Latnus - your experience ?

[Ben Corley]

Hello,

Several years into being type 1 I'm curious to understand other peoples experience with Latnus.

More specifically I'm keen to know whether you split your injections (I currently do) but also how you weight your injection.
For example do you have 6 in the morning and 12 at night?

As many people do I struggle with highs in the morning and I am starting to consider asking about a different long lasting insulin

Any experience / insight to reaction to Latnus dosage would be great

Take care

 

[rebrascora]

Hi and welcome

I use split dose Levemir rather than Lantus, but the profiles of them are similar. I need very little basal insulin during the night so I have a much bigger dose in the morning at 7am plus I have a 1.5-2 units of bolus insulin at the same time, as soon as I wake up and before I get out of bed to counteract "Foot on the Floor" syndrome. I also prebolus for breakfast significantly longer than any other meal. Usually about 45 mins for me with Fiasp (over an hour with Novo(not so)Rapid, to prevent spiking. Not recommending anyone else do this without careful experimentation to find their optimum timing as most people would probably hypo with my timescales.

The recommendation is to space the split dose Levemir 12 hours apart but I find delaying the evening dose helps it to hit peak activity in the morning when I wake up, so my evening dose will be 11pm or even midnight depending upon bedtime..... also convenient to inject before I get up and when I get into bed on a night.

My current split is 30 units in the morning and just 5 or 6 at night but this is a huge increase from Christmas when I was on just 16 units in the morning and none at night..... The Covid vaccine seems to have caused my insulin needs to gradually double since early Feb.

Finding the right basal insulin, dose and timing it to work with your body is a bit of a dark art but makes all the difference to your management when you get it somewhere near right. Of course a pump is the ideal solution because it can be adjusted to what you need hour by hour rather than 2 doses in 24hours, but I find I can usually make a split dose work well for me with a little bolus insulin to cope with the natural rise on a morning.

 

[Lucyr]

I take mine once a day at dinner time. I don’t have problems with my bg rising in the morning, but I do have problems with lows in the evenings sometimes, 5pm used to be a guaranteed hypo regardless of what I did. Since moving the lantus to 5:30-6:30pm I don’t have problems with the 5pm hypo as I think it’s running out then.

 

[trophywench]

The actions of Lantus and Levemir are by NO MEANS the same! Lantus has a very marked peak 4-5 hours after injecting it - Levemir has a far lesser peak after 1 to 2 hours. Levemir does not hang round for days on end in the body like Lantus does, hence any adjustment made to Levemir doses and/or timings of jabs are quickly evident in BG tests thereafter - same day usually! - more like bolus insulin in that, really.

 

[Deleted member 25429]

The actions of Lantus and Levemir are by NO MEANS the same! Lantus has a very marked peak 4-5 hours after injecting it - Levemir has a far lesser peak after 1 to 2 hours. Levemir does not hang round for days on end in the body like Lantus does, hence any adjustment made to Levemir doses and/or timings of jabs are quickly evident in BG tests thereafter - same day usually! - more like bolus insulin in that, really.

This is really helpful as I use lantus and find it is not very effective after 20 hrs was thinking of discussing this with my DSN

 

[mikeyB]

My consultant once told me that splitting Lantus doses was about as much use as a chocolate poker. Whereupon he switched me to Levemir split dose, since when control has been much better. Low dose through the night, almost three times as much during the day. And easily adjusted either way. It’s almost (but not quite) as good as using a pump, which I keep telling my new consultant, but the annoying thing is I’m so good at doing it it’s reducing my chances of getting a pump.

Sometimes you just can’t win.

 

[Dave W]

'How much and when?' is rather like 'How long is a piece of string? So much of the equation depends on the individual's metabolism and lifestyle.
In my case, I take my single dose of lantus in the morning. I do this because it's the one time of day that runs at a similar pace every day whereas evening tend to be a lot more fragmented and I'm quite likely to forget to inject. Over the past few months I've been reducing lantus unit by unit as I had been experiencing early morning (03.00 - 04.00) lows. I'm now down to 10 units and lows during the night are rare. My fasting levels/feet to floor (and sitting checking my emails and reading the news) over the last five days have been - 7.2/6.2/7.3/7.6/7.1 .

 

[Robin]

I’m another one who swapped from Lantus to Levemir. I tried splitting my Lantus, not splitting my Lantus, taking it at bedtime, in the morning, at lunchtime, at 6pm, could never get it to work for me, especially after I started using a Libre and could see what was going on all the time.
Because I only need a small dose (I’m currently on a total of 8 units of a levemir, split 5 at breakfast and and 3 at night) I found 8 units of Lantus was particularly lumpy, and I always had a huge drop about five hours after taking it, and it didn’t last the full 24 hours. Splitting it made the individual doses even smaller and therefore lumpier, so I had two pronounced peaks every day.
Levemir seems to suit better, I take the larger dose at 8am and the smaller at 10pm, so a 14 hr gap then a 10 hr gap, and both seem to last until the next one is due.

 

[nonethewiser]

On lantus before pump, never split dose so just one injection daily.

Did job fine but nowt compared to pump control.

 

[everydayupsanddowns]

My problem with Lantus was overnight hypos.

I tried splitting it, but it made no effect really... so I ended up taking it all in the mornings, which really helped me (though breakfast was a bit tricky).

I was considering a switch to levemir, but in the end I asked about pump therapy instead - and that was the last time I was on MDI 🙂

 

[Bloden]

This is really helpful as I use lantus and find it is not very effective after 20 hrs was thinking of discussing this with my DSN

That’s the reason I switched to a different basal - I realised Lantus was running out of steam after about 16 hours and was therefore leaving me with approx 8 hours of no basal coverage, eek! Also, I got fed up with the overnight hypos.

I was on one Lantus jab a day @Ben Corley.