[jared]

i am on lantus and humalog. i forgot to take my lantus shot last night and am wondering now how much do i take this morning? half and then take the full 23 untis tonight. please help? last night my sugar shot up to 533. and up all night using the rest room

[KrisinNM]

Jared, do you know how many units of Humulog you need to take to bring your bsl down? If so, do it immediately. Also if you have any ketodiasticks to check for ketones, do it now! Call your doctor or CDE NOW!

[Harold]

Originally Posted by jared

i am on lantus and humalog. i forgot to take my lantus shot last night and am wondering now how much do i take this morning? half and then take the full 23 untis tonight. please help? last night my sugar shot up to 533. and up all night using the rest room

Not sure how you manage your Lantus. Do you usually only do one a day of 23 units? It is supposed to last approximately 24 hours so if you take half that now it will still be working when you take 23 tonight.

[jared]

i usally take 23 at 9:00 pm .... well i freaked out and took 24 this am. how do i know switch over to nights again. do i take 23 more units at 9pm tonight?

[mark-TN]

Jared this is a tricky one. I suggest calling your Dr or CDE for advice and guidance right now. If for some reason you do not call your doctor (though there is no reason not to, they will tell you what to do over the phone.) do not take your dose of Lantus tonight what ever you do. I believe they will suggest that you skip the dose tonight and not take any Lantus until tomorrow night. Lantus will stay at base line for about 24 hrs +/- 4 hrs or so, however the Lantus will have action in your body for up to 72 hrs or more after an injection, just at much lower levels after the 24 hrs. It is best to skip the Lantus dose until tomorrow night and supplement with rapid insulin about every 4 hrs starting tomorrow morning through the whole day tomorrow then take your regular Lantus dose tomorrow night. It will take about 3 days for the Lantus level to build up in your system again. It is very important that you monitor a lot in the next 3-4 days. But please, please, please, call your Dr. now. Do not try this on your own.

Mark

[bac4uw]

Hi Jared,
If it were me, I'd probably cut my Lantus dose in half in the morning and take another half dose that night... and then the next night take the full dose. (My experience may be different from yours though, so your doc will likely be the best source for advice) I suppose the important thing is to get your BG down with Humulog in the meantime.

Also, have you and your doctor considered splitting the Lantus dose so that you take one (half) dose at night and one (half dose) in the morning? I've (personally) found the Lantus doesn't last the full 24 hours that it claims to - more like 22-23. By splitting it, I'm covered all day long with at least some level no matter what - even if I forget to take one dose. (Though this means another shot per day!)

Bryan

[mark-TN]

Jared-

I hope you have called your doctor by now and that these suggestions are just mute. However, I think it would be dangerous to take a half dose tomorrow morning and then another full dose tomorrow night. I’m not a Dr. this just comes from experience, but I think it is best to error on the side of caution here. That half a dose will have its full effect for about 24 hrs give or take a few hours. Adding another full dose tomorrow night after taking a half dose in the morning has a great possibility of raising your base basal over and above what your body requires through tomorrow night leading to a chance of a severe hypo.

I like Bryan’s suggestion about evenly splitting the dose in the morning and at night sometime in the future after talking this over with your doctor. I know many that have had great success with this approach even though it does require another shot to remember about taking.

Good luck and let us know how this all works out.

Mark