[Bountyman]

When I left the hospital Dx'd with T1 the hospital doctor prescribed Lantus, 15 units at bedtime. Two weeks later I had my first visit with my PA and brought him my testing numbers and he upped my dosage to 20 units. A month later he upped me again to 22 units and to adjust that to 25 a week later. My next visit two weeks later showed the 25 unit dosage to be correct for my (then) diet and excersize.

I looked up as much information as I could on Lantus and came to the conclusion that Lantus was a very non high/low-peaking background insulin. Rather you took 10, 25, 40, 60, 80 units per day the release was steady (in volume) no matter how much you took. More to my point:

Luke, in another thread, says his doctor prescribes 10 units of Lantus at bedtime...and 18 units of Lantus in the morning. I'm having trouble wrapping my mind around this logic as I was under the impression each injection lasts 24 hours. Injecting 10 units at night, then injecting another 18 units in the morning wouldn't work in the same way a fast-acting insulin like Humalog and Novalog works, would it? Wouldn't the injections start overlapping? I haven't quite learned the right type of math yet to figure out the overlap algorithm!

In essence, as I look at this, to me it's like the doctor is saying that the 10 units Luke is injecting needs a power boost of 18 units in the morning...when it seems that 18 units at night should produce the same results. I'm pretty sure that Lantus doesn't act like a gas pedal.

Not that I'm trying to second-guess the doctor...I'm just trying to understand this. Anybody?

[TommyC1]

For me Lantus seems to last the full 24 hours so I take one 25u dose before bed. I consider myself fortunate.
Others seem to find that Lantus does not last the full 24 so they split their dose in two. If that was me I might take 12 or 13 u twelve hours apart or I might take 10 in the AM and 15 at night or visa versa depending on how my sugars ran.
I think if it comes to that folks ought to do some in depth basal testing to see how it works for them. Dunno as I'd let some Dr. pull a dosage out of his butt like some seem to.

[Luke]

Mine is actually 10 at night and 8 in the morning.

I have found that many doctors do this, to help your lantus "last longer" throughout the 24 hour period.

We found that when I was first taking all of my Lantus at night, my readings would get higher in the evening time, but at the same time, I was crashing around 3-4AM.

Since we have started double dosing, I am no longer crashing at 3-4AM, and I am not spiking around or after dinner time.

It is one extra shot per day that I have to take, but I can tell that it is working.

[poodlebone]

For me, Lantus seemed to last around 18 hours and it did show peaks in action. I would go low overnight and was waking up with some very low numbers. By dinner time I would be high. Switching to two injections spread the coverage out to last all day.

[Joeprep4820]

Lantus acts for 24 hours theoretically. For me, I found it to finish up after 22 hours or so, so I split my doses evenly - one in the morning, one at night. I no longer use Lantus but rather the pump, but was a Lantus user for a good number of years.

[Bountyman]

So, now I'm thinking that the maker of Lantus designed it to release in a 24 hour period to be taken like a daily vitamin with breakfast. After all...every 24 hours IS mighty convenient. If it were rounded off to say, every 25 hours, if you did your first injection at bedtime, let's say at 10 o'clock, the progressional timeframe of injections would be insane.

I have no idea how one would figure out how to split up a 24 hour insulin. I'm not sure that it works the same as splitting a vitamin in two and taking half in the morning and half at dinner.

[Luke]

Originally Posted by Bountyman

So, now I'm thinking that the maker of Lantus designed it to release in a 24 hour period to be taken like a daily vitamin with breakfast. After all...every 24 hours IS mighty convenient. If it were rounded off to say, every 25 hours, if you did your first injection at bedtime, let's say at 10 o'clock, the progressional timeframe of injections would be insane.

I have no idea how one would figure out how to split up a 24 hour insulin. I'm not sure that it works the same as splitting a vitamin in two and taking half in the morning and half at dinner.

I think, that as with anything that comes to diabetes, it is trial and error for each user. What works for me may not work for you, and what works for you may not work for me.

I may have to take more insulin or even less than some others. It all depends on how things are with them.

I think it goes back to trial and error.

[Joeprep4820]

Originally Posted by Luke

I think, that as with anything that comes to diabetes, it is trial and error for each user. What works for me may not work for you, and what works for you may not work for me.

I may have to take more insulin or even less than some others. It all depends on how things are with them.

I think it goes back to trial and error.

That's the name of the game for Type I: trial and error.

[Grunch]

Originally Posted by Bountyman

So, now I'm thinking that the maker of Lantus designed it to release in a 24 hour period to be taken like a daily vitamin with breakfast. After all...every 24 hours IS mighty convenient. If it were rounded off to say, every 25 hours, if you did your first injection at bedtime, let's say at 10 o'clock, the progressional timeframe of injections would be insane.

I have no idea how one would figure out how to split up a 24 hour insulin. I'm not sure that it works the same as splitting a vitamin in two and taking half in the morning and half at dinner.

It doesn't release evenly over 24 hours for anyone. For some people it's close to that so they can take just 1 shot. For others theres a significant peak a few hours after the shot or it may last more or less than 24hs. Splitting the dose helps reduce these problems.

[shiftzor]

If we play it by the book Using insulin it states that Lantus starts within 2 to 4 hours and finishes in 18 to 26 hours. Really you will have to work out how long it lasts for you. If you always spike when you basal test just before your Lantus injection it probably means you need to split your dose.

[Bountyman]

Originally Posted by shiftzor

If we play it by the book Using insulin it states that Lantus starts within 2 to 4 hours and finishes in 18 to 26 hours. Really you will have to work out how long it lasts for you. If you always spike when you basal test just before your Lantus injection it probably means you need to split your dose.

I've never done that...test before my Lantus injection. I'm on Medicare and Medicare allows 3 tests per day. I do a FBG test when I wake up; a test 2 hours after breakfast (usually around noontime); and one more test 2 hours after lunch (usually about 3pm). What my blood sugar does between 3pm and around 8 o'clock the next morning...I have no idea. What I'll have to do is save up another $75 for a box of test strips to dick around with.

I figure if I don't eat for a couple weeks I can save enough to make that happen.

[Granny Shanny]

Pick up a ReliOn meter & 50 strips, all for about $30. That should give you a few days to see what's going on at least. It sure beats believing everything Medicare and the Lantus people say . . . find out for yourself.

Originally Posted by Bountyman

I've never done that...test before my Lantus injection. I'm on Medicare and Medicare allows 3 tests per day. I do a FBG test when I wake up; a test 2 hours after breakfast (usually around noontime); and one more test 2 hours after lunch (usually about 3pm). What my blood sugar does between 3pm and around 8 o'clock the next morning...I have no idea. What I'll have to do is save up another $75 for a box of test strips to dick around with.

I figure if I don't eat for a couple weeks I can save enough to make that happen.

[Bountyman]

Originally Posted by Granny Shanny

Pick up a ReliOn meter & 50 strips, all for about $30.

I'll search around town...see who sells that. Thank you.

[DanG]

Don't be afraid to try stuff away from the prescription of the doctor. Be careful in anything that you do, since insulin is a menace if you get too much.

I take lantus in the morning. I sleep real well, with probably zero insulin in my system. I recommend that, rather than split dose or evening dose. I was waking up at 3am lower than I knew when I took lantus at night. I have no idea what my basal profile is, but the morning lantus allows me to wake well within target.

I am practicing to be on medicare, I guess. I use only 2 or 3 test strips each day also. My test times are: occasionally I test in the morning to see that all things have been operating as planned; mid afternoon to see that morning breakfast and snacks did not lag in to lunch and lunch too large to manage; before bed to see if I need a bit of insulin to drag me down to a target level in the morning. I count on the residual lantus at bedtime to drag me down 50 to 70 points, so I aim for bs at bedtime to be 120 to 150. Sometimes I need to supplement with a few units of humalog at bed, if I enjoy too much dinner.

[Grunch]

Originally Posted by DanG

I sleep real well, with probably zero insulin in my system.

That's certainly wrong. If you had zero insulin you'd probably die or at least wake up with extremely high blood sugars. And you said you expect to drop 50 to 70 points overnight so you apparently have even more insulin than needed during sleep.