Does Lantus or Levemir only work for the night for you?

[Subby]

Bernstein has an "approximate action times of preferred insulins" in his book The complete diabetes solution, in which the action time for Levemir or Lantus, (put in the same category) is:

18 hours if injected in the morning; 8-9 hours if injected at bedtime (apparent).

This apparent phenomenon of Lantus or Levemir action being cut in half if at night, is quite surprising to me! I hadn't heard much about it out there, despite that if it was the case, people (especially insulin dependents) would be in a whole world of hot water with no basal action during the day. Yet have taken, and do know that people take their long acting at night, without that seeming to be a common occurrence. Maybe it shows just how little I know - educate me, please.

Now, he mentions in a general footnote, that variability is expected especially with dosages larger than 7 units. One has to assume, he doesn't mean THAT much variability, if it just deserves a small footnote. Maybe a couple of hours or so either way? Is the impression that gives me.

So I'm interested in the question, if you do or have taken Lev/Lantus at night, do you find it's completely gone by the morning? Or does it last somewhat longer? How long, do you think/is your guess?

I've included a very rough separation of doses in the answer, so we might get a feel if maybe those with doses nearer the stated 7u, find it common. I mean the dose at the time, a split dose is ok, as long as you ascertain how long that actual component of the split dose lasts.

[Scratch]

I take Lantus every night around 9 PM, my basal dose over time has ranged from 15u up to 26u and I have never conclusively observed it running out on me, even on nights when I've had no dinner and therefore no bolus insulin providing coverage during the evening hours.

As you can judge from A1c results, I take controlling and knowing what's going with my body, insulin and food intake seriously.

[Subby]

Thanks Scratch. That was pretty similar to what I found on Lantus, in fact for me I found much more action in the afternoon, whether I took it morning or night. As my basal needs are not suited to an even basal release, I fluctuated a lot on Lantus and the end of the day was shaky, I'm not sure how long it lasted, maybe 20 hours.

Levemir seems to kick in at about 5 hours and peter off at about 15, whether I take it at night or in the morning or at midday.

[poodlebone]

When I took Lantus once at night it would be gone by late afternoon/early evening the next day. It seemed to last about 18 hours. I never tried taking it only in the morning but I did end up splitting the dose, taking it both at night and the morning.

So for me, taking it at night only did not give me just 8-9 hours of coverage but it was closer to 18. It also gave me nasty lows overnight/early morning when I took the full dose once at night.

[Subby]

Just a note, I just realised I must have ticked "public" when I was setting it up, I didn't mean that. I usually don't like answering public polls myself even if they are for something not that personal. I don't know, I feel like I'm giving my soul away or something, really silly.

Sorry about that, if it's an issue to you please let me know some way, maybe I can re-do the poll. I jus want an indication of general trends, as far as that goes in this really limited way.

[plattb1]

The short answer to your question is that the 16 units of Lantus I take at 10PM seems to last in my system until midafternoon the following day.

[notme]

I don't use Lantus anymore, but I used it for over two years. Lantus only lasts for me about 15 hours. I used 26u at 11:00 pm and it would last till about two pm the next day. I did better on Lantus than I did with NPH and R, but the pump gives me the ability to have multiple basal rates. My insulin needs always increase as the day goes on.

[inkvisitor]

I guess I have a kind of oddball regimen - 34 units of Levemir at 6pm. I am seriously considering splitting though (as referenced in another thread I started) but I am still a little unsure of the dosing and times to take it.

I seem to do fine until about 14-15 hours later (8 am-ish) when my BS starts to rise. I assumed it was DP but maybe my Levemir is just calling it quits? If that's the case, then my boluses are carrying me through the rest of the day pretty well! I can't imagine that Levemir works all day just for me..!

I haven't been able to/wanted to do that since I started the Levemir but I need to just take a day and not eat/bolus and see what happens.

[MCS]

Doc put me on Lantus after heart surgery, BG was every where but never in the good range. Started at 20units, nothing, 30 units nothing, I now take 40units twice a day, 40 at 8:00pm, 40 more at 8:00am and I finally fell below 100 after 3 days of this regime. Getting kinda scary having to take this much insulin, when I needed none before.

[plattb1]

Marty, your BG will stabilize once your body recovers. I'm sure it does seem like a lot. But, remember that you are recuperating. Quad bypass is nothing for your body to sneeze at!

[Subby]

I can understand that MCS! One thing to remember about insulin (and this is one reason I like to query rules and regulations) is that there are a number of reasons for needing a high dose. We directly blame things like insulin resistance, or a direct lack of insulin production, but consider this. I need 50u basal on the pump, or 50u on Lantus, to maintain control. On Levemir, I need 145u. Yet on Levemir, I feel less side effects, and I certainly don't seem to have change my weight storage mode in the month I've been using it.

My point: I seem to use different insulins in (what appears to us to be) an arbitrary way when it comes to dose and effectiveness, and we shouldn't draw definitive conclusions that a high exogenous dose is in fact, definitely the equivalent of a high dose of our own internal insulin, with attendant concerns. I am only one person, one example of insulin idiosyncracy: but I have seen enough exceptions to know, you should never assume you are part of the rule, that all is as it seems and conclusions are what they are stated to be, as far as the common beliefs and textbooks go. The forum, and pretty much any other diabetes forum I've seen, teaches me that the rule is we are almost all exceptions. Either that or people on DF are a very, very weird bunch.

It's great we have this tool to keep things in check, Marty. If we do our best with other things as much as possible, then we should rest assured we are on the right track, as much as we can.

[rzrbks]

Lantus --- 24 hrs.

I know 'cause I do checks on how well basal dosage is working every 4-8 weeks. I do 12 to 24 hr checks (typically 18 hrs.) and I base any dosage changes based on several readings done over several weeks. I've had to adjust my basal once in the last 5 years. Had to up it by 3 units.

[MCS]

Thanks, read a couple of articles about By pass surgery. Both state that your Islets take a time to reload for some unknown reason. Lantus ain't cheap at close to $100 bottle. So I am hoping things start to line up again so to speak.

I can understand that MCS! One thing to remember about insulin (and this is one reason I like to query rules and regulations) is that there are a number of reasons for needing a high dose. We directly blame things like insulin resistance, or a direct lack of insulin production, but consider this. I need 50u basal on the pump, or 50u on Lantus, to maintain control. On Levemir, I need 145u. Yet on Levemir, I feel less side effects, and I certainly don't seem to have change my weight storage mode in the month I've been using it.

My point: I seem to use different insulins in an arbitrary way when it comes to dose and effectiveness, and we shouldn't draw definitive conclusions that a high exogenous dose is in fact, definitely the equivalent of a high dose of our own internal insulin, with attendant concerns. I am only one person, one example of insulin idiosyncracy: but I have seen enough exceptions to know, you should never assume you are part of the rule, that all is as it seems and conclusions are what they are stated to be, as far as the common beliefs and textbooks go. The forum teaches me that the rule is we are almost all exceptions. Either that or people on DF are a very, very weird bunch.

It's great we have this tool to keep things in check, Marty. If we do our best with other things as much as possible, then we should rest assured we are on the right track, as much as we can.

[TommyC1]

Seems to run the full 24 for me. 22 to 26 units depending on how active I am expecting to be. Taken once a day at roughly 9 PM.

[lorilei]

i split levemir with a slightly larger dose at night 6 and 4 u both at the 7:15ish time..so i guess my run is 12 hrs..can't say i have noticed any need to alter this except the occassional run of higher numbers be it stress or illness...hmmm