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glargine twice a day

C

chocolate

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Hi, can anyone offer some wisdom?
I've been on glargine for probably 7 years and never found it to provide a level profile, specifically running short of 24 hour duration. Now taking it twice a day to counter its short durationbut there are highs in the morning and hypos throughout the night as demonstrated by a CGMS recently (6 hours at less than 2.2mmol/l).
Anyone have similar issues and what action have you taken to sort it out.
I am an active runner and cyclist but am used to altering doses to suit and need a basal insulin to provide a flat profile as my HBa1C has gradually increased by .1pa whilst on Glargine and I'm running at 8.1 and worried.
Simon
 
No experience of splitting lantus but will bump up your post to see if anyone else can advise.

Nigel
 
Hi,

I used Glargine for many years but then found it became less and less predictable for me. I think the current view is that you can't split the dose. So, what I did was move to Levemir and split that and that's working very well. Ask your GP if you can try?

Best

Dillinger
 
I haven't had to split glargine as I get on with it ok, but I did discuss doing so with my DSN, and I know people who have. I think I'd be inclined in your position to follow Dillinger's advice and try levemir, but in the meantime, might it just be as something as simple as raising the dose you take in the morning and lowering the dose you take before bed? You don't say when you are injecting or how much. Could well be that the doses are overlapping (in which case levemir may well be the answer), or it could be that the doses just need to be different at different times (in which case it may be fine to stay on lantus).
 
Hi Chocolate

I am Type 1 on Lantus and split the dose on some days. If I have had a very long run planned that day that morning's dose (I take my main dose AM, cos of nighttime hypo's) I will cut by 30% , if my sugars are above 12 at bedtime I will take that 30% at night to then slowly lower my BS through the night. This works better for me than having a couple of units of Apidra which I am very sensitive to and brings it down more slowly without the risk of hypo

I agree that the Lantus dose run out and does not keep at the basal rate for the full 24 hours ,like you said 18 yes.

My Endo is cool with me splitting the dose and like your self when you exercise a lot you really need to find what works for you and it can involve some pretty drastic adjustments sometimes. I have had no problem at all splitting the dose on a number of consecutive days then going back to AM injections alone. I have good control.

You really do have to experiment to find out what works for you as an individual, as this is a very individual disease that react with us all very differently...and throws us a good few curve
balls along the way!!

Hope this helps :D
 
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