From Massachusetts, USA:
My teenage daughter with type 1 (diagnosed November 1, 1999) recently switched to Lantus. She takes 32 units at bedtime (9:00 p.m.) and uses Humalog to cover her meals. She has been waking in the morning, at 6 a.m., with low blood sugars, between 40 and 50 mg/dl [2.2 and 2.8 mmol/L]. Her bedtime blood sugars are within range. At dinner, she gives Humalog on a 1 unit for 10 grams scale. Could the Lantus cause the morning lows even though there is no peak, or is it more likely her dinnertime insulin? How can we determine which one should be adjusted?
It is likely the Lantus.
Quick options (all through the input of your own diabetes team):
- Decrease the Lantus somewhat.
- Split the Lantus so some is given in the morning with a more significantly lower dose at bedtime.
- Add more to the bedtime snack, perhaps with protein or extra carbohydrates such as uncooked cornstarch, as in an Extend Bar.
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