Lantus - Splitting - DAFNE Online

October 04, 2014 05:21

Warwick DAFNE Graduate
Diabetes Australia-Vic, Melbourne, Victoria 423 posts

In the book "Think Like a Pancreas" by Gary Scheiner, he details how when switching from any other basal insulin to Levemir, you'll often find that you need to increase your BI dose, sometimes by up to 25%. So if you are switching back from Levemir to Lantus, then you may actually find that you need less BI than you have been taking up until now.

You may well have high levels during the first few days while your body gets used to the Lantus again, but your GP is probably erring on the side of caution (quite rightly) in ensuring that you don't enter the land of endless hypos. Monitor for a few days, and you will quickly get an idea of whether 17 is right for you, or if you need more or less these days. A few days of highs won't hurt, but do monitor more frequently than usual, and use QA where you need to to drop any seriously high readings. A couple of 3 am readings will give you an idea of whether you have got it right or not.

All the best with it.

Warwick.

October 04, 2014 07:00

wigworld DAFNE Graduate
Hull University Teaching Hospitals NHS Trust 19 posts

Switching from Lantus once daily to twice daily isn't quite the same as switching from Humulin I or Levemir, because Lantus does last for 24 hours, whereas the others don't (12 hours for Humulin I and 18 hours for Levemir, if I remember correctly).
Having said that, I understand that evidence does show improved BG control with a split dose of Lantus, but making the switch isn't quite as straight forward as it would be with Levemir or Humulin I.

October 04, 2014 09:46

MelDent35 DAFNE Graduate
Royal Berkshire, Reading 5 posts

Warwick said:
I think you received bad advice there. My endo had no issue with me splitting Lantus, and it worked fairly well for me. The reason I switched to Levemir was that I do long-distance endurance events and I had to mke changes to Lantus about three days prior to my events to avoid hypos during the events. Levemir seems to be better at responding to changes.

Thanks Warwick. I don't do long distance endurance events unless you count the fact I walk pretty much everywhere since I don;t drive and am probably the only able bodied person in UK, if not the world, who can't ride a bike. I'm finding Levemir suits me much better as I was getting high around tea time which is when Lantus would have run out. It's early days but I'm keeping an eye on post Levemir results and changing dose if I see a pattern. I know from dafne that you need to wait 2 - 3 days before changing to see if a pattern emerges. This morning I took 12 units instead of 10 so waiting to see what pre lunch BG is.

October 04, 2014 14:05

Muna A H DAFNE Graduate
Royal North Shore Hospital, St Leonards, NSW 34 posts

Thanks all for your helpful advices Very Happy

October 04, 2014 05:21 Warwick DAFNE Graduate Diabetes Australia-Vic, Melbourne, Victoria 423 posts	In the book "Think Like a Pancreas" by Gary Scheiner, he details how when switching from any other basal insulin to Levemir, you'll often find that you need to increase your BI dose, sometimes by up to 25%. So if you are switching back from Levemir to Lantus, then you may actually find that you need less BI than you have been taking up until now. You may well have high levels during the first few days while your body gets used to the Lantus again, but your GP is probably erring on the side of caution (quite rightly) in ensuring that you don't enter the land of endless hypos. Monitor for a few days, and you will quickly get an idea of whether 17 is right for you, or if you need more or less these days. A few days of highs won't hurt, but do monitor more frequently than usual, and use QA where you need to to drop any seriously high readings. A couple of 3 am readings will give you an idea of whether you have got it right or not. All the best with it. Warwick.
October 04, 2014 07:00 wigworld DAFNE Graduate Hull University Teaching Hospitals NHS Trust 19 posts	Switching from Lantus once daily to twice daily isn't quite the same as switching from Humulin I or Levemir, because Lantus does last for 24 hours, whereas the others don't (12 hours for Humulin I and 18 hours for Levemir, if I remember correctly). Having said that, I understand that evidence does show improved BG control with a split dose of Lantus, but making the switch isn't quite as straight forward as it would be with Levemir or Humulin I.
October 04, 2014 09:46 MelDent35 DAFNE Graduate Royal Berkshire, Reading 5 posts	Warwick said: I think you received bad advice there. My endo had no issue with me splitting Lantus, and it worked fairly well for me. The reason I switched to Levemir was that I do long-distance endurance events and I had to mke changes to Lantus about three days prior to my events to avoid hypos during the events. Levemir seems to be better at responding to changes. Thanks Warwick. I don't do long distance endurance events unless you count the fact I walk pretty much everywhere since I don;t drive and am probably the only able bodied person in UK, if not the world, who can't ride a bike. I'm finding Levemir suits me much better as I was getting high around tea time which is when Lantus would have run out. It's early days but I'm keeping an eye on post Levemir results and changing dose if I see a pattern. I know from dafne that you need to wait 2 - 3 days before changing to see if a pattern emerges. This morning I took 12 units instead of 10 so waiting to see what pre lunch BG is.
October 04, 2014 14:05 Muna A H DAFNE Graduate Royal North Shore Hospital, St Leonards, NSW 34 posts	Thanks all for your helpful advices