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Question:

From Newfoundland, Canada:

I am 27 years old, was diagnosed with type 1 diabetes when I was 18 months old, and for the last few years I've had a problem with high morning blood sugars in the. I've tried Lente, NPH, and Ultralente, and even though my dosages have been changed numerous times, there has been no change, and my morning sugars are usually 13-18 mmol/L [234-324 mg/dl]. At one point, when I was taking long-acting insulin in the evening, if I took it in my leg at 9:30 pm, my blood sugar would be normal in the morning, but I wasn't always home to take it at this time, etc.

I have done testing during the night, and most recently, before bed my blood sugar is ones have shown an below 7 mmol/L [126 mg/dl], at 3 am, it's 7-9 mmol/L [126-162 mg/dl], and then when I get up in the morning, it's 18 mmol/L [324 mg/dl]! My night long acting insulin has been increased dramatically with not much difference in sugars.

The last time I spoke to the nurse, she suggested trying another long acting insulin again. I was just reading some information on Lantus, but I've never heard of it. Is it possible that this would work?

Answer:

It is obvious that your insulin requirements really increase between 3:00 am and breakfast. Lantus is a new form of a long-acting insulin that is peakless. It maintains a basal level of insulin to keep your blood sugars down between meals and overnight. However, one thing it will not do is peak in the morning to meet your needs.

I would suggest you see a physician with expertise in the treatment of type 1 diabetes and that you consider using an insulin pump which would allow you to adjust your basal rates up for the time of day when your insulin requirements go up, or I would suggest using an NPH-based insulin that peaks in the early morning. Either way, I believe you would benefit from working with a physician who specialty is the treatment of type 1 diabetes.

JTL

[Editor's comment: At the present time, Lantus is not sold in Canada. You could check with your physician about whether he/she has any ideas on whether it can be obtained from the US. WWQ]

DTQ-20030713221326
Original posting 20 Jul 2003
Posted to Daily Care

  
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Last Updated: Tuesday April 06, 2010 15:09:46
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