Lantus - Split (2) - scared!

[mum2westiesGill]

Spoke today to my DSN re splitting my lantus and she's advised me I can if I want to. However I'm slightly terrified although as she said you can monitor bs levels at any time especially with changes like this.

One thing I'm thinking is should I maybe be doing a couple more overnight basal tests or just go ahead and make the change tonight 😱 😱

 

[Northerner]

Didn't your DSN give you any advice on what split to make Gill? If it's worrying you, I would leave it until you have thought things through and are happier with proceeding 🙂

 

[mum2westiesGill]

Yes she said about a 50/50 split and said she would phone in 1 week to see how I'm going on with it. What have I started - do I give it a go or don't I - fighttttt lol

 

[trophywench]

Gilll .... {{{Hugs}}}

She could tell you ANYTHING.

But it would just be a GUESS anyway.

You will NOT die!

Logically, if tonight you have 50% of what you normally have - there is No Way you will hypo, is there?

And even if you overlap, there shouldn't be much chance.

Go for it !

 

[mum2westiesGill]

Gilll .... {{{Hugs}}}

She could tell you ANYTHING.

But it would just be a GUESS anyway.

You will NOT die!

Logically, if tonight you have 50% of what you normally have - there is No Way you will hypo, is there?

And even if you overlap, there shouldn't be much chance.

Go for it !

Thanks for the reply trophywench 🙂.

I've not gone for it yet due to doing a couple of nights basal testing.

 

[Robster65]

Hi Gill

Don't want to add any more confusion into the mix but I split about 75/25.

It really depends on when the lantus is dipping away.

I give the bulk in the morning, with my breakfast humalog and the rest around teatime. It seems to work and I just tweak one or the other if the basal goes out of kilter.

The difficulty comes with the 'tail-off' that lantus has. Whatever you inject in the 2nd lot will have some overlap with the tail end of the 1st lot. So it may need a bit of caution for a few days until you're sure it's not dropping your BG like a brick.

Rob

 

[bennyg70]

How much basal do you take?

It may be worth taking things back to basics... I foudn that my dsn seemed to have just plucked a figure out the air when I started. around 35 units.

I actually take 12 units at ngiht now and it seems to work.

This sems to tie in with the lantus reccomendations...

weight in kg x 0.2u

So my weight in KG is 72 KG multiply that by 0.2u is 14.5u. Much close than my dsns initial guesstimate. It may or may not work for you but do a quick calc and see where you came out.

I actually came down and settled on 14u for a while, I just found I was having a fe too many post meal hypos so dropped it a bit more... Do the calc see where you are.

If you split the dose 50 50 on the same units you are on now, and the units you are on now is too high. Its not going to fix your problem I dont think

 

[mum2westiesGill]

How much basal do you take?

It may be worth taking things back to basics... I foudn that my dsn seemed to have just plucked a figure out the air when I started. around 35 units.

I actually take 12 units at ngiht now and it seems to work.

This sems to tie in with the lantus reccomendations...

weight in kg x 0.2u

So my weight in KG is 72 KG multiply that by 0.2u is 14.5u. Much close than my dsns initial guesstimate. It may or may not work for you but do a quick calc and see where you came out.

I actually came down and settled on 14u for a while, I just found I was having a fe too many post meal hypos so dropped it a bit more... Do the calc see where you are.

If you split the dose 50 50 on the same units you are on now, and the units you are on now is too high. Its not going to fix your problem I dont think

I take 28u lantus/BI at the moment.

My weight in kg = 67.0
x 0.2
= 13.4

 

[bennyg70]

I take 28u lantus/BI at the moment.

My weight in kg = 67.0
x 0.2
= 13.4

The calculation is never going to work for everyone, but it could be taken as a suggestion that your dose is high along witht he other evidence that you show us of rapidly dropping sugars over ngiht and the ammount of snacking you need to do to keep your bloods up!.... If it were ME id be loking at reducing the dose..!

 

[mum2westiesGill]

The calculation is never going to work for everyone, but it could be taken as a suggestion that your dose is high along witht he other evidence that you show us of rapidly dropping sugars over ngiht and the ammount of snacking you need to do to keep your bloods up!.... If it were ME id be loking at reducing the dose..!

What Northerner said on the other thread

That's a huge drop Gill, and I can see why you would be confused You dropped considerably during the night and continued to fall, it seems, which I think can only be due to your basal being too high.

Problem is though if I go with a big reduction of BI then I seem to end up with high BS during the day also everything has to be done in babysteps so would I just ignore any high BS for 3-4 days - 1 week?

 

[Northerner]

Problem is though if I go with a big reduction of BI then I seem to end up with high BS during the day also everything has to be done in babysteps so would I just ignore any high BS for 3-4 days - 1 week?

It does look as though a split will suit you better Gill. Probably you need less at night through to morning, and then more during the day. Your numbers already suggest this. If it was me in this situation I would be looking at reducing my overall dose and trying 10 units lantus at night and 14 units for the second injection, but obviously I can't advise - you know yourself better than me! 🙂

 

[everydayupsanddowns]

Don't forget that your basal and meal doses will be working together (unless you regularly skip meals.

So (unless you have run some basal tests and know that you have your basal OK) you could well be on artificially low meal doses, with the shortfall being covered by your over-enthusiastic basal.

This is why many people find it best to get a full set of basal tests in first, so that when it comes to meal doses they know they are working from a fairly level playing surface.

If you are in transition (from a too high basal dose), you may have to do some firefighting and adjust a bit by instinct untl things are stable enough to test properly and make the final fine-tuning adjustments

 

[bennyg70]

Baby steps - For sure - Maybe 10% - 15% per time. So if you take 28 units now, Id maybe try knocking 4 units off and see how I got on, and yes leave it a week. then do a basal test. I think getting that over night steady first would be my priority.

Ive heard lots of success stories splitting lantus, I tried it and it was much better for me than when I was on higher doses!! Then I went back to one dramtically slashed my dose and Im finding things a lot better.

Maybe try reducing to 24 units. Split 50 / 50 to begin with if thats the way you want to go as opposed to 1 injection, leave it a week. Then post results. We then may find it would be better to A) reduce 1 or the other and up the other. and /or up the dose.

If it were me, id be bringing the dose down on an evening (On a one injection per day) gradually until i finally got it settled and steady over ngiht. Id be ignoring my day readings or using the QA to get by. If Id got the nightime dose to keep me steady over night without keeping me steady in the day, id think about introducing a second injection in the morning at that point. But that is just me and MY own logic. I could be completly wrong, its just how Id maybe approach the situation. I can just empathise with your situation as it mirrors what mine was, and the above is how I overcame it.

Good luck