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| | From:  Suregrl (Original Message) | Sent: 1/30/2007 5:17 PM |
Hi Everyone, I am a 43 yo Type I diabetic, since age 17...so I have had IDDM for 27 years. I used to be a Diabetic Educator back in the 80's( I'm also a nurse). Anyway, I have been on Lantus for about 6 months now and I am having troubles. My endo. to me this insulin does not peak...well, it peaks 12 hours after I take it. I also have hypoglycemia unawareness since being on this insulin. I go into focal seizures due to severe hypoglycemia. Last Wed a 21 yo Juv. Diabetic was killed here in NJ while driving on the NJ Parkway. She had IDDM all of her life and was on Lantus. I did not know her personally, but my cousin is a Paramedic and it was one of his coworkers. An investigation is underway and it is thought that she was in "Insulin Shock". I am going to find out more specifics........I am very concerned b/c I feel Lantus does peak in certain individuals. This insulin nearly killed me during one episode b/c I not only seizured......I could not breathe. My Lantus dose has been cut back drastically while I hunt for a new doctor. I am covering my meals using Humalog. I prefer multiple injections vs. a pump. This group seems to be very knowledgable and I think I will gain a lot of insight here. |
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Hi....I'm Cheryl..... I'm T-1, 50 yrs. old, been insulin dependent for 32 yrs. Funny, we recently discussed Lantus and fast acting insulin in the "Insulin Question Room". I think it was under, "long lasting insulin". I'm on Lantus, one shot in the morning. When it was introduced to me, my physician wanted me to go on it with fast acting insulin and I declined. I had an awful lot of serious trouble with the two insulins together. Being in the medical profession, you've probably witnessed how meds work so differently with so many people. I have experienced hypoglycemia unawareness with Lantus (as well as other insulins) and many members have also talked about it....more so since the introduction of synthetic insulin. What is it like in NJ as far as obtaining or renewing your driver's license? When I came to NM, I had to go through this whole screening process to renew my license. Growing up in NY, having moved to AZ, I was never asked anything about having diabetes. It was a direct question here in NM. Please take care of yourself....I know you will but I also know how difficult it is.....this group is very, very good and very, very helpful. Look forward to your input and progress. Peace, Cheryl |
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As a nurse, I'm sure you've observed that different meds cause various reactions in people. Lantus is not supposed to have peaks and valleys of action; it is supposed to have a level action. But what is supposed to happen, and what actually happens in the patient are sometimes quite different than the ideal. If you are finding that you have insulin reactions on Lantus alone, then you may need to lower the dose, or split the dose to 2 smaller doses. You can then better tailor your dose to your individual tolerance. But I'm wondering if you are not missing or skipping a meal or snack, thus leaving nothing for the Lantus to "burn." Even without a rapid acting insulin, your Lantus will lower your sugars, and require that you have regular meals....at least at some point during the day. A personal example: I take my Lantus at night, and take Humalog with meals. But occasionally, I just don't feel up to breakfast. If I try to clean my house, or do anything without some food in me, I will get a low sugar reaction, even without taking the humalog. Just wondering if that might be what is happening in your case. Be careful on the roads, too! Lots of our members post that they do a sugar check prior to driving, just to be safe. Always a wise idea to test before taking a chance! HUGS! sheryl |
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The insulin does not have to have a "peak" for you to go low. It could simply be too much insulin, even at a steady rate of action. You may not have enough food in your system for the insulin to work on. Or you may have had too much exercise for the amount of insulin you took. Either way, if you go low, it is too much insulin in your system. And I think you are referring to "hypoglycemic unawareness"...you are aware of the insulin, just not your low reaction, right? If your doctor is recommending that you take MORE insulin, that does not make sense. What are your readings when you are low? If you are really low, do not take extra insulin. University hospitals normally get the most up to date information on treatments and protocols, and can be a good place to start looking for a new doctor and another opinion. sheryl |
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| | | From: Suregrl | Sent: 2/11/2007 7:14 PM |
My hypoglycemic episodes are normally 30 or below. My husband has seen my blood sugars so low that they don't even record a reading. My PCP told me that I have insulin sensitivity and the culprit is the Humalog. I have cut my Humalog dose down by 50% and I don't take it until after I eat. This seems to be working so far. If this approach does not work I am going to return to Regualr Insulin b/c it is much slower than Humalog... As far as my Endocrinologist goes...HE IS FIRED!!!!!!!!!!!!!!!!! Under his care I am constantly low. |
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When I first go to a doctor (PCP) the first thing I ask is if they are "patient oriented" or "text book" oriented. If they say text book, I book on out of that office!!! With everyone being so different, I want a patient oriented doctor and in my years of diabetes....I've only found two that were patient oriented and we worked together well. As for endos....I think they are the worst! I went to one endo and it was only a couple of times. She was just too much for me. It's like they've read this book on what to do if this or that happens and just like you, she had me bottoming out all of the time with the extreme lows that you talk about. So....go with what you feel comfortable with. Let us know how it goes....Peace, Cheryl |
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Glad things have straightened out for you. And if you feel comfortable with your doctor, it is a good idea to stay there. A feeling of comfort is half the battle. Keep up whatever it is you're doing! Peace, Cheryl |
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You are right about Lantus. It does have a peak and then stays at that peak till it wears off. Talk with your doctor about changing to Levemir. People that use Levemir say it works a lot better than Lantus and they like it much better than Lantus because it doesn't have a peak. |
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| | | From: Julie | Sent: 3/4/2007 1:52 PM |
I am speaking from my own experience here, but a Type 1 will have at least occasional hypos if they are in good control. That is because our bodies are not machines and the odd thing will happen that will make you go low. The key thing is that if your blood sugars are in the normal range most of the time, and you are testing frequently, you should be able to catch the hypo before it messes you up. For people who say they have NO hypos, what is your range of blood sugars? Lantus, Levimir, and the pump has hopefully decreased the number and severity of hypos for us, but if you NEVER have them.......I don't get that for a Type 1. Can you help me out by explaining further? Julie |
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Julie~ I completely agree with you. If your blood sugar is under tight control, you are bound to have the occasional low. Now so it "messes you up," but just that you may notice it. As long as you frequently test your sugars, you should not run into too much trouble that cannot be easily and quickly remedied. All it takes is an extra bit of exercise, or an hour late for a meal, and oops! The trick is to head these lows off before they get serious, or especially, before you get behind the wheel of a car. Insulin doesn't have to have a peak to make you go low. Perhaps the dose of lantus is too high, and you need more fast acting insulin at mealtime. That would give more flexibility in scheduling, since your basal insulin level is lower. You would require more fast acting insulin to cover the carbohydrates, since you don't have as much long acting insulin for coverage. Did that make sense? I think I may have said that in an earlier post...sorry if I'm repeating myself. HUGS! sheryl |
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| | | From: Julie | Sent: 3/4/2007 6:17 PM |
I am also sensitive to insulin. I am on the pump now, and I think control on the pump is much easier for the insulin-sensitive Type 1 than Lantus could ever be. I took Lantus for 15 months before starting the pump. I think it does have peaks, especially for the insulin-sensitive among us. The peaks are smaller than the NPH peaks, but they are still there. I would ignore health professionals who do not take insulin themselves, trying to tell you what your body is doing. They should be listening to US, we are the experts, we live with controlling this illness and we know more than they do about things like this. I am lucky to have an endo who realizes this. When he offers me tips, he usually prefaces his statement with this......"Some of my patients have found that......." He asks us what works for us, and he passes our discoveries on to his other patients. I do appreciate him! I agree with Sheryl that it is better to have the Lantus dose a little too low than a little too high. I went back and forth between 10 and 11 units of Lantus at bedtime, and even when I settled on 10 1/2, I still had lows from the Lantus. This is why I chose to go on the pump. My Diabetes Center pump CDE told me that many people have trouble with Lantus and choose to go on the pump like I did so they did not have to deal with long-acting insulins. Keep us posted on your progress. This is an interesting discussion. Julie |
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