Lantus Questions

I know it's always best to ask for advice from the DSN but just thought I would ask the questions on here while I wait for her phone call.

1. Time Changing
is this best done by just an hour each night/day(depending on when you take lantus)?

2. Nighttime to Morning/Morning to Nightime (I currently take my Lantus at 10pm ish)
with this being such a big jump how would you go about this? Would you forget your nighttime BI then just take it the next morning but obviously monitor blood sugars?

3. Splitting the dosage
how would you go about this?

I know it's my body at the end of the day but even though in the past I may have forgotten a BI injection here and there which I know resulted in a BS of about 30 ish the next morning it's still a scary thing to make a complete change.

When I went from one does to split the evening does I gave half the does and then in morning gave other half and so on. So I was on 28u I took 14u for the evening does and 14u in the morning and have carried on like that. As I said in other post i have found splitting my lantus has worked for me

I have been on Lantus for as long as I've been carb counting (approximately 4 months).

1. Check with your DSN, but mine told me to change it an hour a day. I went from injecting at 10 pm to 7 pm in the event that I ever wanted to get an early night.

2. Again, check with your DSN, but one thing you could consider is injecting at 10 to see you through to the morning and then pick it up from there. To do this you would have to divide up the Lantus to hours in a day and work out how much you would need to give yourself which is going to be a massively reduced dose. I recently had a dilemma where I forgot if I'd done my night time injection and then went to bed thinking that I probably had done it. At that point my BM was 8.9. By 2 am it had crept up to 11. And then half an hour later it was 12.5 or there abouts. At that point I decided I had in fact forgot my night time injection and worked out that I would inject one unit for every remaining hour until my next injection at 7 pm. I talked to my DSN about this and she said that it was good going on my part because I could've started to feel quite unwell.

3. Is there any reason you want to split the dosage into 2?

Consult with your team obviously.........

1. Why are you thinking of changing time? Do you feel you need more or less in the AM part of the day..........?

2. If you were changing then all you could do is just do it and compensate with QA, remember it takes 3 days to take effect....

3. Again, you would just need to do it........a 50:50 split would be good to start with, and you would again need to compensate with QA for a week or something as the doses settle in........

Lantus can be split, but your better on Levemir for this, I think personally your better on Levemir in general as it allows for much more flexibility, especially for exercise and alcohol....

Is this is a possibility Gill............I would strongly recommend it......


Teanosugar........

Splitting the dose into 2 doses allows for 2 parts of the day to be dosed up independently, which is more realistic, as you your body requires different amounts of BI throughout the whole day, in fact, its possible the body needs different doses every hour of the day, something an insulin pump can accommodate for...........so splitting the dose in two is the next best thing for those on MDI, otherwise you will just be compensating with more QA insulin, which in the long run, is not good............you want as little insulin as possible in the system.....

Good questions on here. I too am on Lantus but use AM 14u. I'm trying to loose weight for my wedding in May (been on it for about 6 years now) and have heard it can bulk you up and that Levimir or Detimir are better-any views on this? Is splitting better dor someone like me who works out alot?

I have been on Lantus for about six months; before this it was isophane for many years. I haven't noticed any weight increase or decrease since changing to Lantus. I only know that injecting way too much insulin makes people put weight on. I don't think it's insulin specific.

After learning that MDI is only 50% effective, this may explain why Lantus may tend to put weight on people more than Levemir, because your are stuck with one dose of Lantus, which probably means you will be taking too much at some point in the day.............where as Levemir can deliver a more accurate dose as its split am and pm........

Just a theory thought, no real evidence.........

I split my Lantus a couple of weeks ago and I'm finding the change much better. Previously I was going high between dinner and bed because Lantus had run out, but taking extra QA would give me a hypo. With a 13/13 split, I am finding that everything stays pretty stable.

I didn't get professional advice on how to do it. I just subtracted 3 in the evening and added 3 in the morning, until I had an even split. Had a few hypos along the way, so there are probably better methods as per above.

Cheers,
Warwick.

Hi all,

It's great that people are thinking about and actually trying out Background Insulin twice daily as this is how the whole DAFNE regimen was originally developed; it's only with the advent of these newer insulin like Lantus that health professionals have started to use once daily Background Insulin in DAFNE, which is sad in some ways because as some of you have rightly identified, it does potentially reduce flexibility and may not be apporpriate if you do lots of exercise.

The usual recommendation when you first start a split BI is to do it 50/50, so half your dose as you go to bed and the other half as you get up (need to be 7hrs apart); this does mean that the doses overlap during the morning but this is considered to be beneficial to help control the Dawn Phenomenon.

Then you need to follow the Step-Wise Approach to adjust your doses as required, addressing each BI dose independently, i.e. the morning dose to maintain stable BG through the day; the bedtime dose to maintain stable BG during the night. It is not uncommon to end up needing totally different levels night and morning - they won't always necessarily stay equal.

Carolin