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Splitting lantus

Discussion in 'Type 1 Diabetes' started by NoKindOfSusie, Feb 7, 2018.

  1. NoKindOfSusie

    NoKindOfSusie Type 1 · Well-Known Member

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    I guess I'll just dive in and ask. Right now I take 16 units of lantus at 8pm. I used to take it at 8am, but that was basically making it impossible to function during the morning, when I would be working. I'm pretty sure it's the lantus as it always happens about 3 hours afterwards, even when I have travelled and taken it at weird times compared to when I am asleep, or when I moved it from 8am to 8pm an hour at a time. It was always 3 hours afterward, maybe 4. When I do it at 8pm I just end up sleeping through the worst of it, usually, but it's been building up and building up, to the point where it's waking me up in the middle of the night, not low blood sugars but just feeling like I have flu. I feel like I am just getting over flu most of the time, most of all in this 3 hours afterward sort of time span, but it is getting to the point where I really can't do anything because of it.

    So if there is any chance that splitting it in half would help I would like to do that as I can maybe do it without involving any clinic people. The question is how I would do that. Presumably I would just take 8 units at 8am, and 8 units at 8pm. I have a couple of days free where I can probably do that, and just keep testing like crazy inbetween times to make sure I am not killing myself.

    Yes I know everyone will tell me this is hideously dangerous and I must get a form signed in triplicate from some nurse, but seriously, is there likely to be a problem with me doing this because I am just desperate.
     
  2. scotteric

    scotteric Type 1 · Well-Known Member

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    Lots of people split Lantus, it's nothing novel. Levemir is more conducive to splitting though since it has a shorter duration and lasts approx. 12 hours on small doses for most people, so you can split it without overlap. You might have overlap on Lantus causing lows. The reason people split it is to get 24 hour coverage though, not because it causes them to feel ill. You might be better off switching to a different insulin anyway, such as Levemir or Tresiba if it is making you feel sick.
     
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  3. Circuspony

    Circuspony Type 1 · Well-Known Member

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    I'm getting muscle pains and started to wonder if it was a vitamin deficiency. But I think there's a fair chance it's lantus so I'm going to ask if I can change. Google lantus and muscle pains and you'll end up with a fair few U.S. sites with some interesting / worrying info!
     
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  4. becca59

    becca59 Type 1 · Well-Known Member

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    1. Yes you can split it, I did.
    2. No it doesn’t have to be equal amounts. Split it according to greater need. If you need more in the day take your larger dose in the morning.
    3. Ignore all of the above and get your insulin changed. It obviously doesn’t suit you, and you must insist on an alternative.
    4. This is an important posting as it has given me an insight into something positive you can do for yourself.
    5. It is your body absolutely INSIST! You have given it a good try, it isn’t for you.
    6. Good Luck!
     
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  5. becca59

    becca59 Type 1 · Well-Known Member

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    It wasn’t TIL I came off the Lantus that I made this connection. I had terrible problems with shoulders and hands. Actually had physio for shoulders. I was told there was no strength in my upper arm muscles. As a 3/4 times a week serious swimmer I thought this odd. However, I assumed it was increasing Old age and arthritis.
    Changed to Toujeo 18 months ago and all aches gone!!
     
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  6. NoKindOfSusie

    NoKindOfSusie Type 1 · Well-Known Member

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    Hi everyone

    Thanks for replying, the issue right now is that I won't see the clinic until March (my choice not theirs) and there is a 1% chance they will agree to do anything anyway, we are barely being civil to each other as it is and my demanding changes is not going to go down well...) So I need a fix that has some sort of chance of improving things without any intervention from them as I will probably not get it.

    Really I was after advice on whether the approach I mentioned is the right way to go, do half of it in the morning and half in the evening, or whether that is likely to cause other problems. I mean logically you'd have thought it should work but nothing about this is logical so...
     
  7. Mike d

    Mike d Type 2 · Expert

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    I'm not a T1 but really (and I admit I can be cross at times on certain and quite specific issues) but "fighting city hall" is not going to resolve anything. Can you not see that? Taking a question to an outright war is not going to resolve anything.
     
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  8. NoKindOfSusie

    NoKindOfSusie Type 1 · Well-Known Member

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    That's why I'm not asking them?
     
  9. db89

    db89 Type 1 · Well-Known Member

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    If you strongly suspect Lantus is causing you to feel ill please keep up asking for a change. It's disappointing to hear that your clinic isn't listening to you and allowing you to try and improve your therapy. What reasoning (other than a flat 'no') have they given you when this has been brought up?

    Insulin detemir (Levemir) is the basal insulin of choice according to NICE guidelines that should be offered.

    Lantus doesn't do this to me but my DSN was the one who suggested I split my Lantus in the first place and has allowed me to experiment (carefully) with how I do this. On one occasion I have even gone back to once a day slowly to suit my needs for a few weeks but I do find personally that I get better results with a split dose.
     
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  10. Circuspony

    Circuspony Type 1 · Well-Known Member

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    The only way of knowing whether the split works is to try it and test v regularly.
     
  11. NoKindOfSusie

    NoKindOfSusie Type 1 · Well-Known Member

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    OK, that's what I was after. I'll try it tomorrow. Gulp.
     
  12. Circuspony

    Circuspony Type 1 · Well-Known Member

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    Are you really not able to speak to the nurses? I'm being changed to Tresiba after one phone call.
     
  13. NoKindOfSusie

    NoKindOfSusie Type 1 · Well-Known Member

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    @Circuspony I probably could call, I'd just rather not if there's any alternative.
     
  14. Circuspony

    Circuspony Type 1 · Well-Known Member

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    If you're going 8 units in the evening then you're going to run high compared to where you've been - which is safer overnight.
     
  15. hh1

    hh1 Type 1 · Well-Known Member

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    Very interesting thread; I've been using Lantus for years and as a result of Libre discovered an overall general rise in BG as the day wore on (I took Lantus when I went to bed). I split the dose and made a slight increase from total 16u to 18 and now take 8u @8am, 10u@8pm and that's undoubtedly helped. I am though seriously considering shifting from Lantus as I don't think it gives a smooth profile for me even now, and the muscle pains mentioned here ring bells. @NoKindOfSusie I get all my diabetes advice and support from the diabetes specialist nurse at my GP surgery or my GP; do you have this as an option rather than the clinic? The support I get when I need it is great and there's a massive willingness to help me try things to improve my control, even after 30+ years (things do change over time). It isn't the case that all DSNs are as good as mine - I, like many others, have encountered some true shockers - but might it be an alternative route for you to try? Whether it is or not, good luck with splitting the Lantus.
     
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  16. Rokaab

    Rokaab Type 1 · Well-Known Member

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    You need to try and make peace with them if they are the ones that decide what you are prescribed (all my prescriptions go through my DN at my docs), if Lantus makes you feel grotty you need to get it changed (splitting it may help but it may just make you feel grotty twice a day instead of once - I don't know).

    But one thing I will say is try and be nice to them, if you are nice to people they tend to be nice back and are a lot more likely to cooperate and listen to your side of the story - for instance I've good a good relationship with my DN, I try to be nice, and when I want advice shes normally happy to call me and talk to me about what I'm concerned about,
     
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  17. slip

    slip Type 1 · Well-Known Member

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    Mindi - If it is the Lantus affecting you, splitting the dose is just going to prolong the feeling of awfulness, the only way to hopefully reduce or completely get rid of this is to try another insulin. Bite the bullet and call your DSN now and ask for a different basal insulin, firmly but politely don't take no for an answer. You've suffered this feeling for too long for them to just pass off a comment of well lets wait and see, you've waited and it's still a problem.

    Take care.
     
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  18. Jeremy_Wood

    Jeremy_Wood Type 1 · Well-Known Member

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    Exactly the same with me. the Libre showed that I was rising around 20 hours after taking the Lantus. Switched over to Tresiba and it's been smooth sailing so far. Plus, it doesn't feel like I'm injecting sulfuric acid into my legs any more!
     
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  19. Rokaab

    Rokaab Type 1 · Well-Known Member

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    Very similar here, though for me it seems to run out about an hour before my next one (I tend to take at about 10:30pm) - if I fail next week in my plan to get a pump I may talk to my DN about changing - but for me Lantus has never caused stinging, feeling grotty or muscle pain (the last main muscle pain I had was after an evening of unintended exercise - a few hours playing a VR archery game did my shoulder in for a few days so it was my own silly fault)
     
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  20. LooperCat

    LooperCat Type 1 · Expert

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    I split my Lantus too, after initially taking it just at night. So the night I decided to make the change, I took about 2/3 of the daily dose and the other third the following morning. Then half the next night with half the morning after that, and I’ve been doing half morning and night ever since. I kept a close eye on things and adjusted with Novorapid when needed.

    All these reports of muscle pain etc are very interesting - I’m being investigated for fibromyalgia but I wonder if it’s my Lantus that’s causing the issues? I’ll mention it to my team when I see them next month.
     
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