Lantus Users

[gettingby]

I just had a visit with my CDE this morning. He has decided that we should try taking my Lantus in the AM instead of before bed. How many of you do it this way? Have you noticed any changes in your levels or how you feel? Thanks

[Clint]

I do this. I feel pretty good but I tend to be high in the morning. I may need to take a small dose of Lantus at night.

[MarkMunday]

I am now taking Lantus 6:30am. And it is working pretty well. I take an extra Novorapid bolus at the same time. I do it partially to deal with the DP rise in BS. And partially because the previous morning's Lantus is running out. I used to split the dose between am and pm shots. But I have found the way I described works better for me.

Mark

[christie]

i take my lantus midmorning,i seem to do good this way.i have'nt had too many highs except if i went too long after i took the day befores shot,like if i forgot to take mine until 10:30,and i had taken it at 9 the day before. lantus has been such a great change in my life,before when i was on humalin u i never knew if i could even wake up in the morning.i had sooo many lows and blackouts,which i don't have with lantus.i still have lows maybe one week or every other week,compared to 6 reactions in a week.

[am1977]

When I was on MDI, I took Lantus in the morning. Then I started having a lot of problems with getting my sugars down during most of the day...I had to break up my dose. I took the majority in the morning (22 units) and then I took the rest (8 units) in the evening. It really helped me. Now, I am trying the "Untethered Regimen" and I just take 15 units in the morning. But I may need to increase it as I am seeing elevated numbers lately :rolleyes: .

[sparkle9]

I've never tried taking lantus in the AM only. I've tried it before bed and also at 7:00 PM. Taking it at 7:00 PM seemed to get rid of the nighttime lows, but then I would be high by 4:00-5:00 PM the next day. Apparently lantus was not lasting the full 24 hours for me. Now I'm splitting it evenly (7AM and 7PM) and things are better but still not great. I went to a new endo and am keeping a detailed "insulin and food" diary. I go back January 14th.

Hope the morning lantus works for you.

Sparkle

[gettingby]

Thanks guys. I do hope the morning change works. I've found out that I'm dropping low at about 2-3AM.

[Clint]

does anyone else experience burning after injecting Lantus?

Also, I am now doing 2 injections of Lantus because when only doing 1 injection I am high in the morning...

[Maria]

I don't experience burning after injecting Lantus.
I take Lantus in the evening (9 units).And it's working well.

[Clint]

I don't experience burning after injecting Lantus.
I take Lantus in the evening (9 units).And it's working well.

I take alot more Lantus @ one time... I am taking 30u in the morning and I took 5u last night and was @ 138 when I got up... usually I am around 200 or more when I get up.

[sparkle9]

When I first started taking lantus a year ago I noticed burning. After a while it went away. I can't really say how long it took to go away, but one day I just noticed that it didn't burn anymore.

[Clint]

for me I think its the amount I take. I just took my night dosage and it didn't burn, but my morning dosage does...

[rzrbks]

grumpee

does anyone else experience burning after injecting Lantus?

The only time I get that "Burning Sensation" is when I inject it while it's still cold. I usually draw out my Lantus about 15 minutes before I inject it. That gives the Lantus enough time to warm up to room temperature--then, no burning.

[Clint]

The only time I get that "Burning Sensation" is when I inject it while it's still cold. I usually draw out my Lantus about 15 minutes before I inject it. That gives the Lantus enough time to warm up to room temperature--then, no burning.

I will need to try this. I have always taken it cold.

[may]

Lantus always burns me!
No other insulin that I have taken through the years has done that.
I will take the suggestion and let it set out and warm up a tad first.
Thanks!

[Clint]

I have done that and it still burns... oh well

[buzzborne]

The only time I get that "Burning Sensation" is when I inject it while it's still cold. I usually draw out my Lantus about 15 minutes before I inject it. That gives the Lantus enough time to warm up to room temperature--then, no burning.

hmmm... this doesnt work for me.. i still get the burning sensation.... even if it has been outta the fridge for 1/2 hr... sometimes it doesnt go in the fridge and still get it :confused:

[may]

Letting it sit out last night didn't help!
It still burnt..the stinging sensation.
I asked my sister if she ever has that problem with Lantus,
and she said never. It just must do it to some people, I don't know.
My bottle is new, and my experation date is good, and it is "expensive"!
To expensive to throw out to just try another!
I can live with it!!

[Clint]

mine stung some this morning.... Like may said, 'I can live with it'...

[HeatherP]

My endo warned me ahead of time that Lantus can cause a burning sensation.

I don't have much problem with it, but I inject relatively small amounts. The volume may have something to do with it. You guys can try pushing it a little slower.

[docta-docta]

Some things that may help:

1) After filling the syringe and replacing the Lantus back in the fridge, warm the syringe with your fingers. Warmer insulin doesn't sting as much.

2) With time, the stinging seems to go down... It usually takes about 6 months before one notices it. I'm not sure why the stinging decreases with time. Perhaps the neurons lose their sensitivity to the acidity of the Lantus?

3) I read somewhere on this boad that some people report that it is safe to mix Lantus with Novo/Humalog. I wouldn't suggest doing this based on those people's reports. The acidity of the Lantus is what keeps it "in solution". It precipitates out of solution once the body's tissues neutralize the acidity (at a pH slightly over 7). The pH of Novolog is slightly acidic, but not as aciditic as Lantus. I'm guessing that perhaps the acidity is enough to keep the Lantus "in solution", but probably just by a couple magnitudes of H+ ions. Until the paper inserts in Lantus prescriptions state that it's okay to mix, I don't suggest it!

[zookeeper671]

About a month ago I switched from taking Lantus at night, to in the morning (8 AM). I was experiencing too many night-time lows. The morning shot seems to be working out well. My numbers are good when I wake up (118-130). Hopefully it'll work out for you, too, Cin.

As for the burning: I used to feel some stinging after injecting for a couple of months, but now I don't feel it anymore... unless I inject it cold, from the fridge.

Angie

[gettingby]

Just an update on how the Morning dosing is working out. It seems to be going really well. I don't have the lows at 2-3AM anymore. When I do have lows, it's in the mid-morning or late afternoon range but for the most part, it is my own stupidity. I'm either miscalculating my Humalog dosage and doing more activity than I think I am. So far, so good. Will find out next week how I am doing.

[UpNorth]

I too felt the burning from lantus. I'm on a pump now and switching over to injections again in a few days (just for summer) and seems like i'll be put onto Levemir instead now- apparently it doesn't burn or anything. Will be interesting to see:)
I only took lantus in the PM (around 9pm) and it worked really good for me:) Didn't get the full 24 hours but would just inject some novorapid when Lantus started to wear off after about 22 hours :whistling

[DeusXM]

Lantus burns because it's at a significantly different pH to the rest of the body. Warming it up may alleviate this but in most cases it won't. The pH difference is how Lantus lasts so long - its pH means it is absorbed at a slower rate than other insulins.

The pH difference is also the reason as to why Lantus tends to have a higher risk of side-effects and and more unpleasant side-effects than any other insulin.

Levemir has a much lower side-effect rate because it binds to albumin in the blood to slow its absorption rate. However most people on Levemir will also find that they will need to massively increase their dosage from whatever they were taking previously - I went from taking 30u of Insulatard a day to 60u of Levemir and I was still having to inject with 5u of Novorapid every 2 hours just to keep my bg at around 10. It was at that point I decided to give it up.

[mark-TN]

My Lantus shot does not burn even if it is cold. Like Clint said I think a lot depends on the dose. I take 4 units Lantus between 10:30-11:00 pm and I take 3.5 units of Lantus at or before 6:30 am. Just over 2 years ago I took only a PM shot of Lantus before bed and my sugars would almost always be low in the morning and would always start running high by 4-6 pm. With one shot I needed to take I believe about 11 units of Lantus and the shot would always burn if it was cold. I used to draw my dose and let it sit for about 20 minutes or if I was short on time I would rotate the loaded syringe between my thumb and finger tips to warm it up a bit. The slit dose works a lot better for me as I need less insulin, my sugars are level all day, and I do not get the burning.

Mark

[bac4uw]

I'm a 2-per-day Lantuser... 8 units at 7am and 8 units at 7pm. I've never had any problem with burning -- the only problem I sometimes encounter is that I forget to take one of the doses. (at least, I'm still covered by a 50% dose though when this happens)

Bryan

[james kirk]

My BG this a.m. was 420 and sure enough the 29th day has come and I waste 1/4 of my Lantus...why do we take this so easily...almost everyone who takes Lantus winds up throwing away alot of the Insulin...why do we so sheepishly let this drug company use us and abuse us...everyone on this forum that uses Lantus is a victim who gladly bows to the maker..'thank you, massa'...put the stuff in a regular vial...I've sent a number of notes to their customer service dept. and they haven't responded...maybe it's because I came up in the 60's but this is really pissing me off and it isn't right...maybe the rest of you enjoy your role ( if I had health insurance and somebody else paid for me maybe I would not care either...

[bac4uw]

Wow, you're bitter. Cheer up.

I attribute the *excess* Lantus that I throw away every month to the fact that people have varying insulin needs. So while I throw away 1/3 of my bottle every month -- someone else might need to use nearly the whole thing.

I'd say that it would be much MORE devasting for this person to run out on the 25th day of the month and not be able to get more until the 30th. Don't you?

Have a nice day James. (Massa?... hmmm... that's not quite PC now is it?)

Bryan

[bac4uw]

everyone on this forum that uses Lantus is a victim who gladly bows to the maker..'thank you, massa'....

And oh yeah you're right, silly me, I'll stop taking Lantus now. Those jerks!

Wait... on second thought... ER visits cost way more than I'm paying for an entire year's worth of Lantus. Instead of not taking Lantus, I guess I'll just have to try and keep my hands and knees as clean as possible (from bowing down, of course).

Bryan

[mark-TN]

I use less than a quarter of a bottle in a month. I found that if I keep it in the fridge it will last a good while past the 28 days. One thing that will kill insulin is reusing syringes. When you reuse a syringe you will end up contaminating the bottle of insulin with polymerized insulin (insulin will get polymerized in the needle part of the syringe when it is left in it for several hours). This polymerized insulin is dead insulin and when it gets back in the vial it acts as a seed and causes insulin in the bottle to polymerize. When insulin is polymerized it gets deactivated and eventually it will cause the insulin in the vial to loose all of its strength. If you reuse syringes it is best to rinse the syringe with saline after each use. Pharmacies sell vials of saline and it is very cheap.

Mark

[MarkMunday]

.... I waste 1/4 of my Lantus...why do we take this so easily...almost everyone who takes Lantus winds up throwing away alot of the Insulin ....
The 10ml vials are far too big. So I get Lantus in 3ml cartridges. And they fit perfectly in a Humalog pen. At 8 units a day, a cartridge lasts me 37 days. So I don't have to throw any away. This should solve your problem too

Cheers,

Mark

[Mark C]

My BG this a.m. was 420 and sure enough the 29th day has come and I waste 1/4 of my Lantus...why do we take this so easily...almost everyone who takes Lantus winds up throwing away alot of the Insulin...why do we so sheepishly let this drug company use us and abuse us...everyone on this forum that uses Lantus is a victim who gladly bows to the maker..'thank you, massa'...put the stuff in a regular vial...I've sent a number of notes to their customer service dept. and they haven't responded...maybe it's because I came up in the 60's but this is really pissing me off and it isn't right...maybe the rest of you enjoy your role ( if I had health insurance and somebody else paid for me maybe I would not care either...

I'd prefer a bit larger vials. I use about 1 1/2 vials per month.

Get your Endo to put you onto the pre-filled syringe. There's only 3 ml in each one, and then you won't be throwing it away. However, you will be spending more....

[DeusXM]

Alternatively, move to the EU. Lantus is free there.

[Sparkle]

I've been told Lantus does not have any peaks and is constant level of release over 24 hrs (Diabetes UK also confirm this) - so shouldn't make any difference when it's taken Am or Pm....

[DeusXM]

Well...technically it's supposed to last 24 hours...in reality it really lasts about 18, comparable to Insulatard.

Be careful of Diabetes UK too - I don't mean to sound harsh but frankly they're absolutely useless when it comes to information on diabetes. Not once did they ever even mention the release of Lantus or Levemir, and their 'advice' page dealt with someone who had rapid rising of bg levels early in the morning even when not eating, and the 'expert' completely failed to even mention 'Dawn Phenomenon'.

[Sparkle]

Dawn Phenomenon :confused:
Pls explain!

[Richard B]

Well...technically it's supposed to last 24 hours...in reality it really lasts about 18, comparable to Insulatard..

Well, that might explain why my BG goes in the tank. I take Lantus at 10:00pm every night...and like clockwork, around 6:00pm the next evening, I can get severe drops (sub 45) if I don't grab an apple an hour or so before. I first thought it was my exercise routine which I usually do around 4:30pm.

I've got an appointment next week with my doc and will make note of this. I keep all my records in Diabetes Pilot desktop/pocket pc so he can see the graph.

Thanks for the info.

[MarkMunday]

Well, that might explain why my BG goes in the tank. I take Lantus at 10:00pm every night...and like clockwork, around 6:00pm the next evening, I can get severe drops (sub 45) if I don't grab an apple an hour or so before.
If you were running out of insulin, wouldn't your blood sugar go up rather than down?

Cheers,

Mark

[DeusXM]

Dawn Phenomenon :confused:
Pls explain!

Dawn Phenomenon is the rising of blood sugars in the morning prior to and around waking. When you wake up, the liver begins dumping glucose into your blood. It's an evolutionary safety mechanism to ensure you've got enough energy to get up and go hunting for food.

This is different from the Somogyi Effect, which is the spiking of blood sugars as a response to a hypo that is untreated because you slept through it.

You can find more here:

http://www.diabetic-talk.org/dp.htm

[Richard B]

If you were running out of insulin, wouldn't your blood sugar go up rather than down?

Cheers,

Mark

That's what I thought as well. This has me puzzled because it occurs regularly in the same time frame.

[LonghornLady]

Has anyone felt an overwhelming/all over body sense of being flushed? (i.e. sweating..feeling hot and cold at the same time?) since switching to Lantus?

I myself just switched a couple weeks ago...maybe a month...

I do feel the burning/stinging after injection that I've read about, but hope that will subside after continued use.

Can anyone speak to this overall 'flushed' feeling I've been living? Every night I'll break out in "I'm too hot" sweats only to revert immediately into...."I'm too cold w/o covers". I only sleep for about 1-2 hours before my dreams wake me up.

Has anyone else experienced this sleep pattern after changing to Lantus as a 10PM dose?

[LonghornLady]

Ok, so you guys are basically saying "its hormonal...talk to your doc". Well I have and its not hormonal, its only been since I made the change from NPH to Lantus. Maybe it affects Ladies differently than you "ED" types, eh :-

[DeusXM]

No, it's very probably the Lantus. It has a much higher rate of side-effects compared to all other insulins, and those side-effects typically are more severe than ones usually associated with other insulins.

The unpleasant feelings you are having are caused by the fact that Lantus is at a different pH to the human body - these may subside over time but if they don't I suggest you either go back to isophane or try Levemir. I had the exact same symptoms as you, and some more severe ones too.

[LonghornLady]

Hey Deus...

Thanks for not treating me like just another gal suffering PMS :congrats:

Yeah, I'm gonna keep watching this, but about how long should I wait before complaining to the doc? I've seen that the stinging sensation can take up to 6 months to subside.

Only thing that troubles me is when I get woozey & slightly sweaty, I tend to think low sugar...so I test, and am always 150-180 *hmmmm* (Old dogs, New Tricks....how's that go again?) :wink:

[DeusXM]

If you're really finding the sweats unbearable, change straight away. There's no point suffering for no reason when there's other alternatives.

As for the stinging, in some people that never goes away, but as side-effects go it's a very minor one.

Don't do what I did. I put up with Lantus for about a year before I did anything about it, and because of that I lost one of the most important years of my life.

[MarkMunday]

... Yeah, I'm gonna keep watching this, but about how long should I wait before complaining to the doc? ....
If Lantus is causing the problem, you should get immediate relief when you switch back to NPH. I would do it now if I were you. There is no point in waiting. Use the same number of units of NPH as you are using of Lantus. But split it into two shots 12 hours apart.

You might find that your blood sugars increase a bit. It is better to err on the safe side. And if the unpleasant symtoms subside, you will have proved your point. If the symptoms don't subside, you will know that you have to look elsewhere....

Cheers,

Mark

[BJC411]

My endo decided to put me on lantus on Monday to be given at night before bed and to give myself an injection of humalog before meals, but now I seem to go low all the time? I was on novalog 70/30 and humalog only if over 200 before meals, does anyone think im doing something wrong? I think its to much humalog(1 unit for every 10 carbs)doesnt seem like much but it sure does seem make me go low. I am active all day long and it does happen a few hours after I eat. :dontknow:

Oh yea and I dont get much of a burning sensation from the lantus, I think the humalog burns more, maybe its just me.(Im new to this stuff) :1eye:

[DeusXM]

If you're dropping low, then you're taking too much insulin. I'd reduce your humalog intake right away, and you might also want to consider reducing your lantus one too. You will find that your MDI regime will be far more aggressive at keeping your bg levels lower than your previous one.

[LonghornLady]

Not sure how this happened...I don't mix insulins w/Lantus. I store my insulin in the refrigerator until I need a new vial, then I keep the vials I'm using in my blood machine kit, at room temperature. This worked fine with the first vial I got from my local pharmacy.

The first vial I opened from my mail order pharmacy developed this white gunk floating around in it after about 2 weeks of opening. It's not expired. When left undisturbed, this stuff seems to float to the top and stick to the sides of the vial where the air is, but once you turn the vial upside down...it seems to multiply and is floating around everywere.

Needless to say, I haven't used the funky looking stuff and as a precaution have been keeping the Lantus refrigerated at all times now. I'm wondering, what on earth did I do to cause this? The Lantus package insert said it could be kept at room temp. for up to 28 days.

I've been diabetic for 19 years, but am a newbie to Lantus (1 1/2 months).

[LonghornLady]

This may sound strange, but I noticed the rubber stopper (the part you put the syringe into) at the top of the Lantus vial is more opaque than the Humalog or NPH I'm accustomed to.

Is it possible that by 1) receiving it by mail order at what I call somewhat cool temps, and 2) keeping the vial at room temp when in use, and 3) injecting the required air/drawing the appropriate amount on a daily basis....could that lead to some pieces of that rubber stopper actually falling into the insulin? In other words is it more likely to break up than the thicker caps I've seen on the Lilly brand insulins?