Where do you inject your Lantus?

[gary.keith]

When I was in hospital the nurses did me a huge favor by encouraging me to test using my meter when they tested using their meter, and more importantly, to inject myself with Novolog and Levemir.

For the Levemir they wanted me to inject in my inner thigh, alternating thighs each night.

Now that I'm out of hospital my endo switched me from Levemir to Lantus.

I've been finding that injecting Lantus in my thighs causes a huge amount of post-injection bleeding. It takes at least a minute of pressure on the injection site to stop the bleeding. And my thighs aren't holding-up well at all. Every injection spot is visible for days afterward.

Is there a better place for me to inject?

[kvnkrby]

I typically use the abdomen from the "love handles" region to within about 3 inches of the naval on both sides with good results. I have also used the outer thigh or the upper buttock region, too. It all depends on where I am when I need to dose and how easy it is to access each area.

[NewdestinyX]

When I was in hospital the nurses did me a huge favor by encouraging me to test using my meter when they tested using their meter, and more importantly, to inject myself with Novolog and Levemir.

For the Levemir they wanted me to inject in my inner thigh, alternating thighs each night.

Now that I'm out of hospital my endo switched me from Levemir to Lantus.

I've been finding that injecting Lantus in my thighs causes a huge amount of post-injection bleeding. It takes at least a minute of pressure on the injection site to stop the bleeding. And my thighs aren't holding-up well at all. Every injection spot is visible for days afterward.

Is there a better place for me to inject?The directions on my Lantus Pens seem to prefer the love handles part of the belly. Pinch up a bit of the fat and inject. Remember to hold the needle in for at least 10 seconds after the plunger reaches back to zero.. then 10 seconds and out. I occasionally have a very small bit of bleeding but even less than when I prick my fingers for BG level testing. And I never have to hold a cotton ball against it -- just wipe off with an alcohol swab. 8 out of 10 times no bleeding at all.

Good luck.

[NewdestinyX]

When I was in hospital the nurses Gary I just noticed your signature. A BG of '1,240'?? I think that's a record at the forum.:) It's good they caught it and you're on the right path. They started you right on 60 units of Lantus? or did you work up to that?

Keep us posted on your progress!

[gary.keith]

I typically use the abdomen from the "love handles" region to within about 3 inches of the naval on both sides with good results.The directions on my Lantus Pens seem to prefer the love handles part of the belly.

The love handles seem to be the most popular spot with you guys. I'll give it a try this evening.

Remember to hold the needle in for at least 10 seconds after the plunger reaches back to zero.. then 10 seconds and out.

Do I understand correctly that in addition to holding the plunger for 10 seconds, you also leave the needle in for an additional ten seconds?

Will doing that decrease the amount of insulin that still leaks from my needle after the first ten seconds?

I find it painful to keep the needle in for even 10 seconds. It stings, almost to the point of burning. And the longer I keep the needle in the more bleeding I get post-injection.

Gary I just noticed your signature. A BG of '1,240'?? I think that's a record at the forum.:) It's good they caught it and you're on the right path. They started you right on 60 units of Lantus? or did you work up to that? Keep us posted on your progress!

It was a record at the hospital, too!

Nope, I was started on 35 units of Levemir and my PCP seemed to be okay with my in-hospital BG being in the 400-600 range. Once I got out and started dealing with my Endo, she gradually increased my dose to 40, 45, 50 and then 60. Now I'm almost always in the 80-110 range with occasional PP forays into both the mid-150s and well into the hypo range; I'm still learning to count carbs and bolus accordingly. It was at the 50 mark that she switched me to Lantus. I'm not sure why she did that.

I've seen her for many years for other endocrinic issues, love her dearly--we're on a first name basis, and have learned it's best to just do what she tells me to do and I always get better. Her PA is much better at the question/answer/details stuff, so I'll ask her when I'm there week after next for my monthly visit.

Thanks to both you guys! :)

[Subby]

Gary, I found the butt a wonderful place to inject long acting, whether it be NPH, Lantus, Levemir, over the years. I have very even, slower absorption from there. I don't get nearly as much scarring or hardening there compared to my love handles or around torso.Apart from a very strange couple of times lately, never had bleeding - there's usually a big fatty territory there. Big target, even if a bit hard to see, once practised the action is easy to do. I'm guessing there might be limitations if one is really heavy, I don't know.

Along with that, one thing I will say, I use syringe, with its lightness and the grip of writing or dart throwing, I don't need to even really look. I find a couple of seconds held, and no dribble. I would not want to gouge around in there pushing on a heavy pen and holding it in for the 10 or so seconds that pens seem to need, personally. I found that very awkward when I tried it on my backside.

[Hammer]

Gary, I use the Lantus pen and the Byetta pen, and I inject the Lantus into my outer or upper thighs, and the Byetta into my love handles. There is no special reason I use these locations other than it makes it easier for me to remember where I last injected.(left thigh today, right thigh tomorrow. Left love handles in the morning, right love handles in the evening).

One thing that I do.....I sit in a dining room chair that has armrests, when I inject. I can rest my elbow on the armrest, and it keeps my hand steady when I inject. If I move the pen too much, it will by more painful.

Also, when you squeeze the plunger on the pen, even though the plunger has stopped going into the pen, the plunger inside the pen that is pushing the insulin out the tip, is still moving. That's why you should leave the pen in your skin for 5-10 seconds after you release the plunger.

[gary.keith]

It's not the hard to see part that would be a problem with injecting in my butt. It's more a matter of lack of dexterity due to hand and arm problems related to using a keyboard for endless numbers of hours over the course of 35+ years as a software engineer and programmer.

Maybe it's time to try a syringe again. I tried it in hospital and had a total freakout experience. But I was also dealing with a mini-breakdown then, so perhaps it wasn't a fair test. I'll ask my Endo's PA about it when I'm there next week.

Thanks. :)

ADDED: Thanks, Hammer. The armrest suggestion is a good one that I already follow. I've tried it both ways and using the armrest is a definite help.

[xMenace]

I've injected just about everywhere:eek: Other favs are top of the hips, top of the thighs, and triceps.

It was a record at the hospital, too!

You're lucky to be alive! What was your A1C? The highest I know of is 22.

[enigmalady777]

The burning and for me, horrible bruising is why I switched form Lantus to Levemir several months ago.

For both Lantus and now Levemir, I use my lower abdomen area. Granted, I have a significant amount of fat there to "pad" me, I find that the absorption rate is better there, almost never get any bleeding and bruising is also rare now that I'm on Levemir.

I have also found that needle length makes a difference. For doses over 35-40 units, a longer needle works better for me (I use the 12.7 mm for my Levemir dose of 55 units) from the perspective of absorption and potential discomfort.

[gary.keith]

What was your A1C? The highest I know of is 22.
I'm not aware of having had the A1c yet. It was never mentioned to me in hospital. It's on my list of things to ask the Endo and her PA about next week.

The burning and for me, horrible bruising is why I switched form Lantus to Levemir several months ago.

I have also found that needle length makes a difference. For doses over 35-40 units, a longer needle works better for me (I use the 12.7 mm for my Levemir dose of 55 units) from the perspective of absorption and potential discomfort.
Thanks, I've added a request for a long needle to my list of things for next week's Endo visit. :)

[NewdestinyX]

Do I understand correctly that in addition to holding the plunger for 10 seconds, you also leave the needle in for an additional ten seconds?Sorry, Gary.. That was confusing on my part. No - inject -- immediately press plunger, slowly and when plunger reaches '0' units again count to 10. So it's a total of like 12 seconds from the moment of injection. I get rare bleeding and zero pain in my love handles with a 17 unit injection and the short needles. Others will have other input for you. I'm new at this too.

Now I'm almost always in the 80-110 range with occasional PP forays into both the mid-150s and well into the hypo range; I'm still learning to count carbs and bolus accordingly. It was at the 50 mark that she switched me to Lantus. I'm not sure why she did that.So you're on both basal and bolus insulin? Any oral meds? And as a Type 2, have you begun any diet modification for control -- lower carbing? Just curious.. If you've already explained -- sorry for the duplicate question..

[gary.keith]

Sorry, Gary.. That was confusing on my part. No - inject -- immediately press plunger, slowly and when plunger reaches '0' units again count to 10. So it's a total of like 12 seconds from the moment of injection. I get rare bleeding and zero pain in my love handles with a 17 unit injection and the short needles. Others will have other input for you. I'm new at this too.

So you're on both basal and bolus insulin? Any oral meds? And as a Type 2, have you begun any diet modification for control -- lower carbing? Just curious.. If you've already explained -- sorry for the duplicate question..

Thanks, the clarification was helpful.

Yep, basal and bolus. Lantus and Novolog. No ormeds. I've done a bit too well on the diet modification as my diet is usually almost so low carb that taking the prescirbed 25 units of Novolog pre-meal often sends my PP BG plumenting into dangerous hypo territory; it's gone as low as 32. I call the endo whenever that happens and she always tells me to swallow a tube of glucose gel and in the future eat more carbs or take less Novolog, but has yet to give me any kind of insulin to carb formula for my bolus. I'll be figuring that out on my own with the help of that Using Insulin book and all the kind, generous people here; like you!

Oh, I was a very bad boy tonight. On my own I switched to using my outer thigh to inject Lantus. And man, what a huge difference for the better it made! No bleeding, no stinging or burning, no dripping, and a cute little dimple in my skin!

[xMenace]

Oh, I was a very bad boy tonight. On my own I switched to using my outer thigh to inject Lantus. And man, what a huge difference for the better it made! No bleeding, no stinging or burning, no dripping, and a cute little dimple in my skin!

It's a big step forward to take control of your own management. This is just the beginning. Many of us assume complete control. I decide everything. I don't even show my numbers to my doctors. It's none of their business, unless I need help. Yes we all need help once in awhile.

I don't recommend taking 100% control right away. It took me decades to get there. There's lots to learn and experience first.

[NewdestinyX]

Yep, basal and bolus. Lantus and Novolog. No ormeds. I've done a bit too well on the diet modification as my diet is usually almost so low carb that taking the prescirbed 25 units of Novolog pre-meal often sends my PP BG plumenting into dangerous hypo territory; it's gone as low as 32. I call the endo whenever that happens and she always tells me to swallow a tube of glucose gel and in the future eat more carbs or take less Novolog, but has yet to give me any kind of insulin to carb formula for my bolus. I'll be figuring that out on my own with the help of that Using Insulin book and all the kind, generous people here; like you!Whew... a '32'..:eek: That was 'near death' my friend. You should have been feeling the skakes at that point and not needed to call your doc -- your body should have said -- EAT SOME SUGAR NOW!!!! :D From the Type 1's and 2's here on the forum that I've read.. there is ALWAYS a calculation for determining bolus units. To use a set number, like 25, seems pretty cavalier to me. But your doc did it -- so... She's a doc and we're not. And you WERE indeed HIGH when you started your roller coaster to say the least. But '25' no matter what you eat? That's just -- well weird. DISCLAIMER - I'm new at this too and just reacting to what I've already learned here. You can get some good info on websites about how to determine your 'ratio' (carb to insulin) - then you count the intended carbs of a meal and that's how you determine the bolus.

I like what xMenace said that you need to take your own control but not '100% at first'. From what others tell me -- it's the diabetes educators that help you determine your ratio for bolus so maybe the docs don't always know that part of it. So either get that book quick or get to a diabetes educator in your area -- quick.. A BG level of '45-50' is considered pretty dangerously low -- 32? -- wow... After a number of over 1000 I guess that seems the better end of the scale... right?;)

Oh, I was a very bad boy tonight. On my own I switched to using my outer thigh to inject Lantus. And man, what a huge difference for the better it made! No bleeding, no stinging or burning, no dripping, and a cute little dimple in my skin!So happy for you. You're gonna be doin' a lot of injecting for a long time - likely... It should be as comfortable as possible. Remember 'never into muscle' with insulin. That can be very bad 'and' painful. Only into fat. And Hey -- with your new diet maybe one day you'll be able to control it totally with diet. Many have amazing stories of having gotten down to goal weights with permanent diet changes and now they're on no meds or insulin of any kind! I personally never want to eat 'that' lo carb -- so I'll always be okay with 'some help' from the medical world. :T

[fgummett]

Bear in mind that an home BG test is just a snapshot in time and without a series of tests cannot tell you if your BG is stable, going up or going down. Also remember that there can be meter/test strip variability in accuracy, and I know that my technique is not always perfect. Unless you have been starving, your Liver is likely to have a ready supply of Glucose to lift you out of an Hypo... so yes a 32mg/dl is definitely cause for concern but I'd suggest that "near death" is overstating it a little.

[NewdestinyX]

so yes a 32mg/dl is definitely cause for concern but I'd suggest that "near death" is overstating it a little.Maybe - but my doctor told me that. 30 is the point of coma and only a little bit further than that can cause death. I think it is 'indeed' a cause for 'great' concern to ever see a number like that. Maybe a wording we could all agree on would be a 'dangerously low BG level' -- yeah -- that's probably still pithy but without the hyperbole.

[gary.keith]

Whew... a '32'..:eek: That was 'near death' my friend. You should have been feeling the skakes at that point and not needed to call your doc -- your body should have said -- EAT SOME SUGAR NOW!!!!

so yes a 32mg/dl is definitely cause for concern but I'd suggest that "near death" is overstating it a little.

Maybe - but my doctor told me that. 30 is the point of coma and only a little bit further than that can cause death. I think it is 'indeed' a cause for 'great' concern to ever see a number like that. Maybe a wording we could all agree on would be a 'dangerously low BG level' -- yeah -- that's probably still pithy but without the hyperbole.

What I can agree on is that, perhaps figuratively, a 32 felt like it was "near death." I definitely knew something was wrong when I was standing in the checkout line at the supermarket and inside of a few seconds my tee shirt was quite literally soaking wet with sweat, my vision went blurry, and I was so disoriented that I barely made it to a bench just outside the store. That's when I called my endo's PA. She was very concerned, enough so that she forbade me to drive home from the supermarket until my BG was over 70. This was also in the days before I learned about glucose tablets/gel. So she sent me back into the market to get a bag of white sugar, and had me down the whole two pounds. :D OK, not really. She had me get a half-gallon of orange juice and chug it. Within about 20 minutes or so my BG was back into the 70s, and kept climbing until I was into the hyper range. I didn't know at that time that I should have bolused to get it back down. Now I do. But more importantly, I also know it makes more sense to use glucose gel, which I prefer over the tablets. And it seems to make sense to me that a gel will be more rapidly absorbed than a crumbly, yucky tablet will. Live and learn.

It's a big step forward to take control of your own management. This is just the beginning. Many of us assume complete control. I decide everything. I don't even show my numbers to my doctors. It's none of their business, unless I need help. Yes we all need help once in awhile. I don't recommend taking 100% control right away. It took me decades to get there. There's lots to learn and experience first.I like what xMenace said that you need to take your own control but not '100% at first'. From what others tell me -- it's the diabetes educators that help you determine your ratio for bolus so maybe the docs don't always know that part of it. So either get that book quick or get to a diabetes educator in your area -- quick

I agree about not taking 100% control for now. At this point I know just enough to get myself into some serious trouble if I experiment too much. The book will be here Wednesday. I'll be taking the diabetes education class promptly when Medicare tells me they'll pay for it. I have to be out of hospital for one month before they will pay for the class.

Right now it seems like the best I:C ratio for me is 1.25 units of Novolog for every 3 grams of net carbs. I'm not going to implement this until I'm satisfied I understand the Using Insulin book or I'm done with the management classes.

[NewdestinyX]

What I can agree on is that, perhaps figuratively, a 32 felt like it was "near death." Yeah man!I agree about not taking 100% control for now. At this point I know just enough to get myself into some serious trouble if I experiment too much. The book will be here Wednesday. I'll be taking the diabetes education class promptly when Medicare tells me they'll pay for it. I have to be out of hospital for one month before they will pay for the class.Yeah -- shoot.. Who's going to pay -- it's an issue for so many people..Right now it seems like the best I:C ratio for me is 1.25 units of Novolog for every 3 grams of net carbs. I'm not going to implement this until I'm satisfied I understand the Using Insulin book or I'm done with the management classes.Without books and your classes it seems you've determined that ratio by yourself. Would you mind explaining how you arrive at it? I'm curious to learn how Bolus takers determine this.. And how long before/during a meal do you take the dose.

[gary.keith]

Without books and your classes it seems you've determined that ratio by yourself. Would you mind explaining how you arrive at it? I'm curious to learn how Bolus takers determine this.. And how long before/during a meal do you take the dose.

I use an iPhone app called Diabetes Pilot (DP) that suggests, based on my history of BG, food intake and bolus how much insulin it should take to get me back to what I've told it is the highest I ever want my BG to be: 120. For now I'm pretty much sticking with what the endo said I should bolus. But I am seeing trends developing that lets me say I think I know what my C:I should be. We'll see how it works out once I implement it.

DP is what I use to log every BG test, every bolus and basal, every single thing I eat, my BP, weight and what kind of exercise I did. In time I'll use Using Insulin and what I learn from the management classes to fine-tune the dosage. My endo loves it cause I can e-mail her a copy of the log. It provides reports and graphs to let me see how I've been doing in terms of keeping my BG under control. For an iPhone app it's darned expensive. Most of the diabetes logging apps are free. The average app price across all categories is $1. DP is $12. I tried all the others and found it was worth it to spring for DP. I mean, it's expensive for an app, but it's not at all expensive in terms of how it simplifies my life. It's even got an extensive database of foods/meals, including from restaurants, listing all the important info like carbs, fiber, protein, calores, fat, etc. Plus I can add my own food items and even share them with all the other DP users. Based on what I tell it, it'll suggest how much I should bolus pre-meal. Then, starting at an hour PP the BG tests help me decide how much additional, if any, to bolus.

BTW, that was only an endorsement, not a sales pitch. I'm just a happy customer who does not benefit in any way from giving it glowing reviews.

[NewdestinyX]

I use an iPhone app called Diabetes Pilot (DP)
LOVE THIS APP!!!! Totally worth the $12!!!! :D

[gary.keith]

LOVE THIS APP!!!! Totally worth the $12!!!! :D
I'm glad you like it too! Had you been using it already, or did you go get it because I recommended it?

[Cluck]

The burning and for me, horrible bruising is why I switched form Lantus to Levemir several months ago.

For both Lantus and now Levemir, I use my lower abdomen area. Granted, I have a significant amount of fat there to "pad" me, I find that the absorption rate is better there, almost never get any bleeding and bruising is also rare now that I'm on Levemir.

I have also found that needle length makes a difference. For doses over 35-40 units, a longer needle works better for me (I use the 12.7 mm for my Levemir dose of 55 units) from the perspective of absorption and potential discomfort.

Even on very small amounts of Lantus I had the burning pain, bruising and finally abcesses. I also switched to Levemir successfully and found it much less painful to use.

[NewdestinyX]

I'm glad you like it too! Had you been using it already, or did you go get it because I recommended it?Had been looking for one and didn't think of looking for an app for my iPhone. So your recommendation did it!

[gary.keith]

Had been looking for one and didn't think of looking for an app for my iPhone. So your recommendation did it!

That's great! Let's compare notes on the app every so often.

Right now the only thing I dislike is how the time/date on a new entry always defaults to the previous entry's time/date when the new one is within something like 10 minutes of the previous one. It makes items in the list sort wrong. This happens even when, for example, you enter your BG and then click the Enter Now button to enter your bolus. I don't like the bolus entry to sort before the BG entry and that's what happens when the time/date on both entries are the same.

[NewdestinyX]

That's great! Let's compare notes on the app every so often.

Right now the only thing I dislike is how the time/date on a new entry always defaults to the previous entry's time/date when the new one is within something like 10 minutes of the previous one. It makes items in the list sort wrong. This happens even when, for example, you enter your BG and then click the Enter Now button to enter your bolus. I don't like the bolus entry to sort before the BG entry and that's what happens when the time/date on both entries are the same.Yeah I noticed that, Gary. But, of course, you can easily edit the time of the entry to the time you want it to read and then it will sort perfectly as you'd hoped to begin with. Just select the date after tapping on the entry and the date editor window comes up.

[gary.keith]

Yeah I noticed that, Gary. But, of course, you can easily edit the time of the entry to the time you want it to read and then it will sort perfectly as you'd hoped to begin with. Just select the date after tapping on the entry and the date editor window comes up.

LOL, the problem isn't being unable to edit it, it's remembering to edit it!