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July 31, 2001

Daily Care

Question from New Orleans, Louisiana, USA:

I am 18 years old, was diagnosed with type 1 diabetes a little over two years ago, and since then, I have tried many different types of insulins, but no matter what is tried, I seem to either wake up really high or have severe lows during the day. I am a sophomore in college and have a different schedule day to day, so it is impossible to try to fit diabetes around my schedule. Is there any insulin therapy that I could work around my schedule of eating at weird times and not having a set daily plan? I am in the process of trying to find a new diabetes team because, with my old one, all I am getting is lectures on fitting my life around diabetes. Being a pre-med student it is really difficult and practically impossible.

Answer:

The new Lantus (insulin glargine) insulin may help provide smoother and more reliable overnight and pre-breakfast insulin coverage for you. You should discuss this with your diabetes team and see if this type of intensified insulin regimen would be of benefit to help lower your hemoglobin A1c and also give you less day to day variability, more flexibility, etc.

It sounds like you should try Lantus next, and if that does not solve the problem for your day to day life issues, then a therapeutic trial on an insulin pump would be in order.

SB