AHHH … my pump malfunctioned today and now I need to take Lantus and regular shots until they send me a new one. I’m still waiting for my doctor to call me back about my Lantus dosage, but how does it usually work? Is it usually half of the daily total? It’s been so long since I’ve had to do this… and do you guys take your lantus shot at night or in the AM? any suggestions please help!
I think the percentage of Lantus to bolus really varies from person to person. If I were to have to go back to long-acting right now (Levemir for me; I still have pens in my fridge for back-up) I would figure it more based on my current basal than on a percentage of TDD. I’ve actually only been on the pump for six months so I remember my Levemir dose which was 16 with my 24-hour basal dose now at 12. Most people reduce their basal when they go on a pump. To be safe, if it were me, I would just do my current 24-hour basal (12). I’d probably be high and then increase it depending on how long I had to stay on shots. I took my Levemir twice a day and had started doing so with Lantus as well before I switched - before bed and morning. But if you were only going to take it one time I would go with morning because you can watch your numbers during the day.
I had the same problem but went OTC w/ N, I guessed 50% more. I had a thread about it that somebody had a great post but am on my phone and can’t figure out how to copy a link. :-(. It’s on my page. Perhaps the poster will amble along?
What is up w/ pumps failing on weekends? Mine blew up 4th of July weekend@ 800 on Saturday AM. I saw Kerri Sparling’s blew up on a weekend too?
AC …is this what you are referring to …please ignore if I am off base Temp. removal guidelines : as in pump malfunction and replacement not available …( me talking : you know most /all of this , and you will modify your routine , no doubt !! )
When you are off the pump , stick as close to your " basal/bolus" routine as possible . Check BG more often , including during the night , to assess how this is working .
Daytime
hope this helps anyone on our diabetes globe !!
If you will be off the pump for less than 24 hours during the day , you need to take rapid -acting insulin every 3 hours . Combine : 3 hours basal insulin ; your meal bolus if you eat, and your correction bolus , if needed .
Example : At 8.00 am BS is 14.8 ( x 18 ) you eat 45 grams of carbs . Your insulin /carb ratio is 1 unit /15 grams , insulin sensitivity factor is 3 and the basal rate from 8.00 am to 11.00 am is 0.5 u/hour .
… 3 hours of basal insulin is 0.5 x 3 =1.5 u
…food bolus is 45 g divided by 15 = 3 u
…correction bolus, is 15-6 divided by 3 = 3 u ( personally I would get my numbers down FIRST …you too , I think before adding food to bod
This totals 4.5 u ( 1.5 + 3 + 3 ) so the insulin dose at 8. 00 am to 11.00 is 4.5 u of rapid -acting insulin by pen or
syringe .Another dose is needed in about 3 hours .
Overnight
There are 2 options for being off the pump overnight :
- If long -acting insulin is not available , continue to take rapid acting insulin every 3 hours overnight , as in the previous " day time " example
2 . Take Lantus insulin once a day …( when I received this Levimir was unavailable to Canadians)
Use lantus only if you will be off the pump more than 24 hours . Calculate the total daily basal amount of insulin and take as one dose of Lantus at bedtime or in the morning and then every 24 hours ( I have read to split dose ) During the day , take rapid -acting before your meals to cover the carb and correction .
When you are ready to go back on the pump , you should not have your pump deliver basal insulin until 24 hours after the last Lantus dose . If you want to wear your pump earlier , use the pump for your food and correction bolusses , but a temp basal rate of 0.0 u/hour until 24 hours after the last dose of Lantus .
OR
Take NPH insulin at bed time
Add up the basal amount of insulin during sleep and give 1.5 times this dose as NPH . During the day , follow the " daytime " example as described earlier .
Example # 1 : Hours of sleep are 10 pm to 6 am . Basal rate during this time is 1.0 u/hr
1 u /hr x 8 hours = 8 u x 1.5 =12 u .The dose of NPH is 12 u at bedtime
Example # 2 : Hours of sleep are 9 pm - 7 am . Basal rates during this time are : 0.6 u/hr from 9 pm to midnight , 0.5 u/hr from midnight to 3 am , and 0.7 u/hr from 3 am to 7 am
Calculate : 0.6 u/hr x 3 hours = 1.8 u
0.5 u/hr x 3 hours = 1.5 u
0.7 u/hr x 4 hours = 2.8 u
T otal = 9.1 u The dose is 9 u of NPH at bedtime