More lantus or humalog

[amleolady]

My 23-year-old nephew who is 6'2" and weights well over 230 pounds only takes 34 units of lantus at night and up to 16 units of humalog if he eats pizza.  I have told him that the lantus dose is governed by weight and since I weigh 220 and take 33 units a day, he isn't taking nearly enough.  I think he is compensating with the humalog, which runs a higher risk that he will and does have insulin reactions.  I also started out taking lantus at night.  But since my blood sugar always drops at night, it caused a lot of lows for me.  I switched to taking it in the morning and everything works better now.  My nephew's blood sugar also drops at night.  This is his reason for taking a lower dose of lantus instead of switching to the morning and increasing the dose so he won't have to take such high amounts of humalog.  Is there a medical problem managing or risk in managing his Type 1 diabetes the way he is doing it?  What can I say to him?  He goes to an internist and not an endocrinologist.

[Debbie22]

Hi,
I had great results after I spoke to a Diabetes Educator. I remember leaving my Endocrinologist office very lost and frustrated, having no idea about why I was giving me 15 units of Lantus for Basal and different shots for every meal. I wanted to learn to how do it, how to calculate so I could take charge of my own Diabetes. What I've learned after speaking with the Diabetes Educator (and we did the math together) was that in order to calculate a Basal and Bolus, there are some rules and are very easy to be followed. Also, she told me that the site where you give your shots make a huge difference in how your body will absorve the insulin. For example I don't know why, but she said that Lantus works better if you give the shots on your tummy and buttox and novolog/humalog (fast acting) works better if given in your legs... anyway, this is a lot of information and if you can, please have him see a Diabetes Educator... al least once! It will help a lot because she will provide you with charts and help you to do the math with knowledge of what you are doing, knowing how your body operates! I hope it helps!

[Zoelula]

One thing that is true about diabetes is that we are all different. The dosages that works for one person might not control another person's blood sugar or might result in disasterous lows. Insulin dose is not determined strictly by weight, that is only one factor. You might want to get a copy of Using Insulin by John Walsh or Think Like a Pancreas which will help you understand and determine both basal and bolus doses. What you don't say is what your nephew's blood sugars are like. Is he getting good results with the doses he is using? That is what matters and is a lot better determinant of whether the dose is correct than weight. If he stays within target range with infrequent highs or lows than it is working. In general the bolus dose (Humalog) will influence the blood sugar two hours after the meal and the basal (lantus) will influence the bg in between meals. You can also fast and do basal testing. If you are willing to learn more about dosing one or both these books will help. If not, and the results are not good bg management then a visit to an endo might be in order.