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Lantus question

LianneGaynor

LianneGaynor

Member
Messages
19
Type of diabetes
Type 1
Treatment type
Insulin
Hello

I am just wondering if people have found it better to have their lantus split or to just have the one dose of lantus, either in the morning or night.

I was having 22 lantus in the morning and 2 units in the evening, but then in August the doctor told me to stop having the 2 units at night to see if that would stop the occasional hypos, and thus give me better control during the day I guess. But then I had the continuous glucose monitor and that showed that my lantus was running out, so in December the nurse told me to split my lantus again 16 units in the morning and 6 units at night. I am still having the same problems as I was before but I am constantly hungry on the night now, I don't know if this is a side effect of lantus or what it is doing to my body, but it always feels like my blood is dropping and if I don't eat something I will inevitably drop low. I'm also not sure that 16 units is enough for me throughout the day. The nurse told me that if it was frequently low again to go back to doing 22 units in the morning. So my question really is would it be better to split the insulin and eat something, and maybe hypo or maybe wake up high regardless, or just have my lantus in the morning and then not eat anything in the evening/have a small snack ie an apple, which may result in slight highs. Or if I should maybe have more than the 22 units in the morning and therefore it may last that little bit longer throughout the night.

Thanks for your help.
 
I split my Lantus a few months ago, without informing DSN before hand, at clinic, she noticed a marked improvement of my levels. Then I told her I had split my dose.

The words 'Lantus is NOT made to be split but if it works for you then keep it up' spring to mind.

Trial and error is the only way to know what worjs for you cause everyone is different :)
 
How did you determine how much to split it to for your morning dose and your night dose?

I'm not sure if splitting it is better or not but for years it was split and it took a long time for it to become 22 and 2 so I'm not sure why the nurse decided to make it 16 6 this time!
 
I can't split my Lanus. I use it just to keep me steady while I sleep. I use basal during the day for my food. I tried splitting Lantus and had lows (hunger) and rebound highs (hunger) Are you taking basal? Lantus will work on meals but in an unpredictable way, hence the highs and lows.
 
I started taking a 50/50 split and adjusted it from there.

I now take 20 at 6pm and 10 at 8am.

My HbA1C last month was 40 so I must be doing something right ;)
 
@Kristin251 Yes I am on novorapid for food as well as the lantus. I have between a half unit to one unit per 10 carbs.

@MH2010 Yeah thats what they did for me years ago when they first decided to split it and then worked each dose up and down, which last year I actually thought was finally working, albeit the hypos. Then the dr thought the 2 was pointless and was making my blood dip which in turn made my body dump glucose so I woke up high. So then for a couple months without it I thought it was going ok, but the cgm showed it was running out, so I am back to this dilemma. It just never seems to be right I'm either going too low or going too high, so I think my options are staying with it and fiddling or going back to the 22 dose with either 2 at night or none at night, and occasionally waking up at 11 or 12.

I have no idea what mine is actually I had my last blood test October but haven't seen a Dr since.
 
@LianneGaynor Have you ever thought about switching to Levemir or another long lasting?

I tried Levemir but hated it so went straight back to Lantus.
 
Not really. I don't know the differences between the two but I know that that is a split dose so would it not just cause the same issues?
 
Not too sure to be honest. My DSN said that Levemir was more a 50/50 split and it keeps things more level through the day.

Might be worth researching a bit.
 
I'll have to have a look. At the moment it's like I'm damned if I do, damned if I don't.
 
Yeah more than half my life. I was 10 the month before my 11th birthday, I'm 23 now. Probably the worst time to have developed it with all the hormones and not really having a clue, it was crazy during my teen years.
 
I was 4 when I was diagnosed, 25 years ago. Sure as hell doesnt get any easier lol.
 
It sucks don't it, especially when its hormones causing so many issues, like I can't control that, and the drs I had at the time were no use. If I could go back and do it all again, I'd do so much different!
 
Not sure but just a thought... Find the Lantus dose that keeps you close to the same from bed to morning and use bolus for the day. When I was 1st diagnosed I was put on 5 units nightly and it would take me from 200+ to 70, 80, 120 by morning. Very unpredictable. I landed on 2 units and that takes me from 85-90 to 85-90. Bingo. Then I use Novolog to keep steady during the day. Little squirt of Lantus at the wrong time caused hypos/hypers during the night and day. I use Lantus for before bed to fasting only. I think Lantus runs out around noon as I rise a bit then but inject I unit Novolog 5 min before lunch and back to 85 before dinner.
 
I thought that background insulin has to be in your system for as close to 24 hours as can get it, I didn't realise you could have it for however many hours there are between when you do it and noonish, and the rest of the time only rely on your fast acting insulin. What do you use for your insulin carb ratio? When I first started it I had the whole dose at night but it caused constant hypos, which is why they split it in the first place, so I'm not sure having a small dose at night and none in the morning would help, because it would run out quickly and I'd have nothing left for the day and I fear I'd go too high, and having a larger dose at night would cause too many hypos.
 
For ME, too much at night caused hypos and unpredictable BS swings. Lantus is SUPPOSED to last 18-24 hours BUT I only take 2 units so it runs out faster. I can't take it in the morning or I am all over the place. Lantus is supposed to be back ground insulin to keep you steady in a fasted state like sleeping. It is not designed for food. That is what FA bolus insulin is for. Once I finally found the dose that kept me steady (no hypo/hyper) from bedtime to fasting I stopped fearing hypos and got much steadier BS. Then I take my BS as soon as I get up, inject rapid insulin and eat. I eat the same BF everyday (Guac and celery) and I stay steady from 8 until noon and then I creep up a bit (not hypers, not higher than 112) which makes me think Lantus runs out at small doses. Then at lunch I inject 1 unit 5 min before eating and I am back to 85 pre dinner. Before bed I am usually between 82 and 100. If I am over 100 I take 3 Lantus but usually wake up low 80 or 70's and I feel best around 85.
during the day is when you need fast acting with meals. I don't really do carb ratios because that had me roller coastering. I am VERY low carb. I eat Guac and celery BF. Lunch is half can tuna, about a cup of cooked veg, a few raw veggies and a bunch of fat. Dinner same as lunch but more veg. I have tried every way possible to eat carbs and get my insulin there at the same time to no avail. In MY opinion insulin to carb ratio is a great theory but doesn't work. At least not for me. I rarely have more than a 20 pt spike, ever. I just keep my meals very consistent day to day, meal to meal. Very low carb, moderate P and high fat. Works like a charm for me.
I believe for me 1 carb raises me 7 pts so correcting hypos (which I rarely do ) means I radish with a little hummus, LOL.
For me it is much easier to take Lantus just for sleeping to keep me even and NOT fear hypos and use Novolog during the day. IF I over eat I can take a correction does of a half unit and it will drop me about 20 if I don't eat or take it around food.

Every body has there own targets and methods. I do NOT like moving BS either way. It makes me ornery! My target is 85-100 and I have little trouble keeping it there with MY method. Lantus can cause me far more hypos than Novolog and I prefer to know when I hypo, not while I am sleeping! Then I just get a liver dump at BF and the roller coaster begins. No thanks

From what I understand too is Lantus should NOT move you one way or another more than 30 Points. IF it does it needs to be adjusted
 
Just goes to show no matter what they tell you insulin does not always work the way it's supposed to.
I have my novorapid carbo ratio pretty spot on I think, although with less lantus in the morning I am finding I need another unit of novorapid with lunch.
 
In theory insulin is great but it rarely works that way when you throw carbs into the equation. The problem is getting insulin there at the same time as the carbs. If you miss the mark you roller coaster up and down.
You may need more novorapid during the day but you may also have more predictable BS. Just like some people who still randomly put out some insulin and they have no way of knowing when or how much would have a very hard time staying steady. I can predict my after meal BS most of the time. I would tell my husband every night if he woke up to make sure I was alive. I didn't care for living in that fear so I found my new plan.
What are your bedtime and fasting numbers? What do you typically eat at meals? Do you eat a lot of carbs? If you do I am not sure you can obtain 'steady' in my opinion
Maybe try finding your 'steady' from bed time to fasting and then work out novorapid. SOME novorapid will still be there it might just not be enough to make you hypo. I have much more control with Novolog during the day then trying to figure out what extra Lantus is doing.
 
I feel most of the time my day time is fine hence why I think my novorapid numbers are good, unless I have a new food and have to have it a couple times to work it out, it is just my morning numbers that are an issue. Have been for a while to be fair.
Ok so for example Monday I was 5.5 I had an apple but had a hypo at 5.40 am so woke high. Tuesday I was 8.5 I had a pear and woke 7.9. I tend to find if I'm in the 4s or 5s I'm likely to have a hypo. But it was basically the same when I wasn't having the lantus anywhere between normal to then waking between normal to around 12s, and still had the occasional hypos. (Sorry I don't know how to convert them into numbers you'd use.)
The dr thought the 2 lantus at night was causing a dip and liver dump, however without the lantus at night I think I may have had the dawn phenomenon. I may just have to fiddle around and go for 4 since that's between 2 and 6 see if that's the magic number.
 
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