[Myxel67]

When there are frequent problems with low BG values--especially in older adults, there may be kidney or liver problems which interfere with treatment. If kidneys are not functioning well, insulin stays in the body longer and may lead to hypoglycemia. When there is a problem with liver function, the liver may not be able to make, store, or release glucose effectively.

[dansingrn]

If Lantus is given at bedtime, and the glucose is 45, Lantus should still be given. A person with type 1 DM can go into DKA when basal insulin is withheld. There are many reasons why the glucose is 45, including the patient not eating all of the last meal after rapid acting insulin was given, the last pre-meal insulin dose was calculated incorrectly, or the improper use of premeal "sliding scale" insulin instead of using an insulin to carb ratio to determine the correct dose. Check with the physician who ordered the Lantus, or the CDE who is following the patient's glucose trends so the true cause of the hypoglycemia can be determined. Simply holding bedtime Lantus is not the answer, and will cause more problems.

[ndynrs]

Originally Posted by jmgrn65

Lantus is not to be held, no matter what thier Blood sugar is, it is not that it is slow or short acting it controls the sugar over the course of the day. It may need adjusting but it should NEVER be held. So you were right. It is harder for some of us older nurses to grasp that idea not to hold insulin when sugars are low. but holding the lantus will not effect it.

this post makes me feel alot better about a very similar situation that happened to me at work where the on coming day shift nurse (who is older might i add) proceeded to lecture me about why i shouldnt have given lantus to a pt who had a BS of 64 at 0600. she seemed so upset and made it seem like i was so incompitent for not holding the lantus. needless to say this bothered me forever- being a new nurse.but i could have sworn lantus was long acting and basal. this happened literally 5months ago, i an finally let it go now that i've read this. SIGH. lol

[classicdame]

As a nurse and diabetic I totally agree with FireWolf. The emphasis is on treatment of hypoglycemia FIRST, however, then inject the insulin. Changing the dose will not have an immediate effect on BS. It would be more important to assess why the BS was that low to begin with.

[nursenancy1]

I am a diabetes Educator.Lantus should not be held.Reason even if your patient is NPO the liver is still producing 50% of the body's glucose and the lantus is what is taking the gkucose into the cells.Without it the BG would climb.If you question wether to give insulin or not always call the physician.