Lantus

Hi maryrachel,

I had exactly the same problem with Lantus using a single daily dose. My sugar would be quite reasonable up to mid-afternoon, but then rise into doube figures regardless of what I tried.

The solution was a 50/50 split dose, taken twelve hours apart. After a bit of tweeking, I eventually ended up injecting slightly more AM and a little less PM.

Regards,
timo.

lantus isn't really licensed to be split into 2 doses , it should last the 24 hours , but it depends on the sites that you inject, the needle length and the amount you inject. It needs a fine tuning by your diabetic nurse to sort it out

tonyrees68 said:

lantus isn't really licensed to be split into 2 doses , it should last the 24 hours , but it depends on the sites that you inject, the needle length and the amount you inject. It needs a fine tuning by your diabetic nurse to sort it out

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You are right there Tony, it is supposedly meant to last for a 24 hour period. However, some people do split their dose 12 hours apart and achieve better results. Levemir insulin has a profile of around 18 hours max, so the recommendation is to split the dose when taking this insulin.

Whilst I was attending a DAFNE course last year, 2 people on the course were on lantus and struggling with unexplained increases in their bg readings around the 18-20 hour mark, after having tried increasing their dose by a couple of units with no luck, the dsn suggested splitting the dose in two which would overcome the problem. The dsn said that when lantus doesn't provide background cover for a 24 hour duration, it is fine to do this. Some people switch to Levemir when splitting in this way, but if people are happy with lantus, this is a means to overcome the problem.

Maryrachel,

It may be worthwhile increasing your lantus by a couple of units, see if this resolves the problem first. Sometimes the only way of knowing that your background insulin is correct, is to do a fasting check. Ask your dsn on advice about using this method, I used it last year to determine my correct insulin level.

Regards

Nigel

Insulin lasting 24 hours is only a good thing if you need the same dose day and night, not everyone does. Lantus may be wearing off, or you may need more of it during the day than overnight. Splitting the dose should allow finer adjustment.

I agree with Nigel.....I assume you do your lantus injection in the evening? I used to inject mine in teh moring, and went "high" in the early hours morning so was switched to Levimir. Like everything else, it is down to our metabolism (or whatever the equivalent is for insulin) but I have heard many professionslas say that lantus does not last 24 hours for many/most people.

To spit your dose or change to something else? Your call really.
Good luck!

I was on lantus for about 1 yeat and a half and i had this happen to me sometimes where it would jump up at least 2 or 3 points bout 2 hours before i was due to take next injection which annoyed me and sent my whole morning routine out the window :roll: although it was gd most of the time it often seemed to cause drops and spikes where ther should be none.

i have just switched to levemir which seems much more stbale than lantus i.e overnight . although is it normal for levemir to be weaker than lantus because i used to take bout 14 -15 lantus and im now on 22 levemir (11+11 slpit) and will probably need a touch more.

My problems with lantus were that it would occasionally cause sudden EXTREME drops in BG 11mmol/l- 2.2mmol/l :shock: !!! My DN told me that it was bcuz i was so skinny i injected into muscle occasionally. So u shouldn't wory bout that unless your BMI is low

Bottom line i switched and am finding levemire bettter!

That's interesting Patches,

I don't think lantus works for everyone, and some find a switch to levemir resolves a lot of problems. That said, the same can be said of levemir and some find a switch to lantus can resolve issues. I've noticed that many who change from lantus to levemir have to increse their daily dose, can't say that I have seen anyone post that they need less on levemir than they did on lantus, unless this has past me by.

Nigel

Hi Patches, you are not alone with the BG drops on Lantus. Hopefully it's only a matter of time before it's taken off the market-it won't be soon enough for the likes of me and others who've suffered on it.

Can I just make the point that Lantus and Levemir are NOT the only long-acting insulins available. Whatever is said about animal insulins or even the misleadingly named "human" insulins being old-fashioned our outdated, it's not true. They are as good an option as any other, and there is no evidence that analogue insulins are superior to them.

Jus

I had years of misery with Lantus and a similar experience with Levimir.

Now using Hypurin isophane and neutral.

I am alive


sanofi, novo and lily will only deal through one wholesaler. to be owned by Boots. you get better service from ebay :roll: Its all about money for them. the don't care about patients.
I was having some nervous reaction to that stuff. not good for business. they refuse to answer my questions. and the diabetes clinic at the hospital might aswell work for the drug companies. :roll:


porcine insulin is 99% pure and it shows

Hi There

I am on lantus and I am having problems with high blood sugars at around 10pm until 12 noon the following day. I am currently on 26 units. I tried to increase the lantus only by 2 units to 28 and found that I had really bad hypo's at 4am in the morning ... not ideal !
I am thinking of asking for my insulin to be changed back to animal insulin as since I have been on human insulin I have been unable to control my levels.
I think it really does depend on your body and how you feel and taking advice from your specialist. However, you do need to state your case, the hospitals i find are not willing to keep changing insulins.

Hope this helps

Mary,

Perhaps, but this may take a day or two to settle. Just remember to keep your doses as near to the 12 hour mark as possible. I would also mention to your dsn that you intend to take your lantus in this way, she may offer some other advice which we have failed to mention here.

Nigel

Hi Mary,

You should hopefully be fine right from the off with a 50%/50% split. However, if you're still nervous about your sugars rising overnight, then you could always start with a 60%/40% or even a 70%/30% split.

When you first make these adjustments, be sure to make a note of your dose and the time that it was taken. This will help you keep your bearings if you wake up to an unexpected result. (When I first split my Lantus, I actually woke up slightly lower than normal. :?)

Good luck,
timo.

maryrachel said:

Good news, I split my dose. Last night 9 units, this morning 8 units. BG this morning 7.7 which a touch higher than usual but not too bad. BG still a little high this afternoon so might increase tomorrow mornings dose a bit. Would like to find out more about finding my basal level. Anyone got any ideas? Please dont suggest refer back to DN or Doc becasue I do nto have that support at the moment. Waiting for the referal to the clinic but this could be some time yet.

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Not really accept what has already been said, but do remember just to increase your insulin by only 1-2 units at a time, and test and wait a couple of days before adjusting again. Starting to look a lot better already by the sounds of things!

Good luck

Nigel

Well done, a responsibly solved problem.

Although I still think we need a feature on the forum that pops up a message saying "use Levemir" any time someone posts a topic about Lantus.

DiabeticSkater said:

I had years of misery with Lantus and a similar experience with Levimir.

Now using Hypurin isophane and neutral.

I am alive


sanofi, novo and lily will only deal through one wholesaler. to be owned by Boots. you get better service from ebay :roll: Its all about money for them. the don't care about patients.
I was having some nervous reaction to that stuff. not good for business. they refuse to answer my questions. and the diabetes clinic at the hospital might aswell work for the drug companies. :roll:


porcine insulin is 99% pure and it shows

Click to expand...

I really agree with you on this one my friend, since coming off Lantus & Novorapid 7 weeks ago!

Wahey!

Best Regards,

Steve