How do I split my Lantus and why?

I´ve understood the following:
Lantus does not last 24 hours
Lantus does have a peak
Many people split their dose in two
Dr. Bernstein says to never inject more than 7U in on injection

After 20 years on a pump I try to figure out how Lantus best can work for me and would like any suggestions, knowledge and information you might have on this topic. (I use rapid acting insulin for meals).

Qs:
1.Is it possible to get Latnus to work like a perfectly set up basal rate on the pump? Meaning you can go without eating for 24 h and never get a high or a low if it´s set correct or will the splitting of doses or the peak or something else make this too difficult?

2. When is the best time to inject the split dose? Is it a spesific time in the morning and evening depending on the time you go to bed and when you have breakfast?(Example: always inject 2 h after brakfast and 1 h before going to sleep or 1 h before brakfast and two h after dinner). Or is it always the same time regardless of when you go to bed and when/if you have had your meals/go to sleep?

3. What is the best time split between doses? I see many people use 12 hours and have read that Dr. Bernstein says to never do more than 9h between evening and morning dose if you suffer from the dawn phenomenon. I feel I need to be enlightened in this area.

4. When do you experience the peak?

5. If you experience a peak, what do you do about it to avoid getting low? Do you have to schedule this an eat at the time or how do you solve this? At the time I don´t know how to sleep in without getting low if I get up an inject my morning dose and get back to bed, or avoid getting low during the night when going to bed with a normal reading an zero of the rapid acting insulin in my body.

6. If you need more than 7U at the time, do you simply divide the dose and inject 2-3 times (or more if needed) in a row?

Thanks in advance.

Siri

I think Lantus works differently with everyone. People can only comment on how it works in their exprience. Not to mention how long someone has been diabetic, if they can still produce or use the insulin their body makes, exercise, water intake, sleep, other medications, foods, extra weight and stress effect individuals. There are so many factors to consider!!! I think I experience a peak with Lantus, seems to be 6 hours after I take it. I tried taking it at night and that didnt work for me, I went low overnight. I take it in the morning and by the next day I am high in the morning. I just went to the doc today,and now I am going to split my dose, and just take the meal time(Novolog) insulin with my largest meal (dinner). I am curious, you were on the pump, and now you don't use it? A pump was suggested, but I am very apprehensive about using one.

I´v had two islet cell transplants but the meds I had to take didn´t work for me. I´m in the progress of geting back to insulin again and started with minor injection with pens. Not sure if I want to go back to using a pump because of so much stress getting the cannula to work properly.

I´d really like any answers you´re sitting on out there.

I started split doses years ago. 8:00am and 8 pm. Early on I forgot the nite shot a few times and split has worked. There was a study years ago with a bulk Reg. insulin and found it takes hours to dissipate all the insulin. Similar principle with Lantus. When I am sick and have a high BG or am high after a meal, I take more, but inject in different sites, instead of one site. The delayed affect of say your normal 5u increased to 10u for a 300 is hard to predict and may do little. Also if you have no food in your system, take less to bring down a high, unless it is really high. Take notes to learn your response. It will make sense over time.

We too are splitting the Lanuts TONIGHT! I am a bit nervous and am VERY worried about the Dawn Phenomenon (since we will only have 10 units tonight instead of 20 - YIKES!). We are doing a 10/10 split at 8 & 8. Will let you know how it goes. :/

Thanks, gr78core.

How did it go, Mom 2 Kyle?

I noticed you started a discussion on getting a pump for your son. Are you trying to split doses first?

And have you seen the discussion started by (don´t remember who, will try to find out) who has found out that splitting Lantus in three works best? Every nine hours if I remember correctly.

@Mom 2 Kyle:

This is the discussion I was referring to about splitting Lantus:

http://www.tudiabetes.org/group/lantususers/forum/topics/can-t-believe-the-improvement-in-my-blood-sugars