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Scared of 'Lantus Low'

Q

Quinapril

Active Member
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26
Hello lovely people!

I am writing because I am currently going down the spiral of absolute fear.. Obviously too much Google and 'what if' long story short I am a very anxious person and usually super scared of various health things - Im one of those people who constantly fears something is wrong with me. Well I have been using Basaglar insulin which is Glargline for quite a few years. And theres some weird stuff going on with supply shortages of that specific one over here so I was thinking about switching to Lantus because its kind of the same thing. Now I never even knew about this Lantus low thing and now the more I read I realise that the risk is also there with Basaglar and I got to the point where I have no idea how Ill inject it tomorrow night without freaking out. Ill probably have like a 2 liter bottle of coke right nearby me and warn everyone in the house or something haha.

Anyways I think I understand the principle of it but Im not entirely sure. So does it only really happen when you inject it into muscle or blood? Is it most risky when you are slim and / or inject into not so fatty tissue like the the leg? Now Im not overweight but I have some belly fat and I try to always pinch it. Its just that now im spiraling out of control with worry of what if this happens and what do I do then..

@EllieM Very sorry for the random tag I know you don't know me but I remember u replying to my older posts and being super active and during my spiral I seen a lot of your messages from back a few years ago. Saw you had this happen to you. Did it ever happen again? Did you figure out some 'safe guards' to prevent this? Or did you maybe decide to switch away from Lantus altogether.?

Basically not really a question Im just spiralling and going crazy with worry here now that I know that there's a possibility of something ugly like this happening and Im just curious if there are ways to make sure it doesn't happen..

Thanks :)
 
I would think if you inject in fatty areas (Abdomen lower part of upper arms Buttock and quads area) there is little chance of getting an artery or vein, The needles are tiny and would very doubtfully get deep enough.
 
Hi @Quinapril
I am a worrier.
I get anxious about all sorts of things and i catastrophize alot.
I take anti depressants and have tried all sorts of things to improve my mental state.

Here's the thing....

I do not worry about my diabetes i think about it all the time but don't actually worry.

I am a seasoned pro of 50 years injecting with a hba1c of 39 or 5.7.
I get things right i get thing wrong but have the skills and confidence to put things right.
I am about to change insulin through no fault of my own (levemir is being discontinued) and i'm not phazed about that either.

2 things have helped...my beloved CGM and 4mm needles.
I can see what my levels are by simply glancing at my watch and i can eat or take insulin or increase my activity to balance my levels.

My larger dose of 14 units i inject in my backside and i don't feel a thing.
Smaller doses end up in my stomach or leg or arm if its nigh time and its dark.

If on the very rare occasion i catch a blood vessel its in my leg but i have a CGM to tell me whether the insulin is behaving and the alarm tells me if something is wrong.

I congratulate myself when i get it right which sounds a bit smug but i don't mean it to be its just the way i am.

I wish you well

Tony
 
Hi @Quinapril I'm sorry you're stressing out.

Basically I had a lantus low at least once, possibly twice, and I "fixed" it by splitting my dose so that I took half a dose in the morning and half in the evening, which reduced the risk significantly. I also tried to wait twently minutes after injecting my night time dose before going to sleep. After that change in routine I didn't have another occurrence. And though it was scary it didn't put me into a coma because I was able to keep knocking back the glucose until my bg went up. (Probably my scariest hypo ever was when we were away on holiday and I accidentally injected bolus instead of lantus, and then found we didn't have as much sugar with us as I feared that I might need. No lantus low involved, and I survived without a trip to A&E).

I was on lantus for ten to fifteen years so it wasn't exactly a common occurrence, but I generally found that lantus became less reliable for me (in the sense that it sometimes also acted unpredicatably slowly) so when my clinic offered me a pump two years ago I accepted and have been very happy since then. But I still have lantus as my emergency insulin for if my pump breaks and would use it then.

And the thing is, hypos are unpleasant but if you have carb by your bed you should be able to deal with them, specially with the advent of cgms.

So I personally wouldn't worry about lantus/glargine until I found I was getting issues with it....

Good luck
 
EllieM said:
Hi @Quinapril I'm sorry you're stressing out.

Basically I had a lantus low at least once, possibly twice, and I "fixed" it by splitting my dose so that I took half a dose in the morning and half in the evening, which reduced the risk significantly. I also tried to wait twently minutes after injecting my night time dose before going to sleep. After that change in routine I didn't have another occurrence. And though it was scary it didn't put me into a coma because I was able to keep knocking back the glucose until my bg went up. (Probably my scariest hypo ever was when we were away on holiday and I accidentally injected bolus instead of lantus, and then found we didn't have as much sugar with us as I feared that I might need. No lantus low involved, and I survived without a trip to A&E).

I was on lantus for ten to fifteen years so it wasn't exactly a common occurrence, but I generally found that lantus became less reliable for me (in the sense that it sometimes also acted unpredicatably slowly) so when my clinic offered me a pump two years ago I accepted and have been very happy since then. But I still have lantus as my emergency insulin for if my pump breaks and would use it then.

And the thing is, hypos are unpleasant but if you have carb by your bed you should be able to deal with them, specially with the advent of cgms.

So I personally wouldn't worry about lantus/glargine until I found I was getting issues with it....

Good luck
Click to expand...
Thank you for the advice.

I will definitely be keeping a bottle of cola or something nearby the bed just in case. And I think Ill switch to 4mm needles instead of my 6 mm ones just for more peace of mind.

I do think that I should switch the basal too eventually. Life is just a bit hectic right now and I feel like I want stuff to be more stable before I make such a (big?) change.

I do notice that my basal tends to work okay within the first 16-18 hours and then kind of start working less towards the evening. So maybe splitting the dose would ease this issue over as well.

Now about splitting it. How did you go about? I would want to try it but I want to make sure its safe and I dont do something stupid.
Is it kind of like say I inject 13 units of basal at 10 pm or so, so I move
1 unit over to 10 am and then
2 units 10 am - 11 units 10 pm; then
3 units 10 am - 9 units 10 pm

Is that how I should go about splitting it or is there a better way?
 
You'll be injecting into subcutaneous fat under the skin layer - odds of hitting anything is incredibly low, even if you did you'd go through it into the fat (just end up with a bruise).

In 45 years of injecting I hit a capillary once - didn't make any difference to the insulin absorption.
 
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