When best to inject basal?

Quatrelle said:

I have been T1 for the past few years. Using Lantus for basal, I inject 22 units every evening around 7.30. My waking number is usually between 5 and 6. For the past week I have tried injecting in the morning, around 8.30, thinking that it might be better to have any immediate benefits from the injection while I am awake during the day, rather than at night when asleep. Also that as the injection wears off it’s best it does that at night when I don’t eat etc. (I don’t have a problem with not eating after 7pm).

Now, however, my waking number is around 8, presumably because it’s getting on for 24 hours since I injected (and not 12 hours), and the Lantus has worn off.

Does this mean I haven’t been injecting enough basal? I inject usually about 6 units of NovoRapid before meals.

Any comments would be appreciated, and thanks for reading this far!

Click to expand...

Lantus does not typically last a full 24 hours and typically has a spike in action after about 3 hours

I found this was better taken in the evening as I typically have larger evening meals and helped my not go high in the night

But it’s whatever is best for you.. but more risk of hypo in the day due to more activity

In my opinion Lantus really needs to be split to get its full benefit. For me those splits needed to be higher am than pm. Am now on Tresiba which I find is more stable.

I never needed to split Lantus. It is only necessary if your day and nighttime basal needs are significantly different. But, if that is the case, Levemir is a better option.
I dosed my Lantus in the evening. It tended to run out after 22 hours and I "filled the gap" by increasing my bolus slightly.
I did not I ject Lantus in the morning as it would run out while I was asleep.

It was the consultant that told me to split it as it was just not lasting 24 hours. I take very small doses of basal. 6.5 presently. Levels to take are very personal but when splitting it is best to take 12 hours apart.

Hi
If your waking number was between 5 and 6 why would you want to change the time?

Please don't think i'm being rude i just don't understand.

Thanks

Tony

Every change at the hour you inject Lantus takes time to adjust. Typically lantus lasts 24 hours. Doctors insist in taking it at night before sleep. As it has peak after three hours i tried many times to take it at night but i was waking up during night from the alarm as i had hypos. Then a bad day as in the morning it was high. I decided to inject in the morning. So for my way of life 11 o clock is convenient to my style. Bur recall each day same hour + 1 otherwise hypo. When you change the hour i believe you should wait 4 days to see any change as your organism and your life habits have to adjust accordingly. However it is not if you wake up with 5 or 6 it is the average that you should look to be less than 7 in a month. Also do not forget the most important is how long you are in the thresholds set up by your doctor. Usually 70 to 180. the time inside the limits should be 70 per cent in the thresholds. Talk always with your doctor before any change

Have you seen a corresponding lower BG level in the afternoon when taking your basal in the morning?

I moved mine (Abasaglar which is similar to Lantus) around as I was running low overnight taking the full amount (which was also 22U iirc), but when I moved it all to the morning I'd run high after supper (iirc, it was a while back now.)

In the end I simply split it 50-50% pre-breakfast and pre-bed and it seems to work (with the added advantage that I can reduce the morning dose if I'm going to be particularly active during the day.)

I'm not too bothered about the exact timing, as long as it's within a 3 hour window at either end of the day it seems to work - whatever variability this introduces is vastly outweighed by the variability of other things during the day.

I split my Lantus between waking up (12-14 units) and going to bed (8-10 units).

searley said:

Lantus does not typically last a full 24 hours and typically has a spike in action after about 3 hours

Click to expand...

Thanks for this - I get modest lows at 2-3 am and didn't ascribe it to Lantus as I thought it took 6-8 hours to peak. So I'll take it down a notch.

Jasmin2000 said:

Thanks for this - I get modest lows at 2-3 am and didn't ascribe it to Lantus as I thought it took 6-8 hours to peak. So I'll take it down a notch.

Click to expand...

I thought the peak was around 5h, so we've all got a slight different number, but in the same ballpark.

iirc there's also something of a dosage relationship to the peak time, and absorption variability may also play a part.