Going off the pump to Lantus

[Jenn L]

After much thought, I have decided to take a break from my pump. I have been on it about 7 years. I am tired of sore sites, gushers, where to put it, etc. (if you are reading this and you are a new pumper, please don't worry, the pump is a wonderful thing!!) I simply feel like I am not doing it justice. Like I need a change.

I saw mr Dr. yesterday and got a sample of Lantus. He was not surprised I wanted a change, even he had a hard time with my basals. So I will offically disconnect on Saturday morning.

I am a bit nervous, but feel like it's the right thing to do.

Of course I have a few questions for the forum, this is the best place to get information.

I was told to disconnect at breakfast, take 10 of Lantus, and bolus with a syringe for my food. (two separate injections)
How did any of you who take it get started?

Did you have any major problems in the begining?

Did your ratios or sensitivity chane at all as far as bolusing for food or correcting a high?

Do you use Humalog for your short acting?

Do you refrigerate it?

When on a pump, you can correct with tiny ammounts, what do you do when on Lantus? I know it is supposed to smooth you out, but nothing is perfect, right?

Am I crazy going back to MDI? I am a little scared!!:confused:

HELP!!

[ang]

don't worry. it'll be fine. when i took my pump vacation i was using lantus. basically i just looked in my pump history and whatever my total basal dose was for the day, thats what i took for lantus. so, i was 38 units of humalog for basal insulin for the day, i took 38 units of lantus. my bolus factors were the same on lantus as they were on the pump. and i used humalog, which is what i use in my pump.

i'm not sure if you're going to be using the vial, or the pen fills, but i was using the pen fills. i would refridgerate my stock but the in use pen was just in at room temp.

you can still correct as much as you want when on lantus ... although i guess if you find you're correcting alot then you really need to check that your lantus dose is where it should be. i guess the only draw back with correcting while not on the pump is the you're limited to the size of dose that can be delivered with a pen, and whenever you want to correct you have to give a needle which isn't as easy as just pushing a few buttons.

i don't think you're crazy going back to MDI. although i didn't have any problems with lantus i ended up going back on my pump after a few months. i missed the convenience of it. but to each their own. good luck. you'll be fine.

[type1tenorlady]

Lantus just acts like your basal, and yes it is supposed to be smoother than NPH (ie no crazy peaks). It is also supposed to last for 24 hours but for some it only last 12 or 18 or 20 so with any change you should test test test to see how you respond. I am pretty sure with me it lasted somewhere in the 18 to 20 range, but I never did enough testing to verify it, and I had had lots of trouble with taking my shots at night so I was wary of splitting my dosage.

Before I was on a pump I was using Lantus and Humalog. I always kept my lantus refrigerated. I only took one shot in the morning so having to keep it with me while I was out was not a problem. Some people have mentioned that theirs goes bad after about 28 days; I don't really remember being told this by my dr, or maybe I was and just ignored it so I always just used it until it was finished.

My humalog at first was syringes and a pen, but then just the pen so only the unopened cartridges were refrigerated. With the syringes I never mixed like I used to do with R and NPH because (I think) it changes how the Lantus works. Again I think I was told to discard the pen cartridges after 2 or 3 weeks or something, but ignored that and used them until they finished.

I wouldn't say that my I:C is much different from when I was on Lantus, but now that I'm on the pump (as you know) it is easier to make adjustments and try new rates since I can just program it in when I'm thinking about it and then not worry about remembering to divide my carbs by 8 or 10 or 12 instead of by 15 for my next meal. I also found that before the pump I used to use a lot more approximate carb counts based on my ratio (like 12 or 18 would become 15g) just because I knew I couldn't add or subtract fractions of a unit to account for 3 or 4 carbs. Now that I think about it I would have done better to add up all my carbs for a meal and then round instead of doing it for each item since all the extra 3s or 4s would probably add together to make me need an extra unit or two.

Correcting highs might be a little trickier, not because of the Lantus (like I said, that's going to be your basal so you would be using the short-acting or Humalog to correct) but because with syringes/pens you can only go in 1 unit increments.

Overall I liked Lantus MUCH better than NPH, but since my body responds right away to any slight change in activity/illness/mood etc I found that it didn't give me as much flexibility as I needed, but that's to be expected from any MDI regimen when compared to a pump.

Good luck.

[kgm0612]

Good luck Jenn.............keep us posted on how you're doing!

Karen

[KickStart101]

Hi Jenn: I have no desire to be on a pump since
needles don't bother me. They are quick, out of
the way and effective.

I did go on Lantus in November since my Lente had
been discontinued and I ran out of my stock. I had
3 bad lows with Lantus in the first 3 weeks(a few
People on here can verify one of the lows...:D...I did apologize).

I really had no idea how little it did to lower glucose
levels and I had to over-compensate with Humalog to
bring my sugars down. I was used to my Lente which
actually lowered my sugar level and I knew when it
peaked so I ate accordingly with not many problems.
I thought Lantus is Great if you don't eat anything. :D

Anyhowsie, I started carb counting and finally got my
basals correct so I'm doing Good now that I understand
Lantus. It is nice, if something comes up and you don't
have time to eat and you don't have to worry about it.

Great Luck to you on your change over.

[cheryl]

Yes, good luck with your change, I heard a lot do this for a break, and what not, and change to mdi.......good luck, I don't really have lots of advice on the lantus, because I wouldn't be very uppity up about it, but it is seriously not a bad insulin when you get your dose correct, but couple of things to take note, keep it in the fridge, keep the same activity level as much as possible, and test test test......Lantus is supposed to keep u level.......Good luck, enjoy no sore sites for a while

cheryl

[jeggeman31]

Am I crazy going back to MDI?

Not at all. I go to my Dr at the end of the month and I have decided that I also am going back to MDI for a pump vacation. As of now I am planning on 3 months, but if things go good I may do it longer.

Pre pump I split my Lantus half A.M. half P.M. So I am looking at minimum of 8 shots a day. I don't mind shots.


Good luck

[Jenn L]

So just over 24 hours on Lantus....Started with 10 yesterday morning, everything looked good for a bit, but then an unexpected high after lunch which I took Humalog for. Leveled out well for the rest of the day, but then I started to rise up slowly, I am pretty sure I am only getting 10 or so hours of full impact from the Lantus. How long does it take to kick in after you take it? I am running high right now, and will bolus again for it when I am ready to eat.

I have checked my sugar every hour since yesterday morning, including all night. (plus I am in California, and we went to daylight savings time last night) I am wondering if being so tired is stressing my body out at this point, and that is part of why my numbers are so off. This is harder than I thought!! I wanted a smooth transition, but I feel lost, not understanding Lantus well. Any advise is appreciated!:(

[cheryl]

I heard about three days to see if your dose is correct, and you take it in the morning, I'd feel lost lol, I take mine at night, but some split the doses too, see how you are when you wake up in the morning to decide wheter splitting doses is a good option, but three days is about right in waiting.....

cheryl

[karen]

Type 1 for 40 years, NPH and regular for 35.

Before pumping I switched to Lantus and Humalog and it took me 6 months to figure out that it did not last 24 hours for me and ended up splitting the dose and taking every 12 hours. I am thinking if I take a beach vacation this year that I might take a pump vacation as well. Good luck to you.

Karen

[grace girl]

Not to throw in yet more, but many people (including myself) have found that lantus doesn't really last the whole 24 hours. In my case I get about 20-22 hours out of an injection. A lot of people have ended up splitting it into two doses, taken twelve hours apart.
It really does take at least three days to know what a dose will do for you...after three days I'd do some basal testing just like you did on the pump and see what it's really doing. Then you'll know what you're getting out of it, and how to correct it.

I always refridgerate my lantus...when I don't the bottle tends to go bad before I use it all up. I live in a warm climate, too, so that may have some bearing on that.

Another thing I'll mention is that some people drop a bit when it hits full force, about 4 hours after the injection. Some people don't notice it at all.

And yes, I would think the stress from the change would have some impact. It is a good insulin, it just sometimes takes a bit to get the dose just right.