On 1/20/2008
Kiwi H wrote:
Rick,
I am not aware of a 12 hour Lantus. My understanding is that the long acting insulins like Levemir or Lantus keep your basal insulin levels even. Lwevemir is designed to be taken every 12 hours. I haven't heard of only takeing a 12 hour basal once a day. Without basal insulin, your body has a very difficult time maintaining 'normal' blood sugar levels. If you don;t have enough basal insulin on board, then no amount of rapid will move the numbers, and nor will exercise which could actually be harmful if your numbers are high.
If it is a 12 hour, then taking it at night is the best as there is usually a surge of blood sugar during the night. this is called the Dawn Phenomenon. It is also good that you take a sliding scale as you can go low at night.
HAve you had an A1C done? this is a rest that measures the average of your blood sugars over 3 months. It is an average of your 2 hour post meal numbers as well as your fasting am numbers. If it is over 7.5 then you will need to get your basal insulin tuned up as well as your post 2 hour meal numbers down. If it is under 7>5 then your 2 hour meal numbers need tuning. this is where the Endo will be able to help. Do you have a Medical team? Havard University (joslin) has an excellent Diabetic web site.
When you go low, it is important to stick to the 15/15 rule. 15 gms of carbs every 15 minutes and test. I have dextrasol tablets tucked into the pouch of my glucometer so they are handy when I need them. If you go low and you don't get glucose in quickly your liver will dump a load of glycogen (stored sugar). this will cause a rebound high numbers.
Being active is good, as you will be using up the fuel you ingest. Aerobic exercise will burn fuel, however any form of maximum effort (lifting heavy objects) or short bursts of maximum activity will actually increase your levels. Also if you are exercising/working out on your ranch and your levels are over 240, and you are making ketones, then your levels will actually rise.
Eating low glycemic index food will also help as it is slow to digest so stays as fuel longer.
Another problem is to keep well hydrated, and your electrolytes balanced. High sugar levels will cause dehydration. Once the body is stressed, it releases these hormones called 'counter regualtory hormones'. these include Adrenalin, norepherine, cortisol etc. These will also raise your sugar levels up. You can buy non carbohydrate electrolyte replacement crystals which I find to be very good.
Another factor with food is that higher fat food will cause levels to rise, usually they have a more delayed response. If I am around 120 at night I will eat a small snack of 10gms of carbs in a 0%youghurt plus a handful of nuts. (right now I can't eat nuts, but cream cheese on a rice cake works too). This keeps the night time numbers more stable.
The wild fluctuations are tiring to the body. I hope you can get to an Endocrinologist and see if they can help with keeping the numbers more stable. When you have good control, you feel really good!
Hope this helps a wee bit.
Kiwi