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Lantus dose and time survey

J

JohnJ

Well-Known Member
Messages
78
Type of diabetes
Type 1
Treatment type
Insulin
Dear All, may I ask those of you on Lantus the question of time and number of units taken each day?

We are of course all different but I want to speak to my diabetic care team with some 'numbers' as I consider my own use is not correct.

Many thanks for your time :)
 
The correct dose is what works for your body. It makes no difference how much insulin other people take. We weigh different amounts, we do different levels of activity, we have different other conditions (or not), we have different levels of insulin sensitivity/resistance.

The numbers your diabetes team needs is your blood sugar levels throughout the day.
If you have a Libre, take your Libre graphs with you.

It doesn’t matter that some people take 10 units of Lantus and some people take 80 units. Yes, I have seen this kind of variation.
 
JohnJ said:
Dear All, may I ask those of you on Lantus the question of time and number of units taken each day?

We are of course all different but I want to speak to my diabetic care team with some 'numbers' as I consider my own use is not correct.

Many thanks for your time :)
Click to expand...
Hi,

I use Lantus I’ve been struggling with this basal for years. My endo won’t have it there is anything wrong. (User error.)
However, it can seem to lose potency. I just change the cartridge & this fixes it. (The following day.)
For me it can also seem to keep working, the last dose, long after it should have tailed or even worn off..? But that does depend on my activity levels.

There is a pretty good explanation regarding basal testing on this link. https://www.mysugr.com/en/blog/basal-rate-testing/
Which may help you determine your “relationship” with Lantus..

Best wishes.
 
In Response said:
The correct dose is what works for your body. It makes no difference how much insulin other people take. We weigh different amounts, we do different levels of activity, we have different other conditions (or not), we have different levels of insulin sensitivity/resistance.

The numbers your diabetes team needs is your blood sugar levels throughout the day.
If you have a Libre, take your Libre graphs with you.

It doesn’t matter that some people take 10 units of Lantus and some people take 80 units. Yes, I have seen this kind of variation.
Click to expand...
The issue I have is that I have two diabetic teams, the surgery and hospital diabetic unit. Whilst the surgery is primary care and I was taking 22 units at 6pm for over 20 years, the hospital lowered it to 10 units at 10pm (this I persuaded them back to 7:30pm as many over night hi/lows).

I have discovered that some trusts have stopped using Lantus due to 'exaggerated' performance claims. Takes between 2 to 4 hours to start working and lasts 18 to 20 hours at best.

I asked the question here to just obtain a rough average, so may add to my list of questions to present to both teams.

Many thanks
 
I took Lantus for about 12 years and only changed when I moved to an insulin pump.
I always felt in control of my insulin dose: I lived with it 24x7 rather than the 30 minutes my diabetes teams saw me each year.
If you feel you need a larger basal dose, are you comfortable increasing it (slowly) yourself?
The great thing about Lantus compared to very longer acting insulins like Tresiba is the impact of a dose change can be seen the next day.
I too found it did not last 24 hours but managed this by taking my dose with my evening meal and using bolus (and exercise) to tide me over the 2 hour gap. Some people split their Lantus to take two doses 12 hours apart. This overcome the gap and allows a slightly different dose at night to the day time.
Lantus is still my backup if my pump fails andI am comfortable keeping it.

@JohnJ in your position, I would be taking back control from the two teams who are telling you how much insulin to take - they can advise but you can chose how much insulin to take and when to take it. As @Jaylee suggests, take a basal test and gather evidence for your body about how your is reacting.
 
Last edited by a moderator:
In Response said:
I took Lantus for about 12 years and only changed when I moved to an insulin pump.
I always felt in control of my insulin dose: I lived with it 24x7 rather than the 30 minutes my diabetes teams saw me each year.
If you feel you need a larger basal dose, are you comfortable increasing it (slowly) yourself?
The great thing about Lantus compared to very longer acting insulins like Tresiba is the impact of a dose change can be seen the next day.
I too found it did not last 24 hours but managed this by taking my dose with my evening meal and using bolus (and exercise) to tide me over the 2 hour gap. Some people split their Lantus to take two doses 12 hours apart. This overcome the gap and allows a slightly different dose at night to the day time.
Lantus is still my backup if my pump fails andI am comfortable keeping it.

@JohnJ in your position, I would be taking back control from the two teams who are telling you how much insulin to take - they can advise but you can chose how much insulin to take and when to take it. As @Jaylee suggests, take a basal test and gather evidence for your body about how your is reacting.
Click to expand...
Thank you for your detailed reply. This rollercoaster is a nightmare was better levels before CKD was added to the mix!
 
Hi @JohnJ

I've used lantus for more than ten years now (don't remember the exact change date) and I find it slightly glitchy, I split my dose morning and night, partly to give myself 24 hour coverage and partly because I've had a couple of lantus lows where the whole lot has acted at once and I much prefer that to happen with half my daily dose. (I haven't seen the hospital clinic since I made the change to splitting, so they may or may not approve, though my GP hasn't complained)

Total daily dose has varied between 14 and 22, it depends quite a bit on exercise and sometimes just varies anyway. It's the only long acting basal available in New Zealand so I cope with it, though I have been considering a pump recently.

But people's insulin needs vary so much that it's not going to so you much good to hear are amounts - the figures can vary from a few units to literally 100s. I second @Jaylee 's suggestion to do basal testing.

Have you considered using a pump? They have their pros and cons, but , anecdotally from these forum, people who get on with them do seem to improve their control.
 
EllieM said:
Hi @JohnJ

I've used lantus for more than ten years now (don't remember the exact change date) and I find it slightly glitchy, I split my dose morning and night, partly to give myself 24 hour coverage and partly because I've had a couple of lantus lows where the whole lot has acted at once and I much prefer that to happen with half my daily dose. (I haven't seen the hospital clinic since I made the change to splitting, so they may or may not approve, though my GP hasn't complained)

Total daily dose has varied between 14 and 22, it depends quite a bit on exercise and sometimes just varies anyway. It's the only long acting basal available in New Zealand so I cope with it, though I have been considering a pump recently.

But people's insulin needs vary so much that it's not going to so you much good to hear are amounts - the figures can vary from a few units to literally 100s. I second @Jaylee 's suggestion to do basal testing.

Have you considered using a pump? They have their pros and cons, but , anecdotally from these forum, people who get on with them do seem to improve their control.
Click to expand...
Hi @EllieM
Thank you for your reply, yes everyone is different but I am arming myself with as much info incase of any arguments. I find within the NHS diabetic knowledge can be erratic, doctors experience could be written on the back of a (as the phrase used to go), a 'fag packet', they always refer me to the diabetic specialist nurses.

I tried various testing before, can you believe I tried for a week eating exactly the same meals at the same time each day, same physical activity and insulin doses also the same apart from the monotonous routine my results varied each day - doh!

I think you are right about making changes myself, I have spoken directly to the drug company (Sanofi), of course they said speak to my medical team but did say you can take anytime of the day though many users take at breakfast. Both my teams say in the evening, though the hospital pharmacy said breakfast! But I carb count so would take bolus (fast-acting) with food. You are not supposed to take basal and bolus together at the same time?

I did ask about a pump, but the NHS pumps are generally reserved for children. At the initial cost of £2k to £3k and ongoing supply costs of £2k per year. They are reluctant to provide to those capable of self-injecting.

The battle continues...
 
JohnJ said:
You are not supposed to take basal and bolus together at the same time?
Click to expand...
You're not supposed to mix them in a syringe (yes I used to do that with the insulins used 50 years ago) but I've never heard anyone say that you can't take them one aafter the other, though not in exactly the same spot.
 
Hi @ElleM and @Antje77
Of course you are both correct, I think it comes from end user errors, the hospital diabetic unit, my surgery and on the college diploma in diabetic management all, I think are covering themselves incase their patients inject in the same site area. They tend to treat us 'children' but I understand the duty of care policies they have to follow.
 
@JohnJ sorry you have been put off from pumping but they are not reserved for children or people incapable of injecting. I recommend reading the NICE recommendation (assuming you live in England).
I am very capable of injecting but have a pump because my basal requirements vary significantly at different times of the day and was frequently hypoing during exercise which I do most days.
If you are interested in pumping, it would be good to build your case about why varying basal and dosing small bolus would help you,
 
In Response said:
@JohnJ sorry you have been put off from pumping but they are not reserved for children or people incapable of injecting. I recommend reading the NICE recommendation (assuming you live in England).
I am very capable of injecting but have a pump because my basal requirements vary significantly at different times of the day and was frequently hypoing during exercise which I do most days.
If you are interested in pumping, it would be good to build your case about why varying basal and dosing small bolus would help you,
Click to expand...
I am not put off, I asked my primary care team about it before and was dismissed straight away. The phrase 'post code lottery' is very true. NHS is 'free at point of access'. Politicians try to promote that we have the best health service, in fact we are rated number 17, sorry to get on my soap box!

My reason in posting this discussion was to build a case/discussion on my treatment. Thank you for your knowledge and support :)
 
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