Lantus 100ml cartridges

[Kingfisher]

Dear diabetes forum.

I'm typr 2 and new to Insulin treatments, and I've made a mistake already for all the right reasons.

Lantus 100ml cartridges and an AllStar pro pen is my kit.
The Lantus is a Longterm Insulin.
One dose AM. 6units is the orders.

One dose a day i didn't hear, due to poor signal.

So i loaded the App, and saw Before meal and after meals. Assuming twice a day Insulin.

So i tested, Before breakfast 18.6mmol,
So being a cautious fellow and not wanting to overdo dosage, I did 2units AM & PM. Testing AM & PM

Over following weeks Testing & dosing twice a day. I've found myself at 5 units twice a day and readings of 10mmol AM and 12mmol PM.

And finally today AM was 7.4mmol, so i didn't take any insulin, at all.

Because I'm now worried i would have overdosed, if i had been shooting double dosing AM only.

Was i very wrong doing this twice a day at half dosage.??
And should i double the dose for a once a day shot.??

Best regards Pete

 

[SimonP78]

Yes, you can halve the dosage of lantus and split the dose, or combine it into one injection. The duration of this insulin is ~24h so this works, though the insulin activity is not completely flat (some slight peaks and it tails off) so you may find doing one or the other works better for you. I split my dose for example, which also gives flexibility if I'm going to have a busy day so can then reduce my basal.

Why didn't you take any insulin when your blood glucose was 7.4mmol/l, it sounds like this is a decent reading, presumably you ought to now take the same insulin that you took to get this result, otherwise you'll find your background blood glucose will go back up once the lantus has completely gone.

 

[In Response]

The purpose of long term (basal) insulin such as Lantus is to keep our levels stable.
So, there is no reason to avoid it if your levels are in the normal range such as 7.4.

 

[Philippe T-L]

Because Lantus works for 24 hours, many doctors and specialist nurses prefer their patients to inject Lantus only once a day.

Everybody is different, but the professionals advise to inject the same amount of Lantus everyday. Should your daily amount be too much every day, you can reduce it by 2 units at a time and no more. After a full week, if it is still too much, reduce again by another 1 or 2 units but no more.

Some people can control their sugar level perfectly but others, like me, cannot. Whilst doctors and nurses have tried to get me control my blood glucose level better, over the last 40 years, it has never worked. For a long time, I have had peaks nearly everyday to over 20mml sometimes going over the scale of my testing machine (33+). I have never had ketones. I also do not show any signs of being high at any time, only testing gives me a clue. I also normally have no symptoms of hypo until I am at least about 3.3 or 3.4 sometimes as low as 1.8mmol. I am now 72 years of age and still have no problem with my feet or eyes but, over the past 2 years have had problem with my teeth. Corsodyl tooth paste has been very good but has not stopped gum disease and loosening of some of my teeth following infection of the roots.

After changing the injection sight from tommy (for 30+ years) to thighs (this last year), I have had to reduce my Lantus level from 40 unit a day to 32 units a day (in 3 stages i.e. over 1 month). Apparently, the location can become saturated and does not allow insulin to diffuse as it should. Now I hardly need any short acting insulin unless I eat a lot. If I do any unusual physical work or get cold, then I know that I will need to have a couple of biscuits with a cup of tea or coffee to keep within an acceptable glucose level.

I also can swing very quickly. Measuring 2 hours after my lunch, my reading can be around 12 or 13. If I go outside to cut the lawn, within less than 30 minutes, I can be down to 2.1 mml. I have sometimes got down from 24 mml to 3 mml in less that 30 minutes which means that sometimes, I need to check my blood 4 or 5 times or more a day but this seems to only happen for the odd days.

Diabetes need to be treated like a good friend. It is always with you and you need to take care of it but do not get obsessed with it. The odd high will not affect you long term but avoid having to many lows. Yesterday I had 3 lows (1.8 then 3.2 then 1.9 within 6 hours) for no obvious reason (possibly a bit more activity than usual and colder weather) and, at the end of the day, I felt a bit more tired than usual.

If you carry out more physical activity than usual, or get into a cold environment, check your blood sugar level a bit more often. Some days, cold will affect your blood glucose more than other days.

You also need to avoid some food. For me, pizza will often boost me to over the scale of the machine, so I avoid it but do not ban it altogether. I tend to have pizza once every 3 or 4 months.

I hope this helps.

 

[Kingfisher]

Thank you, Simon
I didnt take the second half dose, really because there was a serious chance of not eating anything or very little for the next 6 to 8hrs.

Although it was a misheard instruction and a total worry of taking too much Insulin, that led me in this direction. Ive found splitting the dose, and applying a cautious volume is leading to a much better control, especially given my circumstances of eating.

Understanding that this Insulin is 24hr and thinking that delivering a half dose seems in practice to give me this flexibility, that i wouldn't have if i were to deliver a full dosage.

It would appear the only detriment would be the extra needle given its a cartridge AllStar.

I am new to this Insulin medication, and i do listen to advice given. If I understand the practice/action taken. sometimes one can find an advantage. In practice this method works for me. But sometimes people can see problems that i hadnt thought of. So i value all comments. Thank you so much.

 

[Kingfisher]

Thank you Philippe, that was very useful, your information and Simons has given me confidence.

At least its taught me its not a mine field if you step lightly.

One comment that did surprise me was the effect of cold on Philippe, but i suppose this could be a personal problem.

I think I'm going to continue with the 2x half dosage, in 24hrs, altering either dosage accordingly. This should smooth my readings out given my sometimes poor eating habits.

Thank you very much for your help. You've all settled my mind.