Just started using the lantus pen yesterday for type 2

[janice88]

1) The clowns at lantus evidently don't know how to write an instruction booklet, so I need to rely on you guys for help. The instructions say to test every new needle before each use by setting the dial to 2 and pressing the injection button. Ok, I did that and now my question to you guys is, "what do you do with the insulin that squirts out, do you wipe it off with a kleenex, just let it dry, or what"? I can't believe the instructions don't tell you.

2) My blood sugar has been around 250 after fasting for 8 or 10 hours which is why I'm on insulin now. My hospital stay doctor for another issue is not an endocr.... and he prescribed 14 units of lantus once a day. Does 14 units seem to low for someone with a 250 fasting sugar level? I know everyone is different, but here is a little more info I weight about 120, I'm 62, and a female.


3) I feel most comfortable injecting myself in the back of my upper arm, am I pretty much safe injecting myself anywhere behind my tricep and more importantly are you suppose to inject yourself straight in or come in at an angle?


Thanks

[Subby]

Hi Janice!

1. Really doesn't matter, as long as you don't touch the needle with anything at any stage until you inject.

2. No one can tell you what dosage you need, no matter what information you give. (That includes the doc, he's just guessing too. Hopefully wisely and with experience). Insulin dosaging needs to be informed primarily by if it is being effective or not. It's sounds like it is not, so go with your gut, expect to increase it, and call your doctor to explain. I think the most desirable situation for a newcomer to insulin, is to be able to adjust insulin as needed with the guidance, help and blessing of the doctor.

3. I don't have a lot of experience injecting in arm, but providing you are using a short needle and don't have emaciated arms, I'd have thought the angle should not matter. But I do not know for sure, and you may be running a risk of injecting into muscle - not desirable, as this will speed up the action of the insulin significantly. I do not know how much of a risk this is for you. Generally, right angle or thereabouts is practised for insulin shots.

[Tribbles]

I was told that Lantus takes a couple days to reflect any dosage change so not to change my does more than every three days. Obviously if it is dangerously out that doesn't apply but otherwise you need a couple of days before you reach a conclusion on it's effect.

As long as you hit subcutaneous fat it doesn't matter what angle you inject at. Remember not to withdraw the needle for about ten seconds or the insulin will leak back out.

[plattb1]

My endo started me on 10 units daily at bedtime & instructed me to check fasting BG daily, then:
If most BG < 70 mg/dl: decrease dose 1-3 units
If most BG 70-120 mg/dl: no change in basal insulin.
If most BG 120-200 mg/dl: add 1-3 units every 3 days
If most BG > 200 mg/dl: add 3-5 units or increase by 10%

I inject mostly in the thighs and tummy, avoiding a two-inch circle around my bellybutton. I find than thinner people do better in meatier areas than the arms. However, arms are perfectable permissible sites. And, I inject straight in, not at an angle.

[Subby]

My endo started me on 10 units daily at bedtime & instructed me to check fasting BG daily, then:
If most BG < 70 mg/dl: decrease dose 1-3 units
If most BG 70-120 mg/dl: no change in basal insulin.
If most BG 120-200 mg/dl: add 1-3 units every 3 days
If most BG > 200 mg/dl: add 3-5 units or increase by 10%


Careful if following this suggestion - insulin can have a wildly different potency from person to person, those unit amounts might be a little for one person and a lot for another. The idea in general seems reasonable, but I highly recommend anyone thinking of such a scheme to run it by by their doc if they are not confident how much an adjustment might make a difference in their body.

[plattb1]

I agree, Subby. These are the directions my doctor gave me. So, they are probably generally applicable. However, I wouldn't suggest that the OP take my advice over her doctor's. It is, however, an incremental approach & fairly conservative.