Splitting Lantus Dose - any advise please.

[samroboli]

Hi,

Lately I have noticed that I am having very high blood sugar readings in the morning when I get up, yet a few hours before, during the night if I test, they have been brilliant, 6's etc. This morning I had a reading of 6 then when I got up about 4 hours later they were at 18!! This has only happened since I changed my Lantus from evening to morning, which I did not do on purpose, I had a late late night trying to get my 7month old daughter to sleep and just forget (yes very silly I know) so I took it as soon as I remembered the next morning about 7.30am. I used to take it about 10 -11pm. I have been taking it in the morning for about 6 days, and I have woken with high sugars and a bad head, but this mornings of 18 was the highest so I got on the phone to the diabetic nurse and I was about to ask if I should split my dose, when she recommended that I do.

She told me to split my 20 units. Take 8 in the morning and 12 at night. I got off the phone and forgot to ask if I leave 12 hours inbetween, so that is what I have done anyway (setting an alarm of course so I don't forget!!) I took just 8 units this morning instead of 20 and thought it seemed very strange and assumed I might have high readings all day, but they have been fine.

When my sugars were high in the evening, like they were before I missed my evening dose, I put it down to the fact that I am on steriods (have been for 3 months as diagnosed with Acquired Hemophillia) but this has changed things, my sugars are good in the evening before meals after all, it wasn't the steriods it seems as if its the lantus, and i have been taking it for years and years! The steriods should not be affecting my readings too much anyway as they have reduced me down to 30mg.

I took the 12 units at 9pm, but I am most nervous of this one. I am so nervous of going low overnight / early hours, my hypo signs aren't the best. Will my 8 units taken earlier be overlapping with the 12 and make me go low? if thats the case the low should be hitting soon or have done? which I feel like I could be actually so I'll test as soon as I've typed. if I had good levels like 6 overnight will they be lowered even more by the 12 units? its such a minefield and I really wish I had looked into it more, or spoke to the nurse more before going ahead : ( I have a feeling I'll be up every couple of hours checking my sugars, I'm awake anyway randomly through the night settling my 7 month old so I won't get much sleep with getting up to test too, but better than the unexpected lows. I don't mind going low in the day at all, I look forward to a snack, ,but I always worry about not waking in the night, not that its ever happened, but I am a worrier : (

Thank you for reading if you have got to the end (sorry I am tired and possibly going low), I would love to know what times and ratio's other people who split the doses do and how it benefits. Sam

Thanks

 

[sarah1282]

hi samroboli. Sorry to hear about your acquired haemophilia. I have boy's in my family with haemophilia which I know is different to your type but they live a normal life
I split my lantus and it's the best thing I've done. Im on 26 units I take 13 at 10pm and 13 at 10am and its the best thing ive done.

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[paul-1976]

I split mine between equally between morning and evening-12 hours apart and it seems to work well for me too. :wink:

 

[Glennbo]

Hi mate. I used to split my lantus about a year ago 16 in the morning and evening which was ok but for me it was another injection to remember.
I'm down to 24 every evening and its perfect now.
The reason your blood was maybe going high is that lantus works only for about 20 hours and not 24 hours. This means your blood would start rising before you wake if you take it in the morning. If you forget to inject at night which everyone does from time to time, just stick half the dose in when you wake and carry on as normal. Also your liver may be responsible for the high in the morning if you were on 6. Its possible your blood may have gotten low without you knowing and your liver helped a bit too much!

I hope this was of some use to you.

Glenn



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[arohi]

Other than they have a small amount of sugar in them I don't know, I've always had them and found it didn't raise my levels by more than 1mmol

 

[Glennbo]

Point taken, the amount can be very little but as always eveybody is different and there are many variables that could contribute to an unusually high BS in this case.

Stress caused by a lack of sleep due to a small baby needing a feed could also cause your blood to spiral but I guess unless we all have CGM's we may never know.

Toodles

 

[samroboli]

Thank you for your replies, it does seem to be working, I am managing to remember the extra injection too as I have to take my steroids in the morning after breakfast so I have kind of got myself into a routine. I did have to increase my evening lantus dose by 2 units though before I felt any benefit so I'm at 14 in the evening and still only 8 in the day which is fine, no highs. Maybe I am more insulin resistant overnight, it's a puzzle!


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[polka]

I have just changed from lantus (which is 20-24 hour) to another insulin called levimir which works over a 12 hour period,
it does seem to give more control over the base insulin i have found.
you have to give an extra injection though as its half a day instead of once a day like lantus.

maybe using something like levimir would avoid having to split lantus?

ie give you more control?