are the experts on Diabetes; all the types of insulins & dosages, equipment, insulin pens and insulin pumps, etc. Also, they will be connected to a Diabetes Educator who can help you with any lifestyle changes, i.e., food, exercise.

Best of luck to you.

Answer 2

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Answer 3

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Answer 4

50 units of lantus is a HUGE amount, especially when you're a normal weight.
Did the doctor start you out on that dosage?, if so I'd seek a second opinion. I would take half that amount tonight, and see how your blood sugar is before bed and first thing in the morning. You're definitely running a risk of hypo with that reading, so I would try 25 units tonight. That's what I've taken in the past, and that's a nice amount to get the right reading the next day. Also, maybe you should try to move your appointment forward, although if you can get good control in the meantime there's no real need to. Good luck!

Answer 5

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Answer 6

Call your doctor immediately. Is this an every night situation? If so, then yes they have you on too much. I wouldn't recommend adjusting your dosage right now, because you've only been diagnosed 2 weeks. Test your sugars often, and make sure that you keep orange juice and crackers/glucose tabs and crackers near by.
If you have an unusually active day, say you jogged that day and you don't normally, then your blood sugars will reflect that exercise.
The best thing you can do is keep an eye on your sugars and call the doctor in the morning.

Answer 7

50 units sounds like a lot, especially at night. First, you need to talk to your doctor ASAP. Ask why do you need lantus in the first place. Does your doctor thinks that your diet is that bad.You should test your blood sugar (BS) for 3 to 7 days without taking meds- under your doctor's guidance- to see if diet and exercise alone is the answer. Test when you get up in the morning before eating, then 2 hours after. then test 2 hours after lunch then just before bed. Record these findings and talk to your doctor to begin a proper regimen to control your BS. check out Diabetes.org for more info.

Answer 8

I would call the Doctors office that gave you the med asap. They will be able to advise you what to do until you see the Doctor next. They may need to adjust your med. Good luck to you!

Answer 9

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Answer 10

Make sure you are seeing an endocrinologist and not a gp.

Call right now and make some changes.I don't think this doctor knows what he/she is doing.

Good luck