lows that take huge amount of sugar to bring up

[scottlaw]

I have been Type 1 for 8 years and over the last week I have had very troubling lows. I am taking Humalog with meals and lantis at night.

I have reduced my lantis at night from 38 to 30 and have been very precise with my carb counting for the meal injections of humolog...but each afternoon I am getting very low and it take huge amounts of food and time to bring it up. Of course I have had lows before but 20-30 grams of carbs and 15 min. I am fine but over the last six days I have had to eat 270-350 grams of carbs (yes I said 350 grams of carbs) over 2-3 hours to get my blood sugar over 100. My blood sugar wants to hover between 65-90.

Has anyone had anything similar happen? does anyone have any advice?

[JDR-VOL-LS]

Scottlaw,
We are volunteers here and not medical professionals.  We do have a lot of experience with Type 1.  

It is time to check in with your end about this pattern.  When we have a severe low, it does take time for our liver to restore the levels of glycogen needed to combat the next low.  If your overall level of activity has increased since diagnosis, or if you're in a different stage of life when your metabolism has increased, you may well need to recompute your insulin:carbo ratio *and* your insulin sensitivity.  These factors affect how much insulin you need (as in your Lantus dose) for background, as well as how much you need to cover your foods.  It's really time for you have a follow up appointment to review your progress and timing of your injections.

Over time you might consider talking to your doc about pumping, which can give folks quite refined control.  Good luck!

[JDRF-VOL-SG]

Concerning the Lantus problem -- how old is the bottle you are currently using? I take mine in the morning like you do, for the same reason, avoidance of night lows. I will have mid- to late-afternoon lows if I let the bottle of insulin get old. Lantus works by crystallizing after injection and the crystals slowly release all day. But in small print in the paperwork that comes with a bottle of Lantus, there is the warning that it should be replaced every 30 days. Unlike other insulins, that work the same until we use them up, the Lantus insulin does seem to lose its 24-hour release capability after about a month. And I have occasionally had to replace it a few days before one month. I will notice the same thing that you are experiencing -- a fairly noticeable drop in glucose in late afternoon. I believe that the older Lantus is just losing its crystallization ability and that I get a bit of a dump at that time of day when it is getting close to time to replace the bottle. I have experimented with my timing on the quick-acting insulin and strongly believe the dump is the Lantus. Try changing to a new bottle, and see if this solves the problem.

[scottlaw]

Thank you so much for the responses, I have been to the doctors twice last week and I have another appointment on Monday to talk about getting a pump...I have been offered 2 pumps the Animas 2020 or the Paradigm with real-time glucose checks...I was skeptical about the pump but as I read on this forum and others they seam to only have good comments. Has anyone used either of the pumps I can choose from?

[AlanK]

I take lantus in the morning, not at night.