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December 8, 2004

Insulin Analogs

Question from Bombay, India:

I have read the following: “Lantus, because it has essentially no peak, reduces the risk of nighttime hypoglycemia compared with NPH.” I do not agree with the above statement because for my daughter, the Lantus peaks every night and her blood glucose levels drop by 150 to 200 mg/dl [8.3 to 11.1 mmol/L]. We’ve had to wake her in the middle of the night to give her something to eat/drink to avoid a hypoglycemic condition.

My daughter currently takes seven units of Regular around 4 p.m. daily and 24 units of Lantus at 7:30 every morning. At night, there is such a big drop. How do they claim that Lantus has “no peak?” Our doctor says the honeymoon period is over.


From: DTeam Staff

I agree that honeymoon is almost certainly over. I don’t think this is anything to do with Lantus “peaking, ” but your daughter may be on the wrong dose with there still being an effect in the middle of the night. More likely is that she has too much Regular at 4 p.m. and this is lagging until the small hours of the night. Does your daughter always have a starchy snack before bed? If not, she should.