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Splitting Lantus Dose

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#1
dbaratta

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I definitely know more than my GP, but I let him think he knows more. This allows me to manipulate the situation to get the Rxs I want. For real advice, I come here, and will run some things by my endo, who usually confirms what I found out here. For example, using advice here, I figured out how to split my Lantus. I ran it by the endo who said it sounds good, please leave your copay with the receptioninst. :)


How did splitting your lantus work better for you? I see that a lot of people in this forum have done that and seem to get good results. I did that in the beginning and my doc freaked and said I could have killed myself. LOL I guess they were trying to scare me at the time becaues I was new to the drug, probably not a bad idea.....so, tell me more.:)
A1C JULY 2010 5.9%
A1C March 2010 6.2%
Lantus 16 units split dose
Novolog as needed


:aetsch:

#2
Delphinus

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How did splitting your lantus work better for you? I see that a lot of people in this forum have done that and seem to get good results. I did that in the beginning and my doc freaked and said I could have killed myself. LOL I guess they were trying to scare me at the time becaues I was new to the drug, probably not a bad idea.....so, tell me more.:)


Your doctor told you that?


If a doctor wants to walk that line, it would actually be more of a risk NOT to split your dose and to take it all in one shot, thus introducing a large amount to your body all at once, rather then two smaller doses, twice a day. IMO anyway.

I found when I wasn't splitting my basal injections, my numbers weren't as good. I suspect that is probably because the longer the insulin is in your body, even tho it is the exact same amount as the two doses, the less effective it becomes, so it's better to take one at a set time, and to "top up" approximately 12 hrs later, thusly supporting/reinforcing the first injection around the time it may be losing it's effectiveness.

Is your doctor a GP or an endo?

I would expect that from a GP.

Suggesting you could have killed yourself is a bit extreme, especially when talking the same doseage amount, but just split into two.

I am sure the doctor's intention was well, just sometimes they want to micro-manage a bit too much, and don't do so properly.

They should educate and guide you, not scare you into not wanting to be pro-active.
[SIGPIC][/SIGPIC]

Type1 diabetic. Son of a Type1 diabetic. Father to a Type1 diabetic.

+++ Jason

#3
dbaratta

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[quote name='Delphinus']Your doctor told you that?

effectiveness.

Is your doctor a GP or an endo?

I would expect that from a GP.

Suggesting you could have killed yourself is a bit extreme, especially when talking the same doseage amount, but just split into two.

I am sure the doctor's intention was well, just sometimes they want to micro-manage a bit too much, and don't do so properly.


I am on Lantus that lasts 24 hours so I am supposed to take it once a day. I asked about a 12 hour drug and they said this one along with novolog works better. I truly don't know. I feel the same way you do, if you take one big shot why would two smaller ones hurt. The doc was an intern,,,,,and I was a new diabetic at the time so,,,,,can you say the blind leading the blind?
A1C JULY 2010 5.9%
A1C March 2010 6.2%
Lantus 16 units split dose
Novolog as needed


:aetsch:

#4
Delphinus

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I am on Lantus that lasts 24 hours so I am supposed to take it once a day. I asked about a 12 hour drug and they said this one along with novolog works better. I truly don't know. I feel the same way you do, if you take one big shot why would two smaller ones hurt. The doc was an intern,,,,,and I was a new diabetic at the time so,,,,,can you say the blind leading the blind?



You are right to ask around tho.

That is how I learned. That and alot of reading and experimenting. :D

Now, if we were talking regular, or rapid insulin, then you have to be more careful with how much, and when you take it.

You have a lot more flexibility with insulins that are meant for your basal plans as they are slower acting, and the effects aren't as notable.
[SIGPIC][/SIGPIC]

Type1 diabetic. Son of a Type1 diabetic. Father to a Type1 diabetic.

+++ Jason

#5
foxl

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I just love the pharmacology concept of drug half-life.

And, I have read if you overlap doses of Lantus too soon, you can crash, but split doses seem to help a lot of people.
Linda


[B]Jan A1c 6.3/B]
Jul 09 ... C-pep 1.3, GAD-65 > 30
Mar 10 C-pep 2.8 (20 g carb); GAD 3.2
dx 02/09 in DKA


Levemir 12U per day; novolog PRN TDD ca 16U
MetforminXR 1000 mg BID
Ramipril 5 mg
T4 112 mcg
Chia oil
Vitamin D3, 4000 IU
Eating 20 - 45 g carb per day ovo-lacto-vegetarian
Walking 30 min 6x week

#6
Real4

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[quote name='dbaratta'][quote name='Delphinus']The doc was an intern,,,,,and I was a new diabetic at the time so,,,,,can you say the blind leading the blind?[/QUOTE]

Every doctor should have learned the basics of pharmacology in med school. And it is basic that the more constant level of a drug is, the more effectively it functions in the body.

The best way to administer drugs is through a constant IV drip, which, by the way, is what one effectively gets with a pump.

Taking Lantus twice a day evens outs the small "spike" it does actually have (ignore the advertising promo) and makes it easier to keep near optimal blood glucose levels.

#7
Delphinus

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[quote name='Real4'][quote name='dbaratta']

Every doctor should have learned the basics of pharmacology in med school. And it is basic that the more constant level of a drug is, the more effectively it functions in the body.

The best way to administer drugs is through a constant IV drip, which, by the way, is what one effectively gets with a pump.

Taking Lantus twice a day evens outs the small "spike" it does actually have (ignore the advertising promo) and makes it easier to keep near optimal blood glucose levels.[/QUOTE]


Haha...

The quote got messed up.

I didn't say that... That was DB. :D
[SIGPIC][/SIGPIC]

Type1 diabetic. Son of a Type1 diabetic. Father to a Type1 diabetic.

+++ Jason

#8
Delphinus

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Hah... Now they are all getting messed up because of the original broken quote. :T
[SIGPIC][/SIGPIC]

Type1 diabetic. Son of a Type1 diabetic. Father to a Type1 diabetic.

+++ Jason

#9
LancetChick

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The doc was an intern,,,,,and I was a new diabetic at the time so,,,,,can you say the blind leading the blind?


I consider myself fortunate to have been diagnosed by an intern who didn't know anything about insulin management (this was back in the 80's) because the only thing he could do was confess that he was ignorant, suggest that I test a-l-l the time and log my results, and occasionally run things by a diabetes "specialist" (it was unusual for diabetics to have endos back then), and we ended up learning a lot more together than if he had been a little more experienced and dogmatic.

In fact, it became patently obvious that carb counting, correction shots and many injections per day was the best way to achieve control, despite the fact that mainstream Diabetesville was still injecting twice a day and trying hard to stick to a rigid diet plan. Years later it was announced that a whole new way of treating type 1 diabetes, called Multiple Daily Injections, was being touted as having better results than conventional treatment. My jaw dropped at the incredible lethargy of the medical community, and, aside from the doctor who diagnosed me, I've scoffed at doctors ever since, and don't take their word for anything.

The thing about diabetes, and type 1 in particular, is that we are not only in a position to educate and treat ourselves, but that it is obligatory for us to do so in order to achieve good health, since the medical community falls short (far short) in that responsibility. If I had followed my various doctors' advice for managing diabetes, I'm pretty sure I'd be on dialysis by now. I was just plain lucky to have been diagnosed by one of the very few doctors on the planet who could admit that he didn't know it all.

As far as splitting your basal dose and which insulin to use, YOU should be the one to make those decisions. Before pumping, I was on Lantus, and split it all by my lonesome without killing myself. No big deal. Aside from providing better coverage (Lantus is only a 24-hour insulin for some people) and smoothing out the "allegedly" non-existent peaks, it provides greater freedom, as I think someone mentioned, since you don't have to wait a whole day to change your dose for exercise, alcohol, hormones or whatever else would cause you to need a change. If you want to try Levemir instead, try it! Lots of people have much better success with Levemir than Lantus, and if your doctor refuses to allow that, find another doc, as so many of us have done when running into a brick wall like that. Anyway, good luck finding what works.... may it be sooner rather than later!

#10
dbaratta

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[quote name='Delphinus']You are right to ask around tho.

That is how I learned. That and alot of reading and experimenting. :D

Now, if we were talking regular, or rapid insulin, then you have to be more careful with how much, and when you take it.

Oh I hate novolog! With foods I eat all the time I know exactly what to dose, with the ones I am not sure of I make mega mistakes. I hate to take big doses of it so I limit my carbs....the nutritionist said I can't do that because of blah, blah, blah....so what did she do for me? She made me eat more carbs to take more novolog to gain 25 pounds. I am not a happy camper. I am back to taking care of myself and what I know works for me......I'm all about feeling good and if that means limiting my carbs then so be it....:)
A1C JULY 2010 5.9%
A1C March 2010 6.2%
Lantus 16 units split dose
Novolog as needed


:aetsch:

#11
jenb

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Good for you Poppy - take the reigns and run!

Jen

#12
dbaratta

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If you want to try Levemir instead, try it! Lots of people have much better success with Levemir than Lantus, and if your doctor refuses to allow that, find another doc, as so many of us have done when running into a brick wall like that. Anyway, good luck finding what works.... may it be sooner rather than later![/QUOTE]

What is the difference between Levemir and Lantus?
A1C JULY 2010 5.9%
A1C March 2010 6.2%
Lantus 16 units split dose
Novolog as needed


:aetsch:

#13
jtausch

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Different companies, Both are 24 hour but some people say lantus last longer than levemir but others say lantus causes problems with some people. I use levemir and have no problem with it Really its personnel choice what workas best with you. I am happy with levemer so far no problems with it
Diagnosed: DEC-08-08: FBS 304 :A1c 12.2:mad:
Minimed Paradigm 723 Revel 12-04-2012
Bayer contour next easy link
NEWEST: A1c 6.0 FBS 97 02/12/13:)
Plavix 75 mg;Aspirin 325 mg;Coreg 2.5 mg
Lisinopril 5.0 mg;Lipitor 20 mg


:)

#14
foxl

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Different companies, Both are 24 hour but some people say lantus last longer than levemir but others say lantus causes problems with some people. I use levemir and have no problem with it Really its personnel choice what workas best with you. I am happy with levemer so far no problems with it


I also have heard Levemir has more of a "peak?"
Linda


[B]Jan A1c 6.3/B]
Jul 09 ... C-pep 1.3, GAD-65 > 30
Mar 10 C-pep 2.8 (20 g carb); GAD 3.2
dx 02/09 in DKA


Levemir 12U per day; novolog PRN TDD ca 16U
MetforminXR 1000 mg BID
Ramipril 5 mg
T4 112 mcg
Chia oil
Vitamin D3, 4000 IU
Eating 20 - 45 g carb per day ovo-lacto-vegetarian
Walking 30 min 6x week

#15
owlyn

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How did splitting your lantus work better for you? I see that a lot of people in this forum have done that and seem to get good results. I did that in the beginning and my doc freaked and said I could have killed myself. LOL I guess they were trying to scare me at the time becaues I was new to the drug, probably not a bad idea.....so, tell me more.:)


I got advice here from... oh fudge I forget his screen name. My bad. He's really good with insulin advice... grrrr. Anyway, between his advice, the Lantus activity curve he posted, some basic math, knowing when I go low and high, I determined that I should split my 32 units into 24 in the morning when I wake up, and 8 units at about 11 PM. Has worked great for me. My Bg when I wake up now isa usually perfect, and it is more stable throughout the day. My A1C dropped from 7.8 to 7.0
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#16
Subby

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Here's a comparison of the action profiles of NPH, Levemir (Detemir) and Lantus (Glargine). It's a controlled study of a number of patients, but should not be treated as how the insulin will work for you.

Posted Image

So this graph shows the rate that insulin release increases, then ebbs off (the actual number amounts will of course change according to the dose). But the other half of the equation, is how those amounts "synch" with your body's 24 hour needs, which between different people can be anything from really flat, to reflecting the same curve of the particular insulin profile (lucky), to for some, a complex rollercoaster through the day!
20 years T1. NPH and Novorapid.
Some essentials for my blood sugar control: dosing via i:c ratio and cf • basal testing when needed • daily 40 minutes moderate exercise (or close) • carbs somewhere below 120g currently • only eating carbs and carb/fat combos that do not cause a problem spike, with or without insulin.

#17
dbaratta

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[ Anyway, between his advice, the Lantus activity curve he posted, some basic math, knowing when I go low and high, I determined that I should split my 32 units into 24 in the morning when I wake up, and 8 units at about 11 PM. Has worked great for me. My Bg when I wake up now isa usually perfect, and it is more stable throughout the day. My A1C dropped from 7.8 to 7.0[/QUOTE]

That is very cool that it worked so well for you. At this time for me I am doing great, I added 2000 mg metformin along with my lantus and novolog. I make a small amount of insulin so the met is working a little which is just helping me stay more in-line with normal or pre-diabetes. Yesterday I was hovering around 108 all day with my highest reading 125 post meal. I have NEVER had a day like that. I get to cut way back on my novolog because I have gone very low carb diet.....it is all finally coming together, but, if I progress I will get your dad to tell me how to split my lantus. ;)
A1C JULY 2010 5.9%
A1C March 2010 6.2%
Lantus 16 units split dose
Novolog as needed


:aetsch:

#18
dbaratta

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[quote name='Subby']Here's a comparison of the action profiles of NPH, Levemir (Detemir) and Lantus (Glargine). It's a controlled study of a number of patients, but should not be treated as how the insulin will work for you.

Posted Image

Wow, this is great!!! Thank you so much! I am still very leary about splitting, but I am very anal about keeping this disease under control so it is now something I will consider if I don't like my numbers. Super info! :D
A1C JULY 2010 5.9%
A1C March 2010 6.2%
Lantus 16 units split dose
Novolog as needed


:aetsch:

#19
dbaratta

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[quote name='owlyn']I got advice here from... oh fudge I forget his screen name. My bad. He's really good with insulin advice... grrrr.

You are lucky you have someone to help. I got nothing, my family didn't even tell me we had a history of diabetes until I got it. UGH! What is that! I tried to show them all once how to test my blood if I have a problem and they were all laughing and joking and my dad yelled "hey pay attention this is important" and they all got louder.....................My mom just keeps trying to feed me candy..............LOL good thing I don't need them. LOL

Well, thanks for your input. It is greatly appreciated!!! ;)
A1C JULY 2010 5.9%
A1C March 2010 6.2%
Lantus 16 units split dose
Novolog as needed


:aetsch:

#20
owlyn

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[quote name='dbaratta'][quote name='owlyn']I got advice here from... oh fudge I forget his screen name. My bad. He's really good with insulin advice... grrrr.

You are lucky you have someone to help. I got nothing, my family didn't even tell me we had a history of diabetes until I got it. UGH! What is that! I tried to show them all once how to test my blood if I have a problem and they were all laughing and joking and my dad yelled "hey pay attention this is important" and they all got louder.....................My mom just keeps trying to feed me candy..............LOL good thing I don't need them. LOL

Well, thanks for your input. It is greatly appreciated!!! ;)[/QUOTE]

It's not my "dad". I was saying "my bad", meaning I am at fault for something. The help was from someone here whose screen name I am still not remembering.
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Unless otherwise stated, the opinions expressed here are my own and are in no way intended to be considered as anything other than my opinion. That's my story and I'm stickin' to it.




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