How to Make Lantus Easy (I Don’t Know)

Evidence of a problem.

Evidence of a problem.

The thing about Lantus is that it doesn’t actually keep working for 24 hours, so you can’t just inject every day at 7AM sharp. In my one-week of experience, Lantus works for about 20 hours and then dumps a person. So to have 24-hour coverage, I’ll have to keep scooting the injection back by 4 hours.

Day 1 7AM

Day 2 3AM

Day 3 11PM

Day 4 7PM

Day 5 3PM

Day 6 11AM

Day 7 back to 7AM.

That’s hard to remember. Hard to set an alarm. So people like Laddie split the dose. Half in the morning, half at night, say. Hmm. This is getting more complicated.

So if you split it, you're never left high and dry, but you're sometimes having a double dose. Right? SO you try to make the double dose parts happen when you naturally need more insulin, like at wake up time?

This is a wrap-around timeline, like a world map with injection 1 beginning at California and injection 2 in Uzbekistan.

So if you split the dose, you’re never left high and dry, but you’re sometimes having a double dose. Right? So you try to make the double dose parts happen when you naturally need more insulin, like at wake up time?

A drawback for me re the split dose, a major one, is that I am pretty sure I would not reliably remember and/or have the gear on me to do the non-morning injection at the right time.

But how about this:

Stick with one injection a day and program the pump to anticipate Lantus’s sudden departure. That seems easier. But makes it extremely more important to really do the Lantus at the same time every day. (So its departure lines up with the pump’s basal oomph.)

 

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13 responses to “How to Make Lantus Easy (I Don’t Know)

  1. As I’m waiting for my new Lantus prescription to become active, I’m trying to figure out how I will remember to take the injections. My basals are very low and it really makes sense to keep Lantus in the refrigerator so that I can count on it being potent for many months. So I think cell phone alarms are definitely in order and I will start having reminder syringes decorate my kitchen counter. It’s definitely tougher for you as you want to minimize the negative impact on Bubs.

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  2. mollyjade

    This is one of the reasons I stopped using Lantus. Lantus worked about 22-23 hours for me. I would take 40% of my Lantus in the morning and 60% at dinner time. It was still way better than planning a life around nph, though.

    I think splitting it or adding on some from the pump is a better idea than rotating the time. Not only would that be hard to remember, but Lantus isn’t *really* flat. There’s still a bit of a peak. So it’s better to have it at the same time every day so you can notice any patterns from that.

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  3. Such is the danger of insulin: Once the insulin is in your system, you’ve got to be ready to take action if necessary. Good luck… I’m quite interested in hearing how well this works.

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  4. Linda

    What is the onset time for Lantus?

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  5. I’ve been counting it as immediate but that can NOT be right!

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  6. I’ve heard of using Lantus as, perhaps, 50% of a pumper’s basal before. It guards against DKA in the event of pump failures, or allows athletes to disconnect for longer periods of time during competition, The downside is that a “temporary” basal can never be lowered all the way to zero.

    Also, when I used Lantus (pre-pump), I had to chuck the vial at the 30-day mark before it was empty (I did see a performance degradation on Day 31…seriously!), If I only took half my required basal via Lantus, I’d be throwing out lots of valuable insulin.

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    • This is why we switched to pens when my daughter was on MDI. I still drew out of them with syringes because she didn’t like the pens, but this way we threw out much less insulin every month since she wasn’t even using 300 units of either lantus or humalog. But throwing away 150 or so units a month of one, and 250 of the other was much better than throwing away 850 of one and 950 of the other with vials. Not to mention that a box of pens would last 5 months for only one copay.

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      • We fill the pump from a pen cartridge, and when we have to do an injection, we do it with a pen needle. Would it be better/more accurate with a syringe? I guess you can do like…0.25u with a syringe and laser-vision?

        This is so helpful.

        Our endo wrote our Rx for pen cartridges, because we weren’t using up the bigger bottles before they’d expire. Also we find we get fewer air bubbles with the cartridge.

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      • I dont know about that. We just did it because she didnt like the click-click-click feeling of the pen. We also did half units of humalog but had the regular pens that do whole units only. It was just her preference, nothing scientific. 🙂

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  7. Just reading through comments plus blog post.

    We did levemir+pump so this response may be slightly different (but also hopefully still relevant) and found onset time to really be about 1-2 hours post injection. If we injected and disconnected right away (giving full basal via levemir for day time, basal via pump for night time) she would go high and need correction before levemir kicked in. Obviously different regimen than what you’re doing but hopefully still good info.

    As for lantus not lasting 24 hours – is there a time of day when basal is much lower in general and would that be a convenient time to inject lantus? (For us it’s those few hours at the end of the school day up until almost dinner time) Just thinking that what *I* might do is just cover the gap with all pump basal for that time period, but I would not want that time period to be the highest basal rate of the day, which for us is that dawn time fighting dawn phenomenon and insulin resistance with breakfast. Of course YMMV. I don’t know if people even inject lantus in the middle of the day. When Ang was on MDI lantus was given before bed and we never noticed that it ran out before 24 hours but it’s also possible that we just didn’t notice because dinner coverage was probably working then or we were seeing post dinner spike at bedtime (or thought we were- I do remember quite a lot of bedtime highs that we blamed on dinner that in retrospect may have been lantus not lasting long enough)

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  8. Oooh, learning so much from all these great comments. #DOC is the best!

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  9. When I split I almost always am late on my morning injection. Mornings are much busier than evenings for me so it’s harder for me to remember. Plus, I think the idea of taking an injection is much less appealing in the AM 🙂 splitting really does help my BG though, so long as I can make the time for it 🙂

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