Balancing Act
As I continue to find balance in my eternal struggle with Lantus, one thing seems to remain constant: it’s never quite good enough. 21 units at night was upfront overkill, but never made it past dinner. 21 units in the morning meant overnight highs. While I don’t have a before and after A1c, I have been very pleased with what I think is solid control since splitting my dosage. But while splitting my Lantus has helped, it’s not quite good enough.
I have been using 10 units on both sides as a baseline dose to see where things need to change. Of course, I kinda fell into a rut and accepted that 10 was the perfect number for a few weeks, but lately I’ve been noticing that I need a little more. Now the challenge is to figure out how much is just right. Since I know that Lantus is not a 24-hour insulin as advertised, I feel like a little bit of overlap would be ideal. Inject the next round of awesome while the current dose is tailing off. Or something like that.
My hope is that I can figure out where the right level of Lantus is and in turn, reduce the amount of Humalog I take during a typical day. I know corrections happen and some days are straight up insulin resistant, but that’s natural when it comes to living with diabetes, right? If I can figure this out, I feel like I will be adding some stability to my diabetes management. Until now, I haven’t really felt too confident in Lantus’ ability to do whatever it is that it’s supposed to do, but maybe that’s because I haven’t tried to work with it.
You’ll have to forgive my slow-to-act nature with this, changing my insulin needs on my own is still kind of new to me. For so long my insulin regimen was set in stone, or at least that’s how I saw it. Now that I’m becoming more flexible (read “realistic”) with what I need to properly manage this disease, I am hopeful that Lantus will be able to play a significant and meaningful role in keeping me healthy.
Is it wrong that it feels like I’ve been doing all of this without reading the instruction manual? Without really thinking about what I’m putting into my body? Until recently, without questioning what I am doing and why? Slow and steady, I’m starting to figure out this balancing act. Let’s just hope I don’t do a face-plant any time soon. That would suck on so many levels.
I’m currently struggling with the exact same issue. 20 at night wake up LOW, 20 in the morning, high. Let us know how splitting the dose works out for you.
I was on NPH and regular for 35 years and then switched to Lantus and carb counting, I was clueless, I did not even know what a carb was or that NPH had peaks as well as regular, I was dumb for so long and now regret all those years of mismanagment.
I started on Lantus one shot a day and omg all the lows in the a.m. and sky highs after dinner. Then on my own I added regular and humalog for my evening bolus, aren’t I smart, then tons of lows after dinner. Again without asking anyone I split the Lantus dosage and when I went to a new endo I told him what I did and he stated wow, I will have to tell others. Well anyway I ended up increasing my evening dosage by 1 unit at a time to cover my dawn phenomenon and finally it worked fairly well. I dosed Lantus at 6 am and 6 pm.
I don’t think you want to adjust your Lantus to use less humalog during the day. You need to start doing some fasting to see if your bgs stay steady. When you reach that fairly steady mode then you need to start addressing your carb to insulin ratio of your humalog to lessen corrections, but that will happen and that is why we test every two hours.
I really don’t think you should adjust your Lantus to use less humalog or you might start to suffer from some lows.
Remember that every day is different and it is not an exact science.
I feel like diabetes management is like riding a bike. We have our doctors and CDEs help us during those first few years until we feel confident enough to take the training wheels off. But like you said, hopefully we don’t get too cocky and end up doing a face plant. Then, back to Square One . . .
Instruction manual? Who gets one of those? Could they please send it my way?
Oh how I hated Lantus! It was my biggest push to get on the pump. Of course no Endos were explaining fasting to figure it all out. I may have given up too quickly, who knows. I do know that when they figure out your Lantus based on your R and NPH intake it doesn’t work. Just hang in there, maybe one day they will get around to sending out that instruction manual
BG testing is your safety net. Do it often.
I think I can understand your hesitance to change stuff on your own. If it would make things more comfortable, would your care team be willing to meet with you more often and talk about some of the changes you want to make? After all, if you’re not comfortable with it, who are we to say you should be?