Splitting long acting insulin dose?

[jerilt1]

I take 40 units Lantus (long acting), and sliding scale Novolog (fast acting) insulins.  My bg is always so high in the mornings, I have to take Novolog and wait for sugar to come down to eat.  I've had diabetes for many years, but never knew for sure which one!  My dr would switch my diagnosis all the time.  But went to endo and they did a blood test, and said I'm type 1. I'm angry my dr. never did anything about this.  My daughter splits her insulin dose, 1/2 in the morning, and 1/2 at night.  I was wondering if this would help?  Also how to do it?  My dr won't help me. Thank you in advance :)

[Super_sally888]

Hello,
Lantus is typically only dosed once a day (even though the duration of action is only about 20 hours a day.  Following are some ideas to run past your dr.

1. Take your lantus at night (instead of in the morning), if you are not already taking it at night.  This way, at least it will be fully active over night.  
2. Split the lantus into 2 doses to get better coverage.  The doses may not necessarily be the same.  ie. You may need a higher dose at night than in the morning.
3. Try levemir (a different long acting insulin), which is typically dosed twice a day.
4. Ask your dr to prescribe you the new insulin Tresiba.  This is an ultralong acting insulin and seems to help many people with avoiding high morning sugars.
5. Take your breakfast soon after you wake up (you will need to dose Novolog to provide both a correction and to cover the food).  it will be best if your breakfast is very low carb ie. eggs or meat and some veges, to avoid further increasing blood sugars too much.   Eating may actually help stop the liver putting out sugar, which it does in response to an overnight fast.
6. Set an alarm clock and take an early morning correction of novolog to counter the rising blood sugars and prevent them going too high.
7. Ask your Dr to refer you to a diabetes educator, who can help you in developing strategies to control your blood sugar better.
8. You may also need to do basal testing to be sure that your dose of basal insulin is correct.

Some good books are "Using Insulin" by John Walsh, "Think Like a Pancreas", "Diabetes Solutions".  All describe how to test and adjust insulin dosing rates to get better blood sugar control.

[caregiver222]

Super_Sally888 has provided good advice. One protocol is to take your blood glucose at night, then administer enough Novalog to bring it to normal levels. Then inject Lantus sufficient to bring the levels to normal in the morning.