Splitting Lantus

JJeenn · #1 (**permalink**) 08-03-2006, 03:56 PM

Hey everyone,

I'm new here. I was told about the forum by another member. I'm wondering if anyone has split their Lantus dose into two shots, and if so how they went about doing it? My blood sugar rises pretty sharply between 8:00-12:00 at night (I take Lantus at 10:30), which I'm pretty sure is the Lantus running out and then the time between when I inject it and when it really starts working. I also have weird things going on overnight including a pretty strong dawn effect (my blood sugar can rise by 3-5mmol/L between 5:00 and 8:00) combined with a dip around 4:00 which (depending on what my blood sugar is going to bed) is sometimes a low. It's so frustrating, and my endo says he thinks it's the only reason (highs at night and in the morning) that my A1c is above 7. I'm looking into getting a pump, but in the meantime I've heard of people who have had success splitting Lantus. I just don't really know how to do it without waking up high at least one morning.

Thanks for any comments!

VanDamage · #2 (**permalink**) 08-03-2006, 04:22 PM

i take lantus at night before bed because of the same thing.i used to take it in the morning and always be high the next day like above 130. so i switched to night and now wake up 80-100 and im fine the rest of the day but i dont eat much any more and walk alot.

seacomp · #3 (**permalink**) 08-03-2006, 05:01 PM

Quote:

Originally Posted by JJeenn

I just don't really know how to do it without waking up high at least one morning.

You could do it a very little at a time, cut 10% from the night and add that in the morning, the next day go to 20%, etc.
When I switched, I didn't bother with any of that and just did it in one cut. It's not a big deal, if you test 1st thing in the morning and correct with some short term (plus the new shot of long term, of course).
Good luch, and BTW usually the total Lantus dose required drops a little bit; maybe 10%.

CiContention · #4 (**permalink**) 08-03-2006, 05:06 PM

Quote:

Originally Posted by JJeenn

Hey everyone,

I'm new here. I was told about the forum by another member. I'm wondering if anyone has split their Lantus dose into two shots, and if so how they went about doing it? My blood sugar rises pretty sharply between 8:00-12:00 at night (I take Lantus at 10:30), which I'm pretty sure is the Lantus running out and then the time between when I inject it and when it really starts working. I also have weird things going on overnight including a pretty strong dawn effect (my blood sugar can rise by 3-5mmol/L between 5:00 and 8:00) combined with a dip around 4:00 which (depending on what my blood sugar is going to bed) is sometimes a low. It's so frustrating, and my endo says he thinks it's the only reason (highs at night and in the morning) that my A1c is above 7. I'm looking into getting a pump, but in the meantime I've heard of people who have had success splitting Lantus. I just don't really know how to do it without waking up high at least one morning.

Thanks for any comments!

I use Levemir, similar to Lantus, but in any event I have set up my Levemir into four shots, to coenside with breakfast, lunch, dinner and bed time. I find it easier to remember to do it with food and at bed time because I'm usually covering with my fast-acting anyway.

I had the high and low effect also, but I have been taking a set amount of Levemir as per my CDE (Diabetic Educator's) advice and it has seemed to taper the effect of the high/low at night and in the morning.

JJeenn · #5 (**permalink**) 08-03-2006, 07:10 PM

Quote:

Originally Posted by seacomp

You could do it a very little at a time, cut 10% from the night and add that in the morning, the next day go to 20%, etc.
When I switched, I didn't bother with any of that and just did it in one cut. It's not a big deal, if you test 1st thing in the morning and correct with some short term (plus the new shot of long term, of course).
Good luch, and BTW usually the total Lantus dose required drops a little bit; maybe 10%.

Thanks for the info. I was thinking of doing it in one go and just being high the one morning, but thought I'd ask and see if others did it another way. Thanks for the information about usually requiring less, that's good to know

Penny · #6 (**permalink**) 08-03-2006, 07:54 PM

I split mine a couple of months ago. When I did the 50/50, I stayed too high in the morning. I experimented until I am doing 60 in at 11pm, and 20 around 11am. It seems like my numbers are very good from late afternoon until 11, now. I was still having high fasting levels, up to 160. The doctor told me to increase the evening dose by 5 units until it went down. Two increases, and I am averaging 135, not good, but better than I was doing. I am going to stay here for awhile, and see if it works out.

poodlebone · #7 (**permalink**) 08-03-2006, 08:59 PM

I was only on Lantus for a couple of months but splitting the dose 50/50 12 hours apart was much better than taking it all in one shot at night. Like you, by 8pm I was high because the shot from the previous night had run out. When I was taking just one nighttime shot I'd wake up low all the time as well.

jenet · #8 (**permalink**) 08-04-2006, 12:36 PM

Lantus has less of a peak than NPH, but it still doesn't last 24 hours for many folks. I've read that approximately 1/3 of the people on Lantus split it AM/PM. Some people split it 50/50; others need to split it 60/40 or some other ratio because they need less Lantus at night. And, some folks use the Lantus profile to their advantage by taking their Lantus in the morning, and do better with it fading out overnight.

When I was taking one shot of Lantus at 9 PM, I was always high the next afternoon around 3 PM. This was less of a problem after I split Lantus into two doses. It wasn't until I started pumping that I confirmed my overnight basal rate really is 30% less than some of my daytime rates.

Good luck in finding the right split for you!
cheers,
j