A Failed Last Attempt

The last week has been a blood sugar disaster.

After scheduling an appointment at the diabetes clinic with the acquisition of an insulin pump in mind, I decided to try one more time to get my morning sugars down by increasing my nighttime Lantus dose. I have tried this in the past and found myself either going low at night or spending the day eating in order to avoid daytime lows. I don’t know why I thought it would be different this time, but since my waking blood sugar levels have been between 130 and 180 for weeks, I decided that correcting this couldn’t wait for an insulin pump. And anyway, I’m still not totally sold on the pump and I’m even a little bit afraid of it.

So Monday night, before going to bed I checked my blood sugar.  It was 120. I took 18 units of Lantus. It had been a long time since I’d taken more than 16 units.  When I woke up the next morning I was happy to see my BS at 125. Not perfect but much better than the 177 and 180 of the previous two mornings. So the next night with my blood sugar at 133 I again took 18 units of Lantus. This time the result was more in the line of my usual morning blood sugar levels -144.  Too scared to try a larger dose I stuck with 18 units of insulin on Wednesday night, too. When I woke up I felt terrible and when I checked my blood sugar I understood why. It was 259.  An hour later after spending 45 minutes working out it was 251.

Was my high blood sugar a result of an overnight hypo?  The next day was even worse.  I had a terrible low after dinner, though I’d eaten the exact same meal I had the night before and took the same amount of insulin. At around 11:00 p.m., three hours after dinner, I suddenly felt terribly woozy.  I checked my blood sugar.  It was 40 and dropping. I quickly ate some fruit and had a glucose drink (a sample I got from a friend). My blood sugar stabilized and fearing another low, I decided to cut the Lantus dose back down to 14 units.  I woke up the next day 190.

Last night, again trying to get my morning numbers down, I took 16 units of Lantus. I woke up the first time at around 6:30am because Adam was making noise.   I felt like I was in a total daze.  I couldn’t move so I fell back to sleep. I kept trying to get up but I could hardly move.  Jess got Adam quiet, and finally, after about an hour I was alert enough to check my blood sugar – It was 61. I think my liver was pulling me out of an early morning low.

I think it’s now safe to say my attempt to stay pump free has failed.

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health monitoring
health monitoring
13 years ago

I am doing a research for good glucose monitor for diabetic patients. Your post is interesting and I am certain that you are one of a knowledgeable person about this product. Can you please recommend some good glucose meter or a correct way to monitor blood sugar?
thanks!

Catherine Price
13 years ago

I have been on MDI for the past 9+ years. I have tried the 3am thing several times and found that my BS was usually higher than when I went to sleep but not as high as when I woke up (last try was two weeks ago for three nights). When I have Increased my Lantus dose it usually brought on nighttime or daytime lows and I felt I was eating for the insulin instead of taking insulin when I eat. Then there is the running. Increasing my Lantus dose usually brought on mid run lows. I’m aware the pump… Read more »

NJB
NJB
13 years ago

So, if you dont check at 3 AM, you will never know what’s happening.  its funny how people would NEVER go 8 hours during a day without checking, but are willing to do it at noght.  If blood sugaqrs were only insulin and carbs we’d all be 100 all the time! Pumps are far from perfect, but when I downloaded mine the other day i took an average of 7.8 boluses per day.  why?  i tritrate so i wont overtreat after meals by using insulin on board, when i am getting high from stress, or dehydration, or my menstral cycle or… Read more »

Amy Stockwell Mercer
amy
13 years ago

Michael,
I hear your frustration! I also use a bedtime dose of Lantus and was on the pump during my third pregnancy, but went off for several reasons. I just wonder, before you start the pump, if you’ve tried waking up at 3am to test? Everyone is different, and maybe the pump will give you the control you want, but I hate for you to leave MDI on a bad note. If the pump doesn’t work out, it’s nice to know you can go back to shots. Good luck!

donna schindler
donna schindler
13 years ago

Diabetes Blogs and websites are sponsored by pump manufacturers. I think they hire people to move people to the inevitability of the pump, to look down on people on MDI, to say things like “since you aren’t pumping yet…” and “Pumping and loving it!”..I am happy for the people who love pumping.  We on MDI are made to feel like some ghoulish creature down in the cellar not allowed to come out or be heard. If you go on forums well over half the discussions are about pump malfunctions, bad sites, kinked cannulas, etc etc where people are not only… Read more »

Tony
Tony
13 years ago

What are you afraid of with the pump?  It is obviously a better choice than Lantus.  No matter how much you try with the Lantus you will never achieve the control you will with the pump.  All of the medical studies and journal articles and MD recommendations are not wrong.  You’re just putting off the inevitable if you want to gain more control of your blood sugars.  I have been pumping for 10 years and it boggles my mind when people talk about wanting better control, but won’t use the best tool out there to get it.

Susan
Susan
13 years ago

What else are you taking to control postprandial blood sugar readings?  Lantus is only meant to control the “basal” insulin needs, and if you are Type 2 either oral medication or a mealtime insulin should be on board to address the mealtime needs.  Insulin needs are sort of like blood pressure measurements in that there are two components (blood pressure: systolic and diastolic) and insulin needs are about 50% basal and 50% mealtime (split between the three meals).  Then titrate your lantus dose (like you are) to your fasting blood glucose reading.  If it’s normal, it’s the right dose.  If you are… Read more »

Robin Cacopardo
13 years ago

I expect to be pumping soon enough. So I won’t be making many changes now.
Thank you.

Julie
Julie
13 years ago

Some ppl split the dose. Long acting insulin is so unpredictable. So glad my son is pumping! I hope you can get your numbers back on track, its so frustrating!

Catherine Price
13 years ago

No. I asked about it. I remember  coming to the conclusion with my Endo that it wasn’t a good idea for me but don’t remember why.

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