Does anyone ever feel like they were punched after they took thier LANTUS shot ?
My 6 year old daughter always complained about her Lantus shots. It is one of the reasons we moved to a pump a month ago.
For me, the only problem I had with lantus was burning when I kept it cold. Now I keep it room temp and have not had any problems. Do you use the pen? It seems to help me also to inject the lantus more slowly… My stomach in the area of all my injection sites does occasionally get tender to the touch. I’ve been doing shots since Feb '08 and all seems to be getting better or maybe I just don’t notice anymore. Just be sure to ask your doctor about it at your next appointment.
I used to leave it out or warm the pen or syringe in my hands before I injected myself. I also would lightly push on the area where I injected the Lantus with my finger after I pulled the needle out, that helped a lot.
I have a problem with a burning sensation when I inject Lantus. I’ve been told it’s because Lantus is acidic. I think the pH level is around a 4 (7 is neutral). I don’t know why temperature would affect that, but I’ve heard several people say it’s worse when it’s cold. I take mine at room temp and that’s bad enough! Just biding my time until my Pod arrives. Otherwise I think I’d try Levemir instead. You might want to check into switching. Good luck!
Hi Lynn,
Lantus does need to be kept refigerated. Hope Kristy’s isn’t losing potency being kept at room temp.
My Lantus stings, but only sometimes. Can’t figure out why it’s not all the time. Warming the filled syringe in my hands for a bit does seem to help. I also got much shorter needles & this helped a lot!
Hi Lynn, yes my Lantus burns when I inject. I try to not pinch my skin and that helps a little. The discomfort goes away in a minute or two. I use a SoloStar pen. I was told to store the pens in the refrigerator until I start using it. Then I am to keep it at room temp. and use it within 28 days.
Ditto on the 28-day rule, Jeanne. That’s what I was told as well.
My Endo told me that insulin is good for 30 day from the time it is opened and air is introduced into the vial. I know there are many people who say it lasts longer and I am sure it still works. Therefore refrigeration isn’t really needed once you start using it.
The package insert with my pens says it is NOT necessary to refrigerate Pens in use… this also applies to my Humalog as well. ONLY UNUSED pens NEED to be refrigerated. I use the SoloStar pens…this is why I asked if she was using PENS… “OPEN(in use) SoloStar disposable insulin device: The opened (in use) SoloStar should NOT be refrigerated but should be kept at room temperature (below 86F/30C) away from direct heat and light. The opened (in use) SoloStar kept at room temperature must be discarded after 28 days.” A direct quote from the package insert. It also states that in use vials CAN be kept at room temp; discard after 28 days. I use mine until it’s gone which is usually 28-30 days. The only Lantus that “NEEDS to be refrigerated is NOT in-use (unopened).” Cold Lantus stings and I have no problem with the potency of my insulin…
Sorry, I use Lantus vials. Endo & pharmacist told me to keep it refigerated when opened (& before opened) because it’s delicate. I’ve had it lose potency before the 28 days are up. Don’t know if I’ve had some bad batches or what. By day 26 it stops working & I’ve had to start a new bottle.
It can sting for sure…it doesn’t sting every time, but when it does i might take half of the dose in one site and then the other half in another site. the back of the arm doesn’t sting too bad. the abdomen hurts the worst.
Lantus is a “cadillac” insulin- it works very well and is about $100 for a vial. Generic insulin, for me, takes twice as much to do the same job. I was on Lantus until I had to go on the county insurance. They don’t pay top dollar for anything, instead you have to switch, even if the generic insulin isn’t the one originally prescribed, and sometimes a diabetic has no business even being on a generic insulin when newer, more effective ones are available.
Gerri,
I was also told at first by the nurse at my PCP’s office to always keep both humalog and lantus refrigerated whether in use or not. I even bought and carried an insulated lunch bag to keep it cold; what a pain! I looked into the the storage of insulin because the burning sensation I got from the cold lantus was sometimes pretty intense and would radiate a few inches from my injection site. I just happened to actually open and read the insert with the humalog and it said, in bold letters, not to refrigerate pens in use; however, regardless of refrigeration or room temp, opened-in use should be discarded if not used within 28 days. I’m sure it’s possible to get a batch that doesn’t last even the 28 days. I have not encountered any burning or stinging since I now keep my insulin pens at room temp. I do keep the pens in the cooler if I know I’m going to be outside in the summer or where the temp is likely to be in the 70’s-80’s.
Guess I’m lucky because Lantus only stings sometimes (can’t figure that one out) & not badly at all when it does. Stinging/burning lasts a second or less. Never had pain radiating–ouch!
My endo is changing me to Levemir, hoping it will help better with my morning phenonmenon–we’ll see.
Yes, here is the pharmaceutical reason why. Lantus in the vial or pen is a Ph of 4 (neutral is around 7.4) When it is injected into the body it causes crystals to form but movers closer to a neutral Ph of 7. Your body dissolves these crystals in an even method and it gives the insulin its 24 hour effect. It is very common to here people complain about a stinging with Lantus. Sometimes a longer needle helps sometimes a switch of insulis is needed.
An alternative would be to tell your doctor about the problem and ask if you can try the newer insulin Levemir. It’s dosed exactly the same and works 24 hours. It is a neutral Ph so you will not feel the sting. The reports are that the insulin is blood bound and it does not form crystals. This effect results in the person having less highs and less lows. The pharmacist told me that when a person is on Lantus, their physical activity can change how it is absorbed into the body, for example exercise would warm up the crystals and cause the body to absorb it, leading to more highs and lows.
Hope this helps!!
Can you tell me what you mean by morning phenmenom, my morning sugars are ALWAYS very high, even if I check in middle of night, they are fine, but by morning, very high. Is that what you mean, you just dont know why they are high?
I just went off of Lantus due to having fluid retention. This is a side effect but not everyone will get it. I lost 5 lbs. in 4 days and was taking diuretics every day and was still bloated with water. I feel so much better being off Lantus. I found out about the side effect in another diabetic newsletter that I get. Just my story.
AZDesertRat
Yep, that’s it. Fasting morning BG is significantly higher than middle of the night & bedtime readings. It has to do with going low overnight & then the liver dumping stored glycogen into the blood (or not even going particularly low & having the liver dump stored glycogen). Without insulin to cover it, high BG.
There are several things you can try. If you don’t take a Lantus dose before bed, talk to your doctor about adding one. It’s not usually a matter of splitting the daytime dose in half. Lantus taken at bedtime gets used up faster than during the day. It tends to only last 8 hours overnight, so you need to take it right before bed. I take it right before bed & then again as soon as I wake up.
Don’t eat for at least 5 hours before you go to sleep. You want to be sure you’re not still digesting food while asleep. This sends BG up, too. Don’t eat things that are slow to digest at dinner, like fatty meals. We all tend to eat our biggest meal of the day in the evening & it’s not good for those of us with morning phenon.
Some people say that eating a small snack (low carb, high protein–cheese) helps by preventing an overnight low. Other people say not to do this. I’ve tried both ways & it didn’t make any difference. I’ve also tried a small glass of wine, apple cider vinegar, apple cider vinegar capsules & a host of other remedies. For me, it didn’t make a difference.
Some mornings I have good fasting numbers, but mostly they’re really high. I truly can’t find a pattern as to what makes them high or low. I’d have a much better A1c if I could get this under control.
Here’s an explantion:
There are three main causes of high morning fasting bg. In decreasing order of
probability they are insufficient insulin, dawn phenomenon, and Somogyi
effect (aka rebound). Insufficient or waning insulin is simple. If the
effective duration of intermediate or long acting insulin ends sometime
during the night, the relative level of circulating insulin will be too low,
and your blood sugars will rise.
Dawn phenomenon refers to increased glucose production and insulin resistance
brought on by the release of counterregulatory hormones in the early morning
hours near waking. It happens in normal people as well as in diabetics; in
nondiabetics it shows up as measurably increased insulin secretion around
dawn. Dawn phenomenon is variable in strength both within the population and
over time in individuals. It can show up as either high fasting glucose
levels or an increased insulin requirement to cover breakfast compared to
equivalent meals at other times of day.
Somogyi effect refers to a rebound in bg after nocturnal hypoglycemia which
occurs during sleep with the patient not experiencing any symptoms. The
hypoglycemia triggers the release of counterregulatory hormones. Somogyi
effect appears to be less prevalent than previously thought. While it does
occur, some episodes of hyperglycemia following hypoglycemia are actually
waning insulin levels following an insulin peak with medium acting insulin.
This can be difficult to sort out.
The best way to sort it out is to test every couple of hours from bedtime to
morning.
If your bg rises all, or much of the night, it is a lack of circulating
insulin.
If it is stable all night, but rises sharply sometime before you wake in
the morning, it is dawn phenomenon.
If your bg declines to the point of a hypoglycemic reaction, it is
possibly Somogyi effect.
You may have to test on several nights to nail the problem. Once you have
figured out the problem you and your doctor can discuss changes in your
insulin regimen to correct it. The answer depends critically on your
particular circumstances.
Mayer Davidson, in Diabetes Mellitus: Diagnosis and Treatment (p 252 in the
3rd edition) says that Somogyi effect rarely causes fasting hyperglycemia,
and cites studies.
Thanks, Chelsea! This is great info. I’m changing from Lantus to Levemir & am eager to see the difference it makes.
Interesting Heide… I seem to also have some fluid retention so maybe I will ask about switching. Are you taking Levemir now? I’d love to lose 5-10 lbs! Anyone know of the price comparison of Levemir and Lantus? I just had my script of Lantus filled (5 pens) @ about $166.00.