16th January 2008
Russell,
The required Lantus dose depends on a number of things, but the main ones are your weight, your level of activity and whether you have insulin resistance. I take 15 units of Lantus a day, and I am a normal weight male (75kg), moderatly active and not insulin resistant. So 85 units seems high.
It doesn't sound like your doctor is very helpful, so here is how to test your dosage. As I mentioned, Lantus should keep your blood sugar reasonably stable throughout the day. You test whether you are on the right dose by skipping a meal and seeing what happens. If your blood sugar goes down during the following hours, the Lantus dose is too high. If blood sugar goes up after skipping a meal, you need more Lantus.
It gets complicated when blood sugar goes up after one skipped meal (like breakfast) but comes down after another skipped meal (say lunch). It happens because our insulin requirements change during the course of the day. And to deal with it, the dose has to be split and taken at the right time of the day. But to start with, just focus on getting your blood glucose stable overnight and after breakfast.