Lantus Twice A Day

Dr Bernstein seems to recommend it, and I gather that a number of you dose your long acting insulin twice a day as opposed to once. I struggle with higher numbers from the afternoon on and am wanting to suggest this option to my endo. Do you split the dose in half? I’d love to hear any experiences with this tactic.

Hello Elaine-
Although I’m now on a pump, prior to that I used Lantus, and was splitting the dose as you say. It seemed to even out my tendency to be low after breakfast. At the end, I took half my day’s dose before breakfast, and the other half before supper. This, for me equated to 6 AM and 6 PM. My endo was all for it – no protest at all. I was actually able to reduce the total dose by a little after starting the split regime.
-Good luck with it!

I split my dosage in half, I was fighting middle of night lows and then high blood sugars in am/afternoon. I take 10 units at bedtime and then 60 at lunch.

I had either afternoon or night lows and then morning highs that were very high. I take 40 with breakfast and 30 with dinner.

I split mine and it’s given me true 24 hour coverage. You have be careful when you change over - do it slowly by adding & taking away just a couple of units at a time. It’s slow but it’s the safest and easiest way to do it and you avoid overlapping and going without.

Thanks, everyone. Reading your experiences makes me think that splitting my dose might help with morning and afternoon lows, as well as evening highs. I appreciate your comments.

Rainbowgoddess (great name,) I have been reading Dr B to try and get some inspiration. I have not been handling things well by doing it my way…my A1c’s are too high. I need to come up with a new way to think about healthful eating. He is a bit too extreme for me, at least at this point, but it has been helpful.

What Dr. Bernstein is basing his recommendation on is this:

If you are taking a very large dose of Lantus, the injection lasts a long time. This is the case for many Type 2s.

If you are using smaller doses, however, it won’t last the full 24 hours, so Type 1s can end up with problems if they don’t split doses.

Levemir lasts an even shorter time when used in small doses.

Hi Elaine, I take 16 units of Lantus in the morning and 17 at night. I’ve been spliting the dose for about 3 years now. I was taking my shot every morning before that and it seemed to fall off after about 18-20 hours leaving me to sky rocket up into the 3 and 400’s while sleeping. We divided my dose in half and since then have tweaked the dose to cover a little more at night becuase my night and before breakfast bs was really goofy and inconsistent. I’ve been taking the higher dose at night now and it seems to be working like a charm! I’m working on getting a pump here soon but have been on Humalog and Lantus for years.

Jenny…I take 8-10 units, depending on how the hormones are behaving. I am thinking that qualifies as a lesser dose.

Mike…I’m glad you were able to work out your timing. I am probably heading toward the pump, as well. Good luck.

Definitely a low dose. Type 2s typically start at 30ish and go up to 100 units a day or more.

I am T1 (1.5?) and may still be producing some insulin? I have been diagnosed 5 years and went on insulin fairly quickly so maybe saved some pancreatic function.

Hi Elaine,
I am a type 2 and we were unable to actually “split” my dose of Lantus that I take at night. My night time numbers were too bad. What I needed though was what my doctor and I jokingly call a cruise control for during the middle of the day and into the early evening. The Humalog takes care of meals for me, but there were unexplained spikes after the Humalog wore off. So he added a morning dose. of Lantus as well. Each dose is 24 units for me. That seems to carry me pretty well. I stay strict with my diet and almost never snack in between meals. If there is a low I do take care of that though. I am much more comfortable on the two doses of Lantus and very happy with the way the Humalog takes care of the rest. I hope you get things worked out for you.

Thanks, Saundra. I am T1 but don’t see why your technique wouldn’t work for me as well. I am trying to be more strict with my diet, but I do snack. I try to limit snacks to nuts or other low carb and try to cheat only when I am able to really keep an eye on my #'s…a couple of extra Humolog units and lots of checking. It’s new to me that "cheating " is fruit or a piece of whole wheat bread! We just keep trying…that’s all we can do. Good luck with your cruise control.

Hi Elaine:

I was on Lente before I started on Lantus 1 1/2 yrs. ago. Most
of the other Diabetics were on a split dose of Lantus(or pumps)
since the one dose didn’t work long enough.

With that knowledge, I went straight to the split dose also. I
started out on the same amount of Lantus as I was taking of Lente.
(I’ve done my own Insulin for more years than I could count)
I had a couple bad lows, then more highs but I finally got it right after
tweaking it a bit and doing the basal testing. So I’m on 12 units when
I wake up and 10 units 12 hours later. I can have a 2 hour leeway on
either side of the 12 hours and still be Fine. It works Good for me. :o)

ps. And it doesn’t sting me any more than any other Insulin did, which
isn’t much or often. Some sure had me scared.

Good Luck with the Lantus and your pump when you get it.

Thanks…glad you’ve got your dose worked out. Thanks for the info on the 2 hour leeway. That had me worried as I am not a regimented type and was hoping to not have to strive for that kind of discipline. I have not had stinging, other than a tiny bit very occasionally. Is that a common issue?

My Goodness, yes. I heard about the stinging the most. I’m
surprised that you didn’t hear that from other Lantus users.
After using it, I’m wondering if one Person experienced it and
that lit a fire of many more passing that on. Oh well, I’m Glad
that it doesn’t sting usually. You’re Welcome. :o)

Stinging is often reported by people injecting 100 units in one shot.

I am curious as to why I need so relatively little insulin, again 10 to 12 units of Lantus and 1 unit humalog per 15 g’s of carbs, but if I don’t inject, my bs can go up to 250+ from a 1/2 an apple. If I am still producing insulin…where is it when I need it?