[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.