I’m traveling to Haiti for a mission trip in a couple of weeks, and as much as it pains me to think about, my back up plan is Lantus. With the weather and the work, I’m as concerned about the pods staying attached as much as a PDM failure.
I see an internist rather than a specialist because I live in a rural community. He’s been fantastic up to this point (have been going there 8 years). And I’m a very healthy, low maintenance patient who goes in quarterly so the nice people at the insurance company will grant my refills on my insulin pump.
So, I called my doctor’s ofc yesterday for a Lantus prescription, and I also asked for dosing guidelines since I haven’t been on Lantus for almost 10 years. What I received from the nurse was an initial dosing recommendation that I know would KILL me. It was a big mess. Even after getting a more reasonable answer, I’m furious. I’m filing a complaint with risk management today. What if I had NEVER been on Lantus before and followed those guidelines? I would have OD’d in a third-world country.
Although quality of health care is worthy discussion, that is not the point of my post.
Does anyone know a good formula for figuring Lantus doses from basal rates? I take 25.2 total units a day for basals. I’ve lost a little confidence in my doctor’s office, and want to check with those of you who may know.
Casey -
I know the anxiety! I used to travel everyweek and always carried lantus as a backup, never had to use it while travelling…but I have had to use it when I ran out of pods and couldnt get ahold of my local rep…(who usually will come by my home and drop off spare pods whenever i am in a pinch). The initial dosing is a little scary…I am on 24 units of basal…a straight 1 unit per hour…and when I use Lantus it is a straight translation…in other words…I went with 24 units of Lantus (which does seem like alot, and I was a bit nervous the first time), and I would recommend maybe using your nurses suggestion, cut it in half the first time, and monitor bg’s every hour for the first time. Do it once while at home and not on the road, so you get the feel for what is right, and hopefully you wont have any problems when you are on the road. Good luck, and PEACE!
I am the same as steve, I translate pretty much perfectly (unit for unit) between Lantus/Levamir and my Basal with fast-acting…my basal is 0.8 u/hr x 24 hrs and I’ve got 19.2 units. I give myself 10u of Levimir every 12 hours because my body doesn’t do well with long-acting insulin…I did the same before I was pumping, too.
20 u. of regular insulin is more than I use in a day for sure, so the thought of doing it in one swoop is frightening, but not that bad…It may sound crazy, but think about it the other way around…when you stated pumping, they translated your long-acting dose to create your basal!
Thanks for your replies! My nurse’s INITIAL suggestion would have been TWELVE TIMES the 24-ish units that you two have suggested, until she put me on hold and got a better answer. I’m relieved.
My body wasn’t doing well with long-acting insulin when I went on the pump 10 years ago (even though I can’t remember how much, I remember it was bad), but I was taking it all in one dose. IF I need to, think I’ll try splitting those doses.
Appreciate the support! I’m guessing I’ll be totally fine, but it’s good to be prepared.
I would always be high in the afternoons and evenings, no matter how big my initial dose of Lantus was…so by splitting my dose in half, I avoided the “low in the morning high in the afternoon” phenomena. Call your office and ask about it, I know when I first split it up I was doing 8u in the AM and 12 u in the evening, but switched to 10&10 when I was waking up a little low in the AM…
