Hello everyone! It’s been a while since I’ve posted anything, but I shall give a little background. For a multitude of reasons, I decided to stop using my pump and go back to MDI for a while. Even when I was on my pump, I had so many problems with morning highs. I’m 16, so I know it has to do with hormones, but it’s EXTREMELY frustrating, I normally wake up around 6:30 with a BG of 150-200 (high, I know… just wait), then I’ll have less than 10 carbs for breakfast and correct for my number. My basal rate on my pump from 6:00 to 10:00am on my pump used to be double for that time frame, and yet when I checked at 10:00 everyday, it would be over 250 and sometimes over 300!
Now that I’ve gone back to Lantus, I’m struggling even more with highs in the morning. Since I can’t adjust the basal rate in the morning (cause its Lantus) I’ve been stuck with highs over 300. This is ridiculous. My endo told me to take 18 units of Lantus at 9 and to see how it goes. Well, other than the highs in the midmorning, its been fine. But now I’m wondering if I should split my dose in half and do it in the morning and night.
SO 2 questions:
1.Should I split my dose and have one shot before school, and one at bedtime?
2. How does Lantus work? I know it gives a continuous dose for 24 hours, but lets say I split it, will the 9 units span over the 24 hours, or will my body recognize that its insufficient and use the amount it needs until the supply is over?
Please tell me if I’m making sense. Also, please respond ASAP seeing as I’m supposed to give my dose soon
Thank you!
Emelina
Hi. I have the exact same situation. I split my lantus into 2 doses of 9units. 9 units at 6:30 am right when I wake up, and then 9 again at 9:00 pm. I have found that it gives me better controls. mornings have always been my trickiest time. I find that working out at night has helped my morning highs in a natural way, but since i have been so busy with schoolwork my BGs are struggling a little bit 
I had a similar problem. Was waking up at 150 or so when my Lantus dose was in the morning. I tried splitting it - morning and night - for me, not much difference. Then moved it all to night. Still had the problem. I slowly increased the basal rate until morning came down to 120- 130 or so. The limit to moving it up further for me is 6PM - my daily low. For me the Lantus action is fairly flat over 24 hours. I know others have better luck with splitting the dose. That’s why I’m wanting to go to the pump - so I can get programmable basal rates and solve this dawn phenomenon.
And yes, to answer your question , if you inject 1/2 the dose, that 1/2 is supposed to act over the whole next 24 hours (but your mileage may vary). So after the day of switching, your 9 and 9 will be the same as the 18 at one time. Unfortunately , your body can only use it as it is released slowly, it can’t grab what it needs. You just have to be careful when you switch from all at night to 1/2 and 1/2 that you don’t overdo it…one way is the first night just put in 1/2 the total dose and the other 1/2 the next morning. You may be higher that morning but at least you won’t have 18+9 active at the same time. The following days you’ll only have the 18 active. You may wish to check with your endo. if you have questions.
Based on my experience, you should definitely split your dose, and take half at night. Then adjust the amount (maybe more at night is better or visa versa) and timing (maybe right before bed or some other time). You also might consider trying Levemir instead of Lantus. It will take some experimentation, so you should get your Dr’s blessing. It is possible to get a good basal using long-acting insulin; it just takes some work. Good luck and ask for help.
Thanks you for responding! I am definitely going to give the split a shot. (no pun intended) haha! Good point though HPNpilot about the carefully switching over. I really appreciate all your answers! I’ll keep ya posted.
I do split doses as well, as for your questions.
- Try taking them 12 hours apart at first.
- There’s no reason I can think of the body to decide there isn’t enough Lantus in an injection and use it up faster. The amount of time Lantus lasts in a person is dependent on it’s reaction with our fat deposits and our unique physiology differences as individuals. That being said the amount of time Lantus hangs around can vary from one individual to the next, although within one person it will be fairly consistant from one day to the next.
If Lantus is only hanging around for 18-20 hours within a given individual then spliting the dose into two injections spreads the onboard insulin across the gap effectively accross 24 hours. This is more common with Levemir since it typically doesn’t last as long as Lantus within individuals. Another advantage is that Lantus while generally flatter than other insulins still has a rise time and some variance in its effect over it course. Spliting doses also can help smooth this out as the two doses are at different points in their action.
I split my lantus dose too. I found that 24 units at bedtime was TOO much overnight, and waking up with some wicked lows. But 24 units wasn’t enough for a full 24 hours. I now take 18 units at night and 13 units in the morning, and it seems to work well for me. Most morning’s Im waking up mid 70’s to low 90’s. Better than waking up in the 40’s, drenched in sweat.