Backup plan - back to MDI

Going travelling soon. I’m trying to prepare a backup plan in the event that my pump fails.

I used to be on lantus for long acting. But i understand that lantus is no longer available, what long acting insulin replaces it - Levemir?

And how to switch over to MDI with dosage. Do i just take my daily basal intake on the pump say 20units, and half it - so 10 in the morning and 10 at night? the novolog stays the same?

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Lantus is still available. I use it.

You should probably check with a medical professional on the dosage if you need to go back to shots for any reason.

Lantus is no longer available where I am.

Isn’t there some kind of guide on how to calculate dosage to transition to MDI? I cant get an appointment in time.

I will carry a spare pump with me so unlikely I need to fall back but I just want to be prepared in case that fails too.

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Basal is the trickier bit, for sure. When I had to do this (a while ago—pump died) I knew that my daily basal after switching to a pump was a bit less than what I required with Lantus. Dunno for other basal formulations, but it seems like you’d be safe to use that as a starting guesstimate, then monitor and adjust accordingly going forward.

You do have a CGM, yes? That should mitigate the risk factor. Last time I had to do it was before I had one so it was a fingerstick adventure for a couple of days.


The last couple times I made this transition, I hit the dosage on the nose (but that was kinda lucky and I was using previous experience and my current weight to guess). My MI basals don’t change a ton - mostly according to weight.

Last time I did this was the DefCon conference in Vegas. I shut down all wifi devices for security conferences. I transitioned to MI a week in advance of travel.

I prefer to hit the basal heavy upfront because highs are so ‘sticky’ and hard to fix. I’d rather go a little low upfront and eat some dessert as needed. It makes for a faster (more enjoyable0 transition, for me.


Thanks both. Do you give it all in one go or do you split it into 2 doses?

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I only ever did 1pd when I was on Lantus-novolog mdi, so that’s what I did when I had to go back to it when waiting for my replacement pump. But if 2pd is what you were used to I’d go with that.

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Where did you hear that Lantus is no longer available? I’m still refilling my 5-pack of Lantus pens every month. $35 Walgreens with Good RX. I’m type 2, and use approx. 30 Units – usually around breakfast and bedtime. (Plus approx. 14 Units Humalog with each of 2 meals – which I’m going to be switching to Lyumjev soon, due to change in insurance coverage.) Using Freestyle Libre 3 CGM.

In Australia it’s been discontinued, I don’t know why though

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If you want a Lantus-like basal insulin option check if Optisulin, also made by Sanofi, is available. Lily makes Levemir, which is being discontinued in the US but is still made for sale in other countries. There are two longer acting options Toujeo (Sanofi) and Tresiba (Lily) but they don’t make good backups because they take ~3 days to fully take effect.


It’s interesting how some countries discontinues a brand and others don’t. I think levemir is still quite relevant here in Australia.

It might be too late, but contact your pump company regarding a travel pump. When I travel out of the US, I always rent a back-up pump. Cheap insurance and one I have never needed.

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When I switched from a pump to MDI last summer I had Lantus and lispro. I used the same dosage plus 20 percent for Lantus. I divided into 2 injections 12 hours apart. I went up or down from there. I can’t remember. I waited 3 days before changing doses and the only in tiny increments. Since then I am still happy doing injections but use tresiba instead once a day. I also heavily rely on my cgm before changing anything. Best wishes.