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Lantus timing

Karenchq

Well-Known Member
Messages
84
Location
Bruxelles
Type of diabetes
Type 1
Treatment type
Insulin
Due to running a bit on the low side at night, my doctor advised me to change the timing of my long acting insulin. I was taking Lantus (7units) at 9 pm and over a week have changed from 9pm to 9am. I felt like this drastic time change would be hard on me so I changed gradually by taking 6 units at night then 1 in the morning, then 5 units at night 2 in the morning etc until all 7units at 9 am. I am now 1 week into the time change and have felt rubbish. Two days ago I had a mild hypo during the day that would not normally have not affected me very much, but it knocked the stuffings out of me for two days. I feel like it was a mistake to change the timing and wonder if it is better to go back as before or wait it out to see if I feel better. Any advice from those who have made this sort of big time change would be helpful.
 
Can I ask what time you had the hypo? Lantus is "kind of" flat, and lasts for "kind of" 24hrs
Would be interested to see if the peaks match.
 
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On Lantus, when I took it before bed (10pm) I would run low in the morning. Reducing my dose made me high in the morning, so my DSN suggested taking Lantus in the evening (6pm). This worked for me.
Unfortunately we are all different, but timing certainly does seem to make a difference.
 
Much like @dancer I use to take my lantus just before bed and would sometimes hypo in the early hours, on the advise of my DSN I changed it to early evening and had very few problems thereafter.

Something to think about @Karenchq , if you don't succeed in getting the dosage and timing right ask to switch to Tresiba, it's a newish basal insulin and apparently has a much flatter profile than lantus & levemir.
 
gavin86 said:
Lantus is "kind of" flat, and lasts for "kind of" 24hrs
Click to expand...

Lantus action time is as follows:
  • 1-2 hours after injecting it starts working
  • Around 6 hours after injecting it peaks
  • Around 18 hours after injecting it stops working.
If you think lantus is causing hypos @Karenchq you should do some basal testing and consider reducing the dose.

The way you moved you injections from pm to an also shows you that lantus can be split so if basal testing suggests lantus runs out for you splitting the dose is something to consider, especially if that was working well for you during the move of the dose.

Sorry it's proving difficult. Don't be too quick to go back as you moved the dose to avoid night lows and that is an important aim.
 
gavin86 said:
Can I ask what time you had the hypo? Lantus is "kind of" flat, and lasts for "kind of" 24hrs
Would be interested to see if the peaks match.
Click to expand...

The hypo was about noon. I expect that my bolus insulin was a slight bit much for what I ate at breakfast. That sometimes happens and a quick snack brings me right back without problems. As I said, this hypo was wasn't very low left me on the sofa exhausted for two days.
 
Thank you all for the advice and encouragement. I have a cgm and will watch my levels closely. Perhaps, as suggested, the time should be earlier evening or split dose. I will talk with my doctor about those possibilities.
 
I can't take lantus during the day. Even one unit and I hypod all day.
I only take one or two units at 10 pm. It doesn't always do the same thing. It can depend on my activity the day before or what I had for dinner or wha ttime I ate dinner. I know mine doesn't last anywhere near 18 hours. I don't think I have any left by the time I get up so I just depend on my bolus for the day. I need a small dose after bf an dbefore lunch to stop the morning rise.

It's not supposed to work on food but it does. At DX they only had me on lantus and I took it with dinner at 6:30. It would drop me in the first hour.
 
Kristin251 said:
I can't take lantus during the day. Even one unit and I hypod all day.
I only take one or two units at 10 pm.
.
Click to expand...
I realize everyone's different, but crashing with only 1 unit of Lantus after an hour? All day? Realize the average Type 1 takes about 1 unit of insulin/kg body weight, and roughly half is basal. So 70kg person might take 35U Lantus. Myself I only take 25 units/day, and I weigh 72kg so that's a pretty low dose. I notice a lot of people here don't take very much Lantus. Make me wonder why the take any at all.
 

Hi Karen, hallo Kristin, I'm taking 1 unit of Levemir in the morning (because honeymoon + low carb diet + always on the go + breastfeeding) but have been having to snack all the time to prevent hypos. I've tried not taking it but feel even more foggy when I don't take it, so clearly need it. I thought of switching to the evening because I would be worried about going too low in the night, but I am rethinking this based on your comments... will see what my Dsn says. Thank you!
 
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Again she takes 1 UNIT and has to snack "all the time to prevent hypos". Does it make any sense to anyone that she still takes 1 unit of Lantus, or is it just me? Maybe I don't understand this disease, but continuing to become hypoglycemic and continuing to do the same thing and get a different result?
 

If this were in the type 1.5/LADA subsection it might make "A tiny bit" of sense but I'd agree with you that in this subsection something isn't right.

To be frank, I'm not aware of anyone who is even close to that level of insulin sensitivity and that even includes reading about children who are still in the honeymoon phase.

I'm not saying that I don't believe it but the only way I do is with the understanding that that individual still makes a considerable amount of endogenous insulin (type 1.5/lada)
 
When I was on MDI, I started off taking Lantus at 7pm (and went to bed around 9pm). At various times I tried taking Lantus in the morning (7am), and splitting my dose between morning and night, and nothing seemed to make much of a difference. Turns out my basal needs vary significantly throughout the day, and a pump was the best solution for me.

As someone who once needed to stop taking Lantus completely, and then took a dose of 1 unit per day for a long time during the start of my honeymoon, I do believe people can be this sensitive to insulin. Maybe rare, but definitely not impossible...
 
At that dose I would also stop taking it if you're going low from 1 unit. It doesn't matter if you feel "foggy" - that could be many things - what matters is your blood sugar level and not having hypos. Perhaps look into half unit dosing?
Also, at such a small volume, any minor variation in injection effectiveness will have a more pronounced effect. Make sure your injection technique is consistent every time.

Perhaps you need to investigate the possibility of some other metabolic disorder too - although it varies between people, there is an upper limit to how much glucose 1 unit of insulin can deal with, and it seems like something there might not be working correctly, if 1u lets you snack all day just to avoid lows.

I'm just entering my "honeymoon" and am taking 24u lantus every day , plus about 18u novorapid. I weigh 75kg.. but I would love to not need as many injections, so count yourself as lucky!
 
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Frankly I'm tired of hearing my doses are irreverent and I shouldn't even take insulin. GAD is over 250 and c peptide .4. So.. I don't produce insulin and I have antibodies. If I eat and don't take insulin I will not ever come down, only rise. I eat very low carb and very small meals but I eat all day long. Fat heavy.
One unit lantus doesn't drop me, two can and three does. I take 1/2 units humalog 4 times a day with food and I stay steady. If I do t take insulin lettuce raises me. Doesn't matter what everyone else does, I eat to my meter and my body.

Seems my insulin is also economical for me. Lol. Whether people understand it or not it works for me. Insulin is NOT irrelevant in my life seeing as I don't make it. Eat what you want, do what you want and eat to your goals.

24 units lantus and 18 novorapid would be suicide to me. I'm way past my honeymoon. I can't imagine ever needing that much insulin but I'm vlc hf. Are you?

Tired of being judged and told I don't need it. Endo knows I do just based on GAD and c peptide. Argue with him, not me.
 
I'm not judging. If you're having hypos and want to stay vlc, there is only one thing to do - reduce insulin.

The reason I ask about looking into other metabolic problems on top of diabetes is:
1) I was told I was quite sensitive to insulin... you are incredibly sensitive to it, which makes me wonder if something else could be happening as well.
2) in April, I barely survived serious metabolic problems ( unrelated to diabetes).

To answer your question, I'm not vlc because there's no need for me to be - Docs actually want me to put on weight.
My lantus keeps me flat. My bolus ratio is 1 unit per 12g carbs morning, 1 unit per 15g carbs lunch/dinner.
 
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I'm not having hypos at 1 unit lantus. Mostly I need two to stay steady. I don't eat carbs other than above ground veggies. I don't need to put on nor lose weight. I don't count carbs because I don't eat them. I bolus for protein. I don't like 'meals'. I like small amounts of food often. My stomach demands that.
I eat very few carbs or protein bf and ramp both up during the day. Always 80% fat, 15-20% protein and 5% carbs. Works for me.

I'm not tying to be edgy with you but if I eat just lettuce it spikea me without insulin and I only keep rising from there. So to imply I don't need it is ridiculous. What I don't need is lots of food requiring insulin. Different diets / different doses

I could make a restaurant meal last for 4 meals. I don't like lots of food at one time. I prefer to top off the tank rather than empty and fill.

I don't eat foods that make me insulin resistant. i.e. Saturated fats, too many nuts, any or all grains , starches or sugars ( kills the stomach) minimal dairy.

So basically some veggies, lots of avocado, some protein and a few nuts and seeds. Bits of dark chocolate. Oh, and mayo junkie.

My endo last year thought about taking away my insulin until his nurse reminded him of my GAD and c peptide. That was the end of that conversation.

As minimal as it may seem it's still necessary for me.
 
Well I don't make insulin an dim extremely insulin sensitive.

As far as a lot of the posts about kids I see them spiking stupid high and then hypoing. Not my ideal world.
I completely believe my vlc moderate protein and highe fat diet makes all the difference but I am not a child. I plan my own meals to reach my meter goals.

To be honest , I CAN be floored by the amount of insulin some people take and the huge variances in their bs. I am fortunate enough to be able to control that. I know it's out of some people's hands but I also know some people like their food more. Diabetes stinks no matter how you look at it. I love my food and meter readings. Blood tests are all great, weight is great, energy and health are great. Sorry if my insulin requirements are lower than some think they should be. It's actually on purpose and the way I chose to eat. It didn't just happen. Again, I'm fortunate but I work hard at it and I feel bad for those that work hard too and it doesn't happen. But please never imply my insulin is irrelevant no matter the math or science. Blood test show I definitely need it. And my meter won't stop reminding me.
 

Thanks Gavin for this useful comment on half dosing and injection techniques. I am eating vlc and breastfeeding a strapping, hungry baby--not an option for you I'm afraid!--which combines to reduce my insulin needs significantly. I wont throw numbers around about endogenous insulin production etc because that wasn't the point of Kristin's original post. Again, Im glad to read of others' experiences of dosing at different times. Hope you find a solution that works for you, Kristin!
 
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