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From New Orleans, Louisiana, USA:

I am 33 years old, I've had type 1 diabetes for 26 years, and I started using Lantus in the morning (38 units) with Humalog before meals (5 units) a little over a year ago. I exercise regularly (usually pre-dinner) and follow a vegetarian diet. Everything I read states that Lantus reduces the incidence of hypoglycemia, but it really has increased the incidence of nocturnal hypoglycemia with me. My blood sugar falls as much as 200 mg/dl [11.1 mmol/L] points while I sleep. Lately, I've been skipping my Humalog injection before dinner which leaves my blood sugar elevated (250-300 mg/dl [13.8-16.7 mmol/L]) before bedtime. I have found that this is the only way that I can prevent severe hypoglycemia while I sleep. My blood sugar still drops considerably while I sleep but since it is so high at bedtime it rarely drops low enough to cause a reaction. While this seems to be working, I am still very confused as to why my blood sugar drops like this. As far as I can tell, the Lantus peaks about 19 hours after I take it. Every time I ask my doctor about this, he replies that Lantus does not peak. Does anyone have any answers?


Most insulin regimens use 50% long-acting insulin and 50% short-acting insulin. You are overweighted in terms of long-acting insulin. Perhaps you can speak to your physician about decreasing your Lantus (insulin glargine) and later on you may have to increase the Humalog.


Original posting 11 Feb 2003
Posted to Insulin Analogs and Daily Care


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