The Times They Are A-Changin'

the timing of my Lantus injection that is...

I am one of the few remaining MDI users in the Diabetes OC, which I am okay with since my A1C are consistently in the low 6's and I'm pleased with my control. However one element has been bothering me for awhile.

As instructed by my doctor many years ago, I have always taken my Lantus injection at bedtime, usually around 10 p.m. each night. The issue (as many Lantus users can tell you) is that the insulin has a gradual peak around 5-7 hours after injection, which meant A LOT of lows around 5 a.m. I ALWAYS got low on nights after I'd exercised (which I do frequently). It didn't matter how many carbs/protein I had for a bedtime snack, that early morning low would hit every time.

This is frustrating on many levels. First of all, I was sick of having to consume so many calories in the evening, especially after a good workout. Kinda defeats the purpose of burning calories if you're just going to put them right back! Plus, my sleep was always disrupted when I had to correct those lows with more food!

I mentioned this to my endo a few months ago. He's not the best doc, but I'll be under the care of the reproductive endo department in a few months (more about that later!!), so I'm not switching doctors for the time being. When I suggested changing the timing of my Lantus injection, he barely gave the idea any consideration. "Oh, it'll be fine" was his response.

So, a few weeks ago, I finally decided to just make the change. I read a lot about Lantus online and felt confident that the change would serve me well.

I knew it would be problematic if I suddenly just did the Lantus in the morning one day. Since Lantus works for 24 hours, it's important do take your dose at the same time each day. So, over the course of a week or so, I just moved my Lantus injection back an hour or so each night. This was a pain, because I had to set my alarm for 2 a.m., 3 a.m., etc. to give my injection, but it was a small price to pay.

I'm LOVING taking my Lantus in the morning!!

There's definitely been a period of transition though. See, now, I basically have very little insulin in my system overnight. Though Lantus claims to work for a full 24 hours, I find that it tapers off pretty strongly after about 20 hours. Before, I'd need a bedtime snack even if my blood sugar was around 150-170 mg/dl, now I don't need any extra carbs when I go to bed with a blood sugar around 100 mg/dl. That took some mental adjustment.

Also, since it take a little while for Lantus to get working, I am working with my breakfast meals to make sure they're lower carb. However, the other bonus is that now the Lantus has it's gentle peak right around lunchtime, so I need much less insulin at lunch! Also, it's still going strong at dinnertime, instead of wearing off, like it did when I injected at 10 p.m.

It just makes sense, why not have the Lantus working its best during my waking hours, especially the peaks! (Note: I don't seem to suffer from Dawn Phenomenon, luckily!)

I've also experimented with splitting the dose a bit. I tried giving myself 4 units of Lantus at bedtime and then 24 units at 7 a.m. (my total dose is 28 units). I still experienced a few lows with this, but it might be a good option when I'm not exercising as intensely.

So, all in all, I'm really happy with the change and I'm pleased with my ability to take diabetes management into my own hands.

And I excited to tell my doctor about the progress at our next appointment!