For those who split lantus...

[grace girl]

Does anyone take the two injections at other times besides 12 hours apart? And if you do, how well does it work for you?
I've been taking mine 12 hours apart for almost 2 years...and it's occured to me that if I changed the times I could make the drop in bs that I get during the first 4 hours after a lantus shot work for me, instead of always feeling like I'm fighting against it.
Just curious of others experiences.

[JBUD]

Girl My Doctor has me take one at bedtime and another in the morning because i take such a large amount it just gets split.
they say more than 80 units at once dosnt do much so we split it overnight.

[Eddy]

Does anyone take the two injections at other times besides 12 hours apart? And if you do, how well does it work for you?
I've been taking mine 12 hours apart for almost 2 years...and it's occured to me that if I changed the times I could make the drop in bs that I get during the first 4 hours after a lantus shot work for me, instead of always feeling like I'm fighting against it.
Just curious of others experiences.

(Apologies for not answering your question directly...)

You could try it. What I've noticed in me:


Lantus begins fading at around 22h
Lantus does not totally stop until 27h or so
Lantus fade raises me about 80 md/dL between 22h and 24h.
Lantus stacking gives me ~50 mg/dL drop around 2h... much as if I'd been steady and had 1U lispro and 1U R.


I moved Lantus to 1730 local time. I shoot a couple units of [extra] insulin-N (in addition to what I'd bolus anyway) at lunchtime to cover the fade zone. I then use the stacking to help with dinner, making my dinner bolus 2U smaller.

In your case, you might try Lantus shortly before breakfast, then again shortly before dinner. Assuming less than 12h between breakfast and dinner, I'd expect BG climbs to be most likely during the couple hours before breakfast. You might try having slightly more than 50% of your daily dose at dinner. (You could cover daytime climbs with additional bolus insulin.)

If you decide to experiment, please let us know how it goes. :)

[grace girl]

(Apologies for not answering your question directly...)

You could try it. What I've noticed in me:


Lantus begins fading at around 22h
Lantus does not totally stop until 27h or so
Lantus fade raises me about 80 md/dL between 22h and 24h.
Lantus stacking gives me ~50 mg/dL drop around 2h... much as if I'd been steady and had 1U lispro and 1U R.


I moved Lantus to 1730 local time. I shoot a couple units of [extra] insulin-N (in addition to what I'd bolus anyway) at lunchtime to cover the fade zone. I then use the stacking to help with dinner, making my dinner bolus 2U smaller.

In your case, you might try Lantus shortly before breakfast, then again shortly before dinner. Assuming less than 12h between breakfast and dinner, I'd expect BG climbs to be most likely during the couple hours before breakfast. You might try having slightly more than 50% of your daily dose at dinner. (You could cover daytime climbs with additional bolus insulin.)

If you decide to experiment, please let us know how it goes. :)


Very interesting. What I'm thinking of doing is taking the AM dose around 12 noon, and the pm dose around 6pm, or when I eat supper. By doing this I could reduce the humalog for those two meals and let the bg drop from the lantus work for me. Another benefit would be that by the time I went to bed it would be flat profile, eliminating over-night drops.
I am currently taking the am dose around breakfast (and it's the larger dose) and I find that it's very difficult for me to work with because I am usually quite active in the mornings, and less so in the afternoons. If I could switch that whole period over to lunch I think it would work out much better for me.

I'm going to graph it all out today and look at it all very closely to see how this will affect me over a 24 period. I know from basal testing that lantus lasts 22 hours for me, so I have some fairly accurate information to work with.

[Eddy]

Very interesting. What I'm thinking of doing is taking the AM dose around 12 noon, and the pm dose around 6pm, or when I eat supper. By doing this I could reduce the humalog for those two meals and let the bg drop from the lantus work for me.


Sounds good to me. :)

You know, I considered trying the lunch/dinner split. The problem is, my mornings and afternoons are so hard to predict; I don't want a hard-to-predict basal. Instead, I basal 1x/day, and use the reg-N to tide me over.

FWIW: The afternoon fade makes me very sleepy. If my schedule is off, and I skip my extra 2U of afternoon reg-N, I inevitably fall asleep during fade... then awaken with higher BG.


Another benefit would be that by the time I went to bed it would be flat profile, eliminating over-night drops.


That's definitely a factor. Staying up for a few hours, trying to stabilize BG, is no fun. Waking up hypo isn't exactly the greatest thing, either.


I'm going to graph it all out today and look at it all very closely to see how this will affect me over a 24 period. I know from basal testing that lantus lasts 22 hours for me, so I have some fairly accurate information to work with.


It sounds like your evening fade would nearly coincide with the afternoon ramp-up. To mitigate morning rises and pre-dinner hypos, you might try:


Shooting afternoon Lantus after lunch
Making the evening dose a little bigger than 50%
Having a little extra Humalog in the morning, assuming you have a normal response.


Just my thoughts and theories. You're obviously the one with the data. :)

[Real4]

What I'm thinking of doing is taking the AM dose around 12 noon, and the pm dose around 6pm, or when I eat supper. You do realize that Lantus takes about 2 hours to begin working don't you and the peak is about 4 hours out, so you have to account for that in your timing. What you say would work if you ate a late lunch and dinner (2->3 and 8->9), but I don't get that from how you put it

[grace girl]

You do realize that Lantus takes about 2 hours to begin working don't you and the peak is about 4 hours out, so you have to account for that in your timing. What you say would work if you ate a late lunch and dinner (2->3 and 8->9), but I don't get that from how you put it

I see an effect from lantus within an hour with every injection. The entire peak is completed within 4 hours of the injection. I've tested this over and over and over again.
It's just another one of those YMMV issues.

[Alice]

When I first started "splitting" lantus...I took 1/2 each 12 hours. My endo said that wasn't necessary and divided my doses a bit different, not sure why.

I ended up taking about 17 in the morning...just whenever, but usually around 7 a.m.

The second dose was around 10 p.m....about 8 units or less then. She said they didn't have to be exactly 12 hours apart, just take second at bedtime.

I thought I was having better mornings, but tested back to one dose and have been happy with my 24 units each morning. I really wanted the split dose to be easier...but I really like just dealing with one curve instead of two curves. My mornings are near perfect (100) almost always...I've never like the night time dose of lantus.

[TenderVittleS]

When I first started "splitting" lantus...I took 1/2 each 12 hours. My endo said that wasn't necessary and divided my doses a bit different, not sure why.

I ended up taking about 17 in the morning...just whenever, but usually around 7 a.m.

The second dose was around 10 p.m....about 8 units or less then. She said they didn't have to be exactly 12 hours apart, just take second at bedtime.

I thought I was having better mornings, but tested back to one dose and have been happy with my 24 units each morning. I really wanted the split dose to be easier...but I really like just dealing with one curve instead of two curves. My mornings are near perfect (100) almost always...I've never like the night time dose of lantus.

I tried it once but I hated taking so many shots. For me Lantus was designed to make things easier and it has been working great. Your body needs a little time to get used to one dose of Lantus, once it does it is soo much easier than taking MDI's of Humalog and Lantus. I felt like a human pin cushion. I think some people should give it more time so the body can adjust, but thats just my case.

[grace girl]

I took it for a year in one dose...most of that year one dose at night and regardless of the size of the dose I had repeated major hypos at night. And I ran high every single day 22 hours after the shot.
Next, I tried taking one dose in the morning, at my endo's suggestion. Same problems, just different times of the day.
Finally, my endo told me to split the dose, which I did a year ago. I find that it works much, much better for me like this. The changes I'm making now are simply due to a lot of reflection of my own personal patterns, and how to make it work better for me.

My endo told me I'm a strange case, though, she'd never seen anyone have such major bs drops from tiny amounts of lantus. I don't have insurance, so a pump is out of the question at the moment. So, I'm working with what I've got to deal with.

I can't tell you how often I've wished that one dose would work for me.

[TenderVittleS]

Yeah I guess a year is long enough LOL! Anyway when I started Lantus years ago I didn't like it at first, but now I love it. My BS ranges from 90-180 with occasional 200's but on Lantus I feel stable, no hypos, even when I get a hypo its slow and very easy to correct. Good luck!

[Alice]

One thing I've noticed tracking Lantus is that my body chemistry has really has changed over the years.

The first couple of years sound like a long time, but if you think about it...I knew very little about Lantus for about the first 24 months.

Next couple of years, I figured out that the night time dose (why doctors say this, I don't know) definitely gave me lows...but I'd be ok during the day. So, I switched to mornings and straightened that out.

Last couple of years I tried splitting...with pretty good results, but still had some early morning lows.

Last year, went back to one dose, taken in morning...amount to keep my daytime pre-meal at normal level...this requires eating about 20-30 carbs at bedtime...which is pretty easy for me to handle! (Always ready for a snack...that's me!)

So far, the snack helped with the early morning low.

What really threw me into a state of confusion was when I wore the CGMS a few years ago. The doctor make all sorts of changes that just frankly, didn't make sense or work.

So, I ignored and figured it out on my own...which we seem to be pretty good at doing...I'm just a little slow since I try to "listen/consider" the doctor's advice.

Now that I'm older, I listen to myself a bit more after leaving the doctors office regarding changing insulin doses. Unless one has walked in our shoes and actually taken insulin, the recommendations are only that...recommendations.

Oh...throw in PMS...and my whole story changes for about 10 days.