Levermir to lantus

[confussedt2]

HI,I went my DR. and we talked about changing to LANTUS, will i have tostart all over with BASIL testing or is there a number that i can go right
to without the prolonged time it can take.
I was up to 120u of LEVEMIR and it appeared that my BASIL was coming down but i did not like the amount of insulin i was taking so that is the
reason for the insulin change to see if i could get by on less insulin,my DR. said to start out with about 60% of what i was using,but i was just a
little Leary of starting at about 70u of LANTUS so i started at 40u and will add a little as time goes on,THANK'S

[Bountyman]

Here's a "dosing" page that Lantus has put up in regards to Type 1s who are just starting Lantus, or switching from NPH. They don't have a recommendation for switching from Levemir. When switching it's kind of a "wing it" at first. 60% sounds like as good a place to start as any.

The chart you'll see recommends 0.2 units per kilogram of body weight per day to start with. I put my weight in the chart, 268 lbs, and the chart recommends 24 units per day...which is exactly what I'm taking now. 24 units at night nets me a 95 mg/dL fasting blood glucose in the morning. Any less and it drives my morning numbers over 100 mg/dL. Any more and it drives me to the food locker. It seems you're a little more insulin resistant...so you'll probably have to titrate up from 60% until you find your magic number.

As an FYI here; Some people who inject a large dosage of Lantus have tried splitting their dosage as with Levemir. Either twice daily...or in two different spots with the same injection. The theory behind this is better absorption and avoiding the possibility of lipodystrophy, found here under Insulin Injections.

[confussedt2]

HI,Bountyman,I am skinnier then you are at 257lbs,i am going to use noon as a starting time today that will allow me to keep an eye on how it effects me at 60%
which should be about 70units and as people have done is inject two smaller amounts so it doe's not pool under skin,THANK'S

[Bountyman]

I think the term "skinny" doesn't really apply to either of us.

Awhile back I went on a search in respects to lipodystrophy. Specifically; how often can I inject in the same spot and avoid lipodystrophy. I found a few suggestions, but no one really that had a plausible answer. After months I found a credible source who suggested a two-week rotational regimen. I tried several injection sites on my body and found my abdomen the easiest place to deal with. I mapped out 14 spots on my abdomen and had them tattooed. At 24 units I start a new pen at a different spot every 12 days. It's been 3 years now using this method and it's worked well for me. No one spot has less absorption than another.

You may find that Lantus gives you a little "sting" once in awhile, where Levemir didn't. It's attributed to the pH factor (for "potential Hydrogen"), wherein 1.0 to 6.9 is considered acidic, 7.0 is neutral, and 7.1 to 14.0 is alkaline. The lower the pH number, the greater the acidity, and the higher the pH number, the greater the alkalinity. The lower pH in Lantus is what keeps it in a liquid suspension in the pen/vial. Once in your body, the insulin normalizes its pH and turns it to a crystal releasing the insulin in "supposedly" a 24 hour period. With some people that time is less. The lesser times have been documented...but in my opinion injecting twice a day insures you that won't happen.

In regards to the amount of time that Lantus lasts...24 hours or less is the ideal time for Lantus to use itself up...otherwise you would get into "stacking", which is introducing more insulin while your previous injection is still active.

[confussedt2]

So it might be to my advantage to split injections at 35u each string today and see what happens over the coming week,then adjust as needed in the future.

[Bountyman]

So it might be to my advantage to split injections at 35u each string today and see what happens over the coming week,then adjust as needed in the future.

I'm not a doctor...all I'm doing is providing you with information. Whatever you decide...I suggest you guide yourself in that decision with your glucometer for factual results. You might want to read this as well: Getting Down to Basals by Gary Scheiner, MS, CDE

I hope that link was okay to put here.

Let us know how it goes...

[jenb]

Many people find that an uneven split of basal is useful. I, for instance, need a lot more basal for the 12 hour period from 6pm to 6am - I use 12.5 units in that timeframe. Between 6am and 6pm I use 8.5 units. As you can see, it's a huge differential! Basal testing and experience will show you what the best scheme is for you. (The Gary Scheiner recommendation is super.)

Jen